# Change History - Da Vinci - Documentation Templates and Rules v2.2.0

## Change History

### Release 2.2.0

**Non-Substantive changes:**

*  [FHIR-55885](https://jira.hl7.org/browse/FHIR-55885) - Making clear that the responsibility rests with the DTR server to produce distinct questionnaires ([link](specification.md#passing-dtr-questionnaireresponses-to-downstream-processes)) 
*  [FHIR-55884](https://jira.hl7.org/browse/FHIR-55884) - Requirements around primary keys and update behavior for coverage-information extensions are out of sync between server and client sections ([link](specification.md#passing-dtr-questionnaireresponses-to-downstream-processes)) 
*  [FHIR-55883](https://jira.hl7.org/browse/FHIR-55883) - Clarify §spec-125 regarding not supporting previously completed QuestionnaireResponses ([link](specification.md#FHIR-55883)) 
*  [FHIR-55866](https://jira.hl7.org/browse/FHIR-55866) - Expand narrative to clarify where the CQL Identifier mime type gets used ([link](specification.md#use-of-cql)) 
*  [FHIR-55693](https://jira.hl7.org/browse/FHIR-55693) - Clarify scope of hyperlinks to contained Binary resources ([link](specification.md#questionnaire-design)) 
*  [FHIR-55692](https://jira.hl7.org/browse/FHIR-55692) - Clarification of location of 'contained' Binary XHTML/PDF/image resources ([link](specification.md#questionnaire-design)) 

-------

### Release 2.2.0-snapshot

**Breaking changes:**

*  [FHIR-52804](https://jira.hl7.org/browse/FHIR-52804) - Change SHOULD to SHALL for returning HTTP 400 error with an OperationOutcome indicating the circumstances where the QuestionnaireResponse is invalid ([link](specification.md#questionnaireresponse-validation)) 
*  [FHIR-52801](https://jira.hl7.org/browse/FHIR-52801) - Change SHOULD to SHALL regarding the use of logic ensuring only questions and answer choices which are required for the intended clinical or administrative purposes ([link](specification.md#questionnaire-design)) 
*  [FHIR-52791](https://jira.hl7.org/browse/FHIR-52791) - Include expectations that DTR Services SHOULD have DTR questionnaires available for all covered items that require additional data collection ([link](specification.md#questionnaire-use)) 
*  [FHIR-52320](https://jira.hl7.org/browse/FHIR-52320) - Use a List profile instead of a logical model for supported payers ([link](StructureDefinition-dtr-supported-Payers.md)) 
*  [FHIR-51736](https://jira.hl7.org/browse/FHIR-51736) - Constrain DTR to only take a single coverage as input ([link](OperationDefinition-questionnaire-package.md)) 
*  [FHIR-51631](https://jira.hl7.org/browse/FHIR-51631) - Give users an idea of how much time completion will take by adding `estimatedCompletionTime` extension to base Questionnaire ([link](StructureDefinition-dtr-base-questionnaire.md#profile)) 
*  [FHIR-50789](https://jira.hl7.org/browse/FHIR-50789) - Provide clarity around simple logic in Adaptive forms and adaptive processing expectations and requirements ([link](specification.md#adaptive-form-considerations)) 

**Substantive changes:**

*  [FHIR-55401](https://jira.hl7.org/browse/FHIR-55401) - Documenting that hyperlinks in XHTML or supportLink may point to 'contained' binary resources, and include note on security implications ([link](specification.md#questionnaire-design)) 
*  [FHIR-53496](https://jira.hl7.org/browse/FHIR-53496) - Adding a 'request-specific' flag on Questionnaire to clarify circumstances allowed to re-use a form ([link](StructureDefinition-dtr-base-questionnaire.md#profile)) 
*  [FHIR-53050](https://jira.hl7.org/browse/FHIR-53050) - DTR version discovery as referenced in HRex 
*  [FHIR-53041](https://jira.hl7.org/browse/FHIR-53041) - Making DTRMetricData providerId and groupId optional, but with a constraint that they are required if the source is the EHR ([link](StructureDefinition-DTRMetricData.md#profile)) 
*  [FHIR-52803](https://jira.hl7.org/browse/FHIR-52803) - Removed statement about translation between standard codes "where possible" as it is too ambiguous 
*  [FHIR-52455](https://jira.hl7.org/browse/FHIR-52455) - Added clarification narrative regarding what is considered a 'portal' and expectations for it ([link](specification.md#overview)) 
*  [FHIR-50465](https://jira.hl7.org/browse/FHIR-50465) - Added a new page called Conformance Details ([link](confdetails.md)) 
*  [FHIR-50033](https://jira.hl7.org/browse/FHIR-50033) - Added clarification narrative regarding If both orders and a context id are present ([link](StructureDefinition-dtr-qpackage-input-parameters.md)) 
*  [FHIR-48879](https://jira.hl7.org/browse/FHIR-48879) - Added clarification narrative regarding issues with source data in retrieving questionnaire packages ([link](specification.md#data-expectations-for-invoking-questionnaire-package)) 

