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We had a great active discussion on today's profiling call - so much so that we're going to extend the discussion/feedback deadlines to account for another profiling session where the proposal can be discussed further.
It seemed like folks want to do more risk/benefit analysis against the profiles and discuss items we'll need to address before a major change could take place. With that in mind - the Governance call on June 9th will still be used to discuss feedback to date - but the feedback window won't close until at least June 16th.
There's been a fair bit of effort that's gone into trying to land on the MS assertions, so it'd be a shame to throw all of that away. However, the new "obligation" framework that allows more specific SHALL/SHOULD/MAY assertions specific to particular types of apps (and that can be maintained separately from the base profiles) is definitely where we should go with this. Perhaps, for now, move the MS notion into a parallel spreadsheet pre profile with rows for each element that we can eventually migrate into Obligations?
As part of our recent efforts to make the CA FHIR Baseline profiles more use case agnostic - we are considering the removal of the MustSupport flags on the current profiles and using a section in the guide to indicate which elements that implementers should consider for MustSupports in their respective profiles.
Given what we've learned from other National bases recently + the efforts that are coming forward for the alternative to MustSupport (particularly for bases and cores) + the work that is occurring with the pan-Canadian data models and CA Core+, we believe now is the right time to modify the approach we've been using (applying MustSupports on items we see are MS across implementation guides and removing the flag during Due Diligence Reviews that identify evidence that the element isn't MS for a use case).
We will have a discussion on the proposed change on the next CA FHIR Profiling call - June 2nd. We're asking for feedback to be provided during that call and through this forum thread by June 9th 1pm ET.
We will collect any feedback received and discuss how it should be dispositioned during our June 9th CA FHIR Baseline Governance Call.
Afterwards a decision will be posted to this forum thread and reiterated on the subsequent CA FHIR Baseline call.