**Non-Substantive changes:**

*  [FHIR-53484](https://jira.hl7.org/browse/FHIR-53484) - Multiple narrative and conformance updates to improve testability guidance ([link](specification.md#pre-population)) 
*  [FHIR-53225](https://jira.hl7.org/browse/FHIR-53225) - Attribute all conformance requirements to distinct actors ([link](confdetails.md)) 
*  [FHIR-52982](https://jira.hl7.org/browse/FHIR-52982) - Clarified expectations around communicated public keys via SMART on FHIR Backend Services ([link](specification.md#appehr-to-payer-connectivity)) 
*  [FHIR-52796](https://jira.hl7.org/browse/FHIR-52796) - Improve clarity for exposing question text and answers in API, as well as use of third party logic in data gathering ([link](specification.md#questionnaire-use)) 
*  [FHIR-52802](https://jira.hl7.org/browse/FHIR-52802) - Clarified expectations around questionnaire design for absence of data ([link](specification.md#questionnaire-design)) 
*  [FHIR-52794](https://jira.hl7.org/browse/FHIR-52794) - Provide narrative to note that adaptive forms may help to protect intellectual-property (IP) and licensing exposure ([link](specification.md#questionnaire-design)) 
*  [FHIR-52792](https://jira.hl7.org/browse/FHIR-52792) - Include reference that the guide has requirements under HT1-4 ([link](index.md#boundaries-and-relationships)) 
*  [FHIR-52701](https://jira.hl7.org/browse/FHIR-52701) - Clarify that CQL SHALL be compatible with CQL version 1.5 ([link](specification.md#cql-constraints)) 
*  [FHIR-52700](https://jira.hl7.org/browse/FHIR-52700) - Added references to CQL content ([link](specification.md#use-of-cql)) 
*  [FHIR-51869](https://jira.hl7.org/browse/FHIR-51869) - Added section named "Launch Workflow" enumerating DTR's launch circumstance ([link](specification.md#launch-workflow)) 
*  [FHIR-51629](https://jira.hl7.org/browse/FHIR-51629) - Set expectations for splitting clinical/patient and non-clinical forms ([link](specification.md#questionnaire-design)) 
*  [FHIR-51577](https://jira.hl7.org/browse/FHIR-51577) - Included guidance that server organizations MAY allow clients to pre-examine/pre-process questionnaires ([link](specification.md#questionnaire-use)) 
*  [FHIR-50790](https://jira.hl7.org/browse/FHIR-50790) - Clarified guidance on ability for DTR client to expose questionnaire items and how they are exposed ([link](confexpectations.md#mustsupport)) 
*  [FHIR-51100](https://jira.hl7.org/browse/FHIR-51100) - Added a 'dragon' warning about legal rights to terminology in "Questionnaire Design" ([link](specification.md#questionnaire-design)) 
*  [FHIR-50499](https://jira.hl7.org/browse/FHIR-50499) - Added narrative guidance to explain rules for updating coverage-information with DTR ([link](specification.md#determinations-from-adaptive-forms)) 
*  [FHIR-49898](https://jira.hl7.org/browse/FHIR-49898) - Updated the context parameter to say "CRD, CDex, or PAS-provided context" ([link](StructureDefinition-dtr-qpackage-input-parameters.md#profile)) 
*  [FHIR-49885](https://jira.hl7.org/browse/FHIR-49885) - Corrected the Questionnaire Package operation to explicitly list all parameters ([link](OperationDefinition-questionnaire-package.md#parameters)) 

-------

### Release 2.2.0-ballot

**Breaking changes:**

*  [FHIR-51020](https://jira.hl7.org/browse/FHIR-51020) - Provided guidance that `cql-identifier` should be used as mime type for CQL identifier. 
*  [FHIR-50797](https://jira.hl7.org/browse/FHIR-50797) - Updated Questionnaire Package operation to always return a Parameters resource upon successful execution. 
*  [FHIR-49726](https://jira.hl7.org/browse/FHIR-49726) - Made `Questionnaire.text` optional and also made `item.text` mandatory. 
*  [FHIR-49663](https://jira.hl7.org/browse/FHIR-49663) - Removed coverage from context extension (qr-context) and split out into a corresponding coverage extension (qr-coverage) 
*  [FHIR-49339](https://jira.hl7.org/browse/FHIR-49339) - Sliced QuestionnaireResponseBundle entry to enforce a single QuestionnaireResponse (1..1) and provided clearer guidance in specification. 

**Substantive changes:**

*  [FHIR-50240](https://jira.hl7.org/browse/FHIR-50240) - Included narrative to specification to clarify expectations for sending more than one of orders/contextId/Questionnaire and cross-checking. 
*  [FHIR-50020](https://jira.hl7.org/browse/FHIR-50020) - Rewrote section on Storing QuestionnaireResponses because it contained contradictory guidance and was misleading. 
*  [FHIR-50013](https://jira.hl7.org/browse/FHIR-50013) - Updated the **SHOULD** to a **SHALL** in the `$log-questionnaire-errors` operation definition to align with narrative guidance. 
*  [FHIR-49862](https://jira.hl7.org/browse/FHIR-49862) - Created Adaptive QuestionnaireResponse profile to enforce adaptive requirements on DTR QuestionnaireResponse used in $next-question operation. 
*  [FHIR-49845](https://jira.hl7.org/browse/FHIR-49845) - Added MustSupport flag to both the `context` and `intendedUse` elements of the QuestionnaireResponse. 
*  [FHIR-49836](https://jira.hl7.org/browse/FHIR-49836) - Redesigned 'Questionnaire Design' section to remove subjective qualifications. 
*  [FHIR-49811](https://jira.hl7.org/browse/FHIR-49811) - Created 'audience' extension to differentiate administrative vs. clinical forms. 
*  [FHIR-49810](https://jira.hl7.org/browse/FHIR-49810) - Added a complex constraint that says you must either have context id or Coverage. 
*  [FHIR-49744](https://jira.hl7.org/browse/FHIR-49744) - Included narrative guidance within section '9.6.3 CQL Constraints' indicating that DTR **SHOULD** support additional FHIRPath variables/functions. 
*  [FHIR-49743](https://jira.hl7.org/browse/FHIR-49743) - Added new invariants to Questionnaires that require certain extensions based on question type. 
*  [FHIR-49729](https://jira.hl7.org/browse/FHIR-49729) - Constrained `supportLink` cardinality from 0..* to 0..1. 
*  [FHIR-49724](https://jira.hl7.org/browse/FHIR-49724) - Created abstract 'Base Questionnaire' (`dtr-base-questionnaire`) to contain common elements for both Standard and Adaptive questionnaires. 
*  [FHIR-49699](https://jira.hl7.org/browse/FHIR-49699) - QuestionnaireResponse item cardinality loosened from 1..* to 0..* to accommodate initial `$next-question` call. 
*  [FHIR-448824](https://jira.hl7.org/browse/FHIR-48824) - Created internal DTR valueset `$expand` operation to focus parameter expectations specific to DTR. 

**Non-Substantive changes:**

*  [FHIR-50587](https://jira.hl7.org/browse/FHIR-50587) - Added 'QuestionnaireResponse Contained Resources' section describing expectations for contained resources within QuestionnaireResponses. 
*  [FHIR-50282](https://jira.hl7.org/browse/FHIR-50282) - Split apart previously 'temp' codesystem codes into appropriate, internal code systems (used in 'code' datatype elements) 
*  [FHIR-49929](https://jira.hl7.org/browse/FHIR-49929) - Included guidance in the Questionnaire Package operation regarding the expectations for handling 'optional' forms. 
*  [FHIR-49879](https://jira.hl7.org/browse/FHIR-49879) - Provided clarifying narrative in Questionnaire Package operation regarding location of context. 
*  [FHIR-49815](https://jira.hl7.org/browse/FHIR-49815) - Updated narrative in 'EHR to App Connectivity' to provide clarity around DTR support for payers. 
*  [FHIR-49814](https://jira.hl7.org/browse/FHIR-49814) - Added `alternateExpression` extension (as mustSupport) to each 'expression' extension in the Questionnaire profiles. 
*  [FHIR-49730](https://jira.hl7.org/browse/FHIR-49730) - Constrained out `itemOptionalDisplay` in base questionnaire. 
*  [FHIR-49648](https://jira.hl7.org/browse/FHIR-49648) - Clarified that both the target resource and QuestionnaireResponse can contain multiple coverage-information extensions 
*  [FHIR-49639](https://jira.hl7.org/browse/FHIR-49639) - Adaptive Form Search profile modified to constrain out (0..0) the item due to questions not being relevant and were marked as MustSupport. 
*  [FHIR-49343](https://jira.hl7.org/browse/FHIR-49343) - Narrative guidance for QuestionnaireResponse Bundle change of 'will' to **SHALL** addressed by ticket [FHIR-49399](https://jira.hl7.org/browse/FHIR-49339). 

-------

### Release 2.1.0

*  [FHIR-48744](https://jira.hl7.org/browse/FHIR-48744): Align endpoint discovery language w/ CRD 
*  [FHIR-48728](https://jira.hl7.org/browse/FHIR-48728): Inconsitency between contexts in CRD and DTR 
*  [FHIR-48703](https://jira.hl7.org/browse/FHIR-48703): Coverage context search parameter inconsistencies 
*  [FHIR-48694](https://jira.hl7.org/browse/FHIR-48694): Clarify ValueSet and $expand Guidance 
*  [FHIR-48686](https://jira.hl7.org/browse/FHIR-48686): Profile $next-question (or create a new operation) so there's an actual use for the DTR adaptive questionnaire profile 
*  [FHIR-48524](https://jira.hl7.org/browse/FHIR-48524): Constraining Queries example clarification 
*  [FHIR-48523](https://jira.hl7.org/browse/FHIR-48523): Is the "Retrieving Launch Context Information" informational? 
*  [FHIR-48521](https://jira.hl7.org/browse/FHIR-48521): Determining support for payer questionnaires 
*  [FHIR-48520](https://jira.hl7.org/browse/FHIR-48520): Clarify use of PH Alternate Expression Extension 
*  [FHIR-48519](https://jira.hl7.org/browse/FHIR-48519): Clarify whether FHIRPath is allowed in pre-population expressions 
*  [FHIR-48518](https://jira.hl7.org/browse/FHIR-48518): Are there required DTR client responses to an added coverage-information extension? 
*  [FHIR-48517](https://jira.hl7.org/browse/FHIR-48517): Library and ValueSet Caching requirements for DTR Apps and Full EHRs 
*  [FHIR-48516](https://jira.hl7.org/browse/FHIR-48516): Clarify QuestionnaireResponse contained Questionnaire Requirements for adaptive questionnaires 
*  [FHIR-48515](https://jira.hl7.org/browse/FHIR-48515): Explain Reasoning behind the difference in Questionnaire Adaptive extension cardinality 
*  [FHIR-48513](https://jira.hl7.org/browse/FHIR-48513): No examples of Questionnaire Package Bundles with a QuestionnaireResponse 
*  [FHIR-48511](https://jira.hl7.org/browse/FHIR-48511): Change SHOULD to SHALL 
*  [FHIR-48510](https://jira.hl7.org/browse/FHIR-48510): suggest adding "including appeals" 
*  [FHIR-48508](https://jira.hl7.org/browse/FHIR-48508): change conformance language for the retrieving launch context 
*  [FHIR-48506](https://jira.hl7.org/browse/FHIR-48506): SHOULD have CQL logic 
*  [FHIR-48504](https://jira.hl7.org/browse/FHIR-48504): Questionnaire-package Bundle Example not updated to only have one questionnaire 
*  [FHIR-48501](https://jira.hl7.org/browse/FHIR-48501): Change SHOULD to SHALL 
*  [FHIR-48499](https://jira.hl7.org/browse/FHIR-48499): add or staff to better capture people who populate 
*  [FHIR-48495](https://jira.hl7.org/browse/FHIR-48495): CMS enforcement discretion comes out of nowhere 
*  [FHIR-48494](https://jira.hl7.org/browse/FHIR-48494): Include CMS requirements 
*  [FHIR-48490](https://jira.hl7.org/browse/FHIR-48490): $questionnaire-response output parameter name inconsistency 
*  [FHIR-48488](https://jira.hl7.org/browse/FHIR-48488): Ambiguous SHALL on resource support requirement 
*  [FHIR-48487](https://jira.hl7.org/browse/FHIR-48487): Replace EHR with Provider HIT 
*  [FHIR-48314](https://jira.hl7.org/browse/FHIR-48314): providers need a way to indicate if they want pre-emptive prior auth as part of adaptive forms 
*  [FHIR-47995](https://jira.hl7.org/browse/FHIR-47995): Must Support guidance section should be moved from Specification page to a 'Conformance Expectations' page 
*  [FHIR-47706](https://jira.hl7.org/browse/FHIR-47706): Add support for US Core 7 
*  [FHIR-47250](https://jira.hl7.org/browse/FHIR-47250): Clarify adaptive architecture 
*  [FHIR-46754](https://jira.hl7.org/browse/FHIR-46754): $questionnaire-package narrative and DTRQuestionnairePackageBundle do not align. 
*  [FHIR-46750](https://jira.hl7.org/browse/FHIR-46750): Clarify that CQL expectations are for app/EHR, not payer 
*  [FHIR-46646](https://jira.hl7.org/browse/FHIR-46646): Conformance requirement on subjective determination 
*  [FHIR-46554](https://jira.hl7.org/browse/FHIR-46554): Include questionnaire details in the example 

-------

### Release 2.1.0-preview

**The following issues are addressed in preparation for this STU Update:**

*  * Multiple changes have been incorporated to provide support for both US Core 3.1.1 and 6.1 * 
*  [FHIR-44930](https://jira.hl7.org/browse/FHIR-44930): extra period breaks out a requirement in section 7.10.2 of the formal spec 
*  [FHIR-45010](https://jira.hl7.org/browse/FHIR-45010): Why does OperationOutcome repeat 
*  [FHIR-46288](https://jira.hl7.org/browse/FHIR-46288): Identifying the minimum resource read access ought to be SHALL instead of 'will' 
*  [FHIR-45945](https://jira.hl7.org/browse/FHIR-45945): Clarify links to base FHIR resources in Background section 
*  [FHIR-45075](https://jira.hl7.org/browse/FHIR-45075): DTR should not point to CDS Hook security guide 
*  [FHIR-44929](https://jira.hl7.org/browse/FHIR-44929): Ambiguity within the formal specification on use of SMART on FHIR Backend Services 
*  [FHIR-42809](https://jira.hl7.org/browse/FHIR-42809): allowing linking to a portal rather than building out a questionnaire is not in line with regulation, legislation, or even the spirit of IG 
*  [FHIR-45020](https://jira.hl7.org/browse/FHIR-45020): $questionnaire-package Operation Definition incorrectly states to return warning in outer Bundle 
*  [FHIR-46627](https://jira.hl7.org/browse/FHIR-46627): Include Burden Reduction common narrative for Enforcement Discretion 
*  [FHIR-46569](https://jira.hl7.org/browse/FHIR-46569): Use EHR rather than EMR throughout 
*  [FHIR-46525](https://jira.hl7.org/browse/FHIR-46525): Discrepancy in DTR Package output definition 
*  [FHIR-44789](https://jira.hl7.org/browse/FHIR-44789): Can DTR be satisfied by a pre-existing QR? 
*  [FHIR-45967](https://jira.hl7.org/browse/FHIR-45967): questionnaire-package bundle needs to allow for QuestionnaireResponses 
*  [FHIR-46441](https://jira.hl7.org/browse/FHIR-46441): Add endpoint discovery expectations 
*  [FHIR-46285](https://jira.hl7.org/browse/FHIR-46285): Need to formalize expectation around use of 'questionnaire-adaptive' extension 
*  [FHIR-46002](https://jira.hl7.org/browse/FHIR-46002): Provide guidance on how to transmit FHIR resources to Adaptive Questionnaires 

-------

### Release 2.0.1

**The following issues are addressed in this technical correction:**

*  [FHIR-43030](https://jira.hl7.org/browse/FHIR-43030): Information Origin Extension challenged to be supported by SMART 

-------

### Release 2.0.0

**The following issues are addressed resulting from this ballot:**

*  [FHIR-24714](https://jira.hl7.org/browse/FHIR-24714): This is a security risk as described in the last ballot. - DTR #60 
*  [FHIR-33328](https://jira.hl7.org/browse/FHIR-33328): Need clarification of what the DTR Task page is actually for 
*  [FHIR-36117](https://jira.hl7.org/browse/FHIR-36117): DTR Document Reference R4 Resource Profile Inappropriately Marks Elements As Must Support 
*  [FHIR-36220](https://jira.hl7.org/browse/FHIR-36220): CQL execution errors in an automated process should not require an end user to be notified 
*  [FHIR-36225](https://jira.hl7.org/browse/FHIR-36225): statement doesn't quite make sense 
*  [FHIR-36227](https://jira.hl7.org/browse/FHIR-36227): fix link (& therefore normative requirement) to DTR Questionnaire, instead of base CQF questionnaire 
*  [FHIR-36228](https://jira.hl7.org/browse/FHIR-36228): Need clearer expectations around reusing and refreshing the QuestionnaireResponse 
*  [FHIR-36355](https://jira.hl7.org/browse/FHIR-36355): Refactor the overview 
*  [FHIR-36371](https://jira.hl7.org/browse/FHIR-36371): Clarify 'required' documentation 
*  [FHIR-36378](https://jira.hl7.org/browse/FHIR-36378): Clarify CQL version expectations 
*  [FHIR-36481](https://jira.hl7.org/browse/FHIR-36481): STU note should go away 
*  [FHIR-36484](https://jira.hl7.org/browse/FHIR-36484): Remove SMART on FHIR applications and servers section 
*  [FHIR-36489](https://jira.hl7.org/browse/FHIR-36489): Requesting user identity stuff belongs in section on launch 
*  [FHIR-36522](https://jira.hl7.org/browse/FHIR-36522): add to sentence 
*  [FHIR-36523](https://jira.hl7.org/browse/FHIR-36523): change SHOULD to SHALL 
*  [FHIR-36525](https://jira.hl7.org/browse/FHIR-36525): Change MAY to SHALL 
*  [FHIR-36528](https://jira.hl7.org/browse/FHIR-36528): it is essential that payers create extensive CQL for payer rule automation 
*  [FHIR-36529](https://jira.hl7.org/browse/FHIR-36529): Change MAY to SHOULD 
*  [FHIR-36530](https://jira.hl7.org/browse/FHIR-36530): refine verbiage 
*  [FHIR-36532](https://jira.hl7.org/browse/FHIR-36532): Operation needs a detailed description 
*  [FHIR-36139](https://jira.hl7.org/browse/FHIR-36139): More clarity around how UM Payer multi party arrangements are handled 
*  [FHIR-36148](https://jira.hl7.org/browse/FHIR-36148): no template property is defined in appContext, and questionnaire is OPTIONAL 
*  [FHIR-36150](https://jira.hl7.org/browse/FHIR-36150): is a CRD server the same as a payer API? 
*  [FHIR-36433](https://jira.hl7.org/browse/FHIR-36433): Should be guidance about the use of versioning 
*  [FHIR-36439](https://jira.hl7.org/browse/FHIR-36439): Why do we mandate the use of library? 
*  [FHIR-36445](https://jira.hl7.org/browse/FHIR-36445): Caching guidance needs to be clarified 
*  [FHIR-36538](https://jira.hl7.org/browse/FHIR-36538): DTR Questionnaire should be removed 
*  [FHIR-36542](https://jira.hl7.org/browse/FHIR-36542): Context extension needs more definition 
*  [FHIR-36548](https://jira.hl7.org/browse/FHIR-36548): add guidance to value set 
*  [FHIR-36549](https://jira.hl7.org/browse/FHIR-36549): relaunch for other users 
*  [FHIR-36550](https://jira.hl7.org/browse/FHIR-36550): Add SHALL save DTR response in EMR to beginning of section 
*  [FHIR-36551](https://jira.hl7.org/browse/FHIR-36551): change SHOULDs to SHALLs in task creation 
*  [FHIR-36553](https://jira.hl7.org/browse/FHIR-36553): change from "needs to" to SHALL 
*  [FHIR-36555](https://jira.hl7.org/browse/FHIR-36555): limit scope 
*  [FHIR-36624](https://jira.hl7.org/browse/FHIR-36624): attestation concern 
*  [FHIR-34121](https://jira.hl7.org/browse/FHIR-34121): Provide a mechanism for Template to specify what to do when DTR ends 
*  [FHIR-33224](https://jira.hl7.org/browse/FHIR-33224): Add support for SDC Adaptive forms 
*  [FHIR-36276](https://jira.hl7.org/browse/FHIR-36276): Security review of SDC Adaptive Forms in DTR 
*  [FHIR-36492](https://jira.hl7.org/browse/FHIR-36492): Handling updates to Questionnaire.effectivePeriod 
*  [FHIR-36478](https://jira.hl7.org/browse/FHIR-36478): SDC questionnaire responses will always have a Questionnaire url somewhere 
*  [FHIR-36527](https://jira.hl7.org/browse/FHIR-36527): refine language 
*  [FHIR-36483](https://jira.hl7.org/browse/FHIR-36483): Need to clarify pruning expectations 
*  [FHIR-36390](https://jira.hl7.org/browse/FHIR-36390): Launch instructions need correction/clarification 
*  [FHIR-36491](https://jira.hl7.org/browse/FHIR-36491): Drop section on "usage sessions" 
*  [FHIR-36385](https://jira.hl7.org/browse/FHIR-36385): No guidance on CRD 
*  [FHIR-40438](https://jira.hl7.org/browse/FHIR-40438): Section on DTR use of US Core has link which points to general US Core page instead of 3.1.1 
*  [FHIR-24581](https://jira.hl7.org/browse/FHIR-24581): Identify the subject extension. - DTR #15 
*  [FHIR-36151](https://jira.hl7.org/browse/FHIR-36151): Again, DTR <-> Payer should use SMART backend services 
*  [FHIR-36365](https://jira.hl7.org/browse/FHIR-36365): Downloads should be a separate page 
*  [FHIR-36394](https://jira.hl7.org/browse/FHIR-36394): CQL logic guidance is misleading 
*  [FHIR-36367](https://jira.hl7.org/browse/FHIR-36367): Talk about DTR before you talk about CRD 
*  [FHIR-40549](https://jira.hl7.org/browse/FHIR-40549): Guidance regarding the Endpoint for adaptive form next question 
*  [FHIR-36470](https://jira.hl7.org/browse/FHIR-36470): Fix guidance on saving state 
*  [FHIR-36434](https://jira.hl7.org/browse/FHIR-36434): Revamp endpoint description a bit 
*  [FHIR-36369](https://jira.hl7.org/browse/FHIR-36369): Payer 
*  [FHIR-36376](https://jira.hl7.org/browse/FHIR-36376): Fix wording on SDC 
*  [FHIR-36374](https://jira.hl7.org/browse/FHIR-36374): Should be no conformance rules around CDS Hooks or CRD 
*  [FHIR-36377](https://jira.hl7.org/browse/FHIR-36377): Clarify language on CQL 
*  [FHIR-36435](https://jira.hl7.org/browse/FHIR-36435): Remove CRD paragraph 
*  [FHIR-36362](https://jira.hl7.org/browse/FHIR-36362): "CQL and FHIR Questionnaires SHALL be required" is unclear 
*  [FHIR-39504](https://jira.hl7.org/browse/FHIR-39504): Add guidance on endpoint discovery/configuration 
*  [FHIR-36539](https://jira.hl7.org/browse/FHIR-36539): DTR QuestionnaireResponse should be based on SDC 
*  [FHIR-36395](https://jira.hl7.org/browse/FHIR-36395): Context needs to talk about hierarchy of expression too. 
*  [FHIR-36380](https://jira.hl7.org/browse/FHIR-36380): Why is change history wrapped in an STU note? 
*  [FHIR-36386](https://jira.hl7.org/browse/FHIR-36386): DTR to payer security doesn't belong in CRD links section 
*  [FHIR-38837](https://jira.hl7.org/browse/FHIR-38837): Specific issues related to sensitive or patient restricted information 
*  [FHIR-36138](https://jira.hl7.org/browse/FHIR-36138): Clarify what information is in scope for FHIR CQL support 
*  [FHIR-36430](https://jira.hl7.org/browse/FHIR-36430): Clarify expectations on missing context 
*  [FHIR-36300](https://jira.hl7.org/browse/FHIR-36300): Who is responsible for provision of the token 
*  [FHIR-36482](https://jira.hl7.org/browse/FHIR-36482): Patient must always be in context 
*  [FHIR-21006](https://jira.hl7.org/browse/FHIR-21006): DTR should point to SDC, not CQIF Questionnaire 
*  [FHIR-36479](https://jira.hl7.org/browse/FHIR-36479): Provide proper details on authentication 
*  [FHIR-36392](https://jira.hl7.org/browse/FHIR-36392): Guidance on CQL isn't quite right 
*  [FHIR-36379](https://jira.hl7.org/browse/FHIR-36379): Spec *MUST* use mustSupport in its profiles 
*  [FHIR-36384](https://jira.hl7.org/browse/FHIR-36384): "Profiles" page doesn't really make sense as a page 
*  [FHIR-36382](https://jira.hl7.org/browse/FHIR-36382): Formal specification page should be revamped 
*  [FHIR-36447](https://jira.hl7.org/browse/FHIR-36447): Guidance on handling Questionnaire is insufficient 
*  [FHIR-36364](https://jira.hl7.org/browse/FHIR-36364): Home page should appear on the menu 
*  [FHIR-36465](https://jira.hl7.org/browse/FHIR-36465): DTR is repeating guidance better covered in SDC 
*  [FHIR-36360](https://jira.hl7.org/browse/FHIR-36360): Conformance statements don't belong on the home page 
*  [FHIR-36368](https://jira.hl7.org/browse/FHIR-36368): Conformance language doesn't belong on use-case page 
*  [FHIR-36410](https://jira.hl7.org/browse/FHIR-36410): Title and content don't jive 
*  [FHIR-36356](https://jira.hl7.org/browse/FHIR-36356): Adjust note to implementers 
*  [FHIR-37949](https://jira.hl7.org/browse/FHIR-37949): Remove all notion of storing work-in-progress on payer 
*  [FHIR-40421](https://jira.hl7.org/browse/FHIR-40421): Guidance on this page needs to be rewritten 
*  [FHIR-36450](https://jira.hl7.org/browse/FHIR-36450): Goal is overstated and user input always required 
*  [FHIR-36476](https://jira.hl7.org/browse/FHIR-36476): Refactor relaunch documentation 
*  [FHIR-36349](https://jira.hl7.org/browse/FHIR-36349): Split menu into background and spec 
*  [FHIR-36149](https://jira.hl7.org/browse/FHIR-36149): appContext should be a black box to EHR, use SMART launch param's instead 
*  [FHIR-36440](https://jira.hl7.org/browse/FHIR-36440): Remove the 'relaunch' section 
*  [FHIR-36517](https://jira.hl7.org/browse/FHIR-36517): Clarification on Tasks 
*  [FHIR-36531](https://jira.hl7.org/browse/FHIR-36531): Change SHOULD to SHALL and delete the MAY sentence that follows 
*  [FHIR-36146](https://jira.hl7.org/browse/FHIR-36146): Clarify that DTR app should authenticate to payer with SMART Backend Services 
*  [FHIR-36441](https://jira.hl7.org/browse/FHIR-36441): Remove FHIR version discussion 
*  [FHIR-36298](https://jira.hl7.org/browse/FHIR-36298): CRD linking to website versus a DTR solution 
*  [FHIR-36429](https://jira.hl7.org/browse/FHIR-36429): No appContext on stand-alone launch 
*  [FHIR-36547](https://jira.hl7.org/browse/FHIR-36547): data SHOULD NOT be stored on the payer server 
*  [FHIR-36540](https://jira.hl7.org/browse/FHIR-36540): Improve description of SDC Questionnaire profile 
*  [FHIR-36383](https://jira.hl7.org/browse/FHIR-36383): Are you using SDC or CQF? 
*  [FHIR-36361](https://jira.hl7.org/browse/FHIR-36361): Provenance expectations need more clarity 
*  [FHIR-36507](https://jira.hl7.org/browse/FHIR-36507): Correct and re-organize this section 
*  [FHIR-36533](https://jira.hl7.org/browse/FHIR-36533): Issues with lack of guidance on storage 
*  [FHIR-36129](https://jira.hl7.org/browse/FHIR-36129): Initial DTR Launches should not be restricted to CDS Hooks Cards within the CRD workflow. 
*  [FHIR-36988](https://jira.hl7.org/browse/FHIR-36988): Not clear where to get Requester Organization when creating PAS request 
*  [FHIR-36366](https://jira.hl7.org/browse/FHIR-36366): Actors are unclear and in wrong place 
*  [FHIR-36438](https://jira.hl7.org/browse/FHIR-36438): Questionnaire guidance is incorrect 
*  [FHIR-36537](https://jira.hl7.org/browse/FHIR-36537): DocumentReference profile isn't sufficient 
*  [FHIR-36253](https://jira.hl7.org/browse/FHIR-36253): DTR Spec needs a way to pass a questionnaire / response across organizations 
*  [FHIR-34151](https://jira.hl7.org/browse/FHIR-34151): Need an ability for DTR to store prior authorization 
*  [FHIR-39443](https://jira.hl7.org/browse/FHIR-39443): Add expectations about terminology mapping 
*  [FHIR-36119](https://jira.hl7.org/browse/FHIR-36119): DTR SDC Questionnaire For Adaptive Form Profile Inappropriately Marks Elements As Must Support 
*  [FHIR-36373](https://jira.hl7.org/browse/FHIR-36373): Clarify US Core expectations 
*  [FHIR-36299](https://jira.hl7.org/browse/FHIR-36299): Mapping CQLs to PA criteria 
*  [FHIR-36466](https://jira.hl7.org/browse/FHIR-36466): Provider Attestation guidance needs fixing 
*  [FHIR-34103](https://jira.hl7.org/browse/FHIR-34103): Clarify minimum Questionnaire capabilities 
*  [FHIR-33226](https://jira.hl7.org/browse/FHIR-33226): Formalize how DTR passes information to PAS, PAO or other exchange IG 
*  [FHIR-36219](https://jira.hl7.org/browse/FHIR-36219): The CDS Hooks Card Link object should not require a DTR launch URL 
*  [FHIR-36004](https://jira.hl7.org/browse/FHIR-36004): Change to use the CRD unsolicited prior auth profile 
*  [FHIR-36467](https://jira.hl7.org/browse/FHIR-36467): Need a section on privacy/security 
*  [FHIR-36346](https://jira.hl7.org/browse/FHIR-36346): Add 'support' menu item 
*  [FHIR-36118](https://jira.hl7.org/browse/FHIR-36118): DTR SDC Questionnaire Profile Inappropriately Marks Elements As Must Support 
*  [FHIR-36370](https://jira.hl7.org/browse/FHIR-36370): Clarify expectations on QR approval 
*  [FHIR-36372](https://jira.hl7.org/browse/FHIR-36372): Do we need a CRD & DTR section here? 
*  [FHIR-36393](https://jira.hl7.org/browse/FHIR-36393): Page names are overly long 
*  [FHIR-36432](https://jira.hl7.org/browse/FHIR-36432): Are DTR Questionnaire valuesets pre-expanded? 
*  [FHIR-36524](https://jira.hl7.org/browse/FHIR-36524): remove references to manual alternatives/solutions that do not leverage the specs 
*  [FHIR-34291](https://jira.hl7.org/browse/FHIR-34291): Deferring and relaunching DTR App 
*  [FHIR-37270](https://jira.hl7.org/browse/FHIR-37270): Access Token must not be included in appContext 
*  [FHIR-36443](https://jira.hl7.org/browse/FHIR-36443): How does an app notify the payer system 
*  [FHIR-36520](https://jira.hl7.org/browse/FHIR-36520): Change operation invocation 
*  [FHIR-36391](https://jira.hl7.org/browse/FHIR-36391): Need more launch details 
*  [FHIR-39492](https://jira.hl7.org/browse/FHIR-39492): Allow DTR to be used from CDex 
*  [FHIR-36543](https://jira.hl7.org/browse/FHIR-36543): Need a search parameter for new context extension 
*  [FHIR-36534](https://jira.hl7.org/browse/FHIR-36534): Correct operation adaptive expectations 
*  [FHIR-40605](https://jira.hl7.org/browse/FHIR-40605): Update Questionnaire package operation per discussions 
*  [FHIR-36431](https://jira.hl7.org/browse/FHIR-36431): Inconsistency in how value sets & libraries are returned 
*  [FHIR-36625](https://jira.hl7.org/browse/FHIR-36625): please clarify data access by payer 
*  [FHIR-34128](https://jira.hl7.org/browse/FHIR-34128): Allow passing 'order' context when launching DTR 
*  [FHIR-36436](https://jira.hl7.org/browse/FHIR-36436): Do better job of explaining HRex decision points 
*  [FHIR-36468](https://jira.hl7.org/browse/FHIR-36468): What's the point of distinguishing CQL vs. human-authored? 
*  [FHIR-36535](https://jira.hl7.org/browse/FHIR-36535): We need examples for operation inputs and outputs 
*  [FHIR-36437](https://jira.hl7.org/browse/FHIR-36437): Revamp payer authorization language 
*  [FHIR-36455](https://jira.hl7.org/browse/FHIR-36455): Utilization of CQL 
*  [FHIR-36375](https://jira.hl7.org/browse/FHIR-36375): Loosen rules on SMART 
*  [FHIR-36359](https://jira.hl7.org/browse/FHIR-36359): Need CapabilityStatements 
*  [FHIR-36331](https://jira.hl7.org/browse/FHIR-36331): Revamp expectations around launch parameters 
*  [FHIR-36192](https://jira.hl7.org/browse/FHIR-36192): Include CRD questionnaire workflow, not just prior auth questionnaire 
*  [FHIR-36412](https://jira.hl7.org/browse/FHIR-36412): Need more guidance on CDS Hooks launch 
*  [FHIR-36544](https://jira.hl7.org/browse/FHIR-36544): Examples are incomplete and have extras 
*  [FHIR-36409](https://jira.hl7.org/browse/FHIR-36409): EHR and DTR initiation 
*  [FHIR-36411](https://jira.hl7.org/browse/FHIR-36411): Organize interactions along likely HIT modules 
*  [FHIR-41557](https://jira.hl7.org/browse/FHIR-41557): Guidance on Referenced resources missing 
*  [FHIR-41576](https://jira.hl7.org/browse/FHIR-41576): Prohibit alternate use of 'next-question' data 
*  [FHIR-41168](https://jira.hl7.org/browse/FHIR-41168): "How DTR Passes Information" page is no longer accurate 
*  [FHIR-40421](https://jira.hl7.org/browse/FHIR-40421): Guidance on this page needs to be rewritten 
*  [FHIR-41854](https://jira.hl7.org/browse/FHIR-41854): DTR needs to be re-organized quite a bit 

