# hl7.fhir.us.davinci-dtr 2.0.1 → 2.2.0 — version-difference evidence pack

The only pair that moves on both planes at once: two OperationDefinitions added and ten operation-level changes, beside 284 element changes.

This pack is the downloadable form of the public report at `/ig-gap/davinci-dtr-2-0-1-to-2-2-0`. It is per-pair and carries public content only; the cross-pair rollup and arbitrary-pair export remain a separate, gated capability (IG-115 / Suite B).

## Inputs

| Side | Package | sha256 |
|---|---|---|
| Baseline | `hl7.fhir.us.davinci-dtr#2.0.1` | `a2840c31da3277d7b78c74baf65bcbeee97ddfe4f956810bffd79d9cfe5c64f0` |
| Target | `hl7.fhir.us.davinci-dtr#2.2.0` | `027894027a86e3a250252ac61476f82ca509a2ed04dbd4bad0816d2e24f204ea` |

Engines: comparison 1.0.0 · normalization 1.3.0 · schema v2 · generator 1.1.0 · inputs hash `0d152adea100b3b5c8a2c2f0012f5102`

These two archives, identified by SHA-256, are the complete input. Anyone can fetch them and confirm they are looking at the same bytes this analysis read. The analysis itself is ImOnFHIR's.

There is deliberately no generation timestamp: the report is a pure function of the two archives, so the digests date it better than a clock would.

## The shape of the change

284 element-level requirement changes, each graded to exactly one tier — every count in this pack is complete, computed over the full change set.

| Tier | Count |
|---|---|
| Critical | 23 |
| Needs review | 193 |
| Indeterminate | 0 |
| Informational | 68 |
| **Total** | **284** |

### Read the element counts as a floor

11 profiles exist only in 2.2.0. Those have no counterpart to compare against, so they contribute no element-level rows — the element comparison covers the 14 profiles present in both versions. Neither number is a total on its own.

The 144 mandatory or must-support elements attributed to added profiles are counted from each profile’s effective element list; where a profile ships no snapshot that list is reconstructed by merging its differential onto its base, so treat the figure as indicative rather than audited.

## Where the change concentrates

Most breaking changes (absolute critical count):

- `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt` — 6 critical of 103 changes
- `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters` — 5 critical of 10 changes
- `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search` — 3 critical of 38 changes

Most sharply changed (critical share; profiles with at least 5 changes — the floor keeps one-change profiles from scoring 100%):

- `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters` — 50% of 10 changes critical
- `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QRBundle` — 40% of 5 changes critical
- `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QPackageBundle` — 25% of 8 changes critical

## The other planes

| Plane | Changes | Highest severity present |
|---|---|---|
| Operations | 10 | needs review |
| Value sets | 13 | needs review |
| Capability statements | 10 | needs review |

## Profile coverage

Compared in both versions: 14 · added in target: 11 · removed from baseline: 0

- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-base-questionnaire`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/estimated-completion-time`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-coverage`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/questionnaireAudience`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-next-question-output-parameters`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse-adapt`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/containedReference`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-next-question-input-parameters`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/alternativeExpression`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/request-specific`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-supported-Payers`

## Changes by effect

| Effect | Count |
|---|---|
| informational change | 13 |
| invariant added | 41 |
| invariant changed | 1 |
| invariant removed | 1 |
| newly required | 13 |
| new support expectation | 10 |
| no longer required | 10 |
| profile inheritance changed | 2 |
| reference requirement changed | 24 |
| slice added | 89 |
| slice cardinality changed | 10 |
| slice removed | 10 |
| support expectation removed | 7 |
| target profile expanded | 1 |
| target profile narrowed | 5 |
| unknown | 3 |
| valueset reference changed | 44 |

## Sampled evidence rows

Every count above is complete. The rows below are a bounded, deterministic sample of 40 (244 further changes are counted above but not sampled here), chosen so every kind of change and the most-affected profiles are each represented. Each row carries its stable change id — cite the id, not the prose; the id survives regeneration, the prose may not.

- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QPackageBundle|Bundle.entry.resource|library|MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QPackageBundle`
  - element: `Bundle.entry.resource` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QPackageBundle|Bundle.entry||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QPackageBundle`
  - element: `Bundle.entry` · newly required · critical
  - 0 → 2
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QRBundle|Bundle.entry.resource|questionnaireResponse|MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QRBundle`
  - element: `Bundle.entry.resource` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QRBundle|Bundle.entry||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QRBundle`
  - element: `Bundle.entry` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters|Parameters.parameter|outcome|MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters`
  - element: `Parameters.parameter` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters|Parameters.parameter|outcome|SLICE_CARDINALITY|outcome|:SLICE_CARDINALITY_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters`
  - element: `Parameters.parameter` · slice cardinality changed · critical
  - {"min":0,"max":"*"} → {"min":1,"max":"*"}
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters|Parameters.parameter|questionnaire|MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters`
  - element: `Parameters.parameter` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters|Parameters.parameter|questionnaire|SLICE_CARDINALITY|questionnaire|:SLICE_CARDINALITY_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters`
  - element: `Parameters.parameter` · slice cardinality changed · critical
  - {"min":0,"max":"*"} → {"min":1,"max":"*"}
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters|Parameters.parameter||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters`
  - element: `Parameters.parameter` · newly required · critical
  - 1 → 2
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search|Questionnaire.extension|questionnaireAdaptive|MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search`
  - element: `Questionnaire.extension` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search|Questionnaire.extension|questionnaireAdaptive|SLICE_CARDINALITY|questionnaireAdaptive|:SLICE_CARDINALITY_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search`
  - element: `Questionnaire.extension` · slice cardinality changed · critical
  - {"min":0,"max":"*"} → {"min":1,"max":"*"}
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search|Questionnaire.extension||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search`
  - element: `Questionnaire.extension` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt|Questionnaire.extension.value[x]|questionnaireAdaptive|TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt`
  - element: `Questionnaire.extension.value[x]` · target profile narrowed · critical
  - ["http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-library"] → []
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt|Questionnaire.item.answerValueSet||TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt`
  - element: `Questionnaire.item.answerValueSet` · target profile narrowed · critical
  - ["http://hl7.org/fhir/StructureDefinition/ValueSet"] → ["http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-valueset|4.0.0"]
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt|Questionnaire.subjectType||MAX_CARDINALITY||:INFORMATIONAL_CHANGE`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt`
  - element: `Questionnaire.subjectType` · informational change · critical
  - * → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt|Questionnaire.subjectType||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt`
  - element: `Questionnaire.subjectType` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt|Questionnaire.url||MAX_CARDINALITY||:INFORMATIONAL_CHANGE`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt`
  - element: `Questionnaire.url` · informational change · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt|Questionnaire.url||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt`
  - element: `Questionnaire.url` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse|QuestionnaireResponse.author||TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse`
  - element: `QuestionnaireResponse.author` · target profile narrowed · critical
  - ["http://hl7.org/fhir/StructureDefinition/Device","http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient","http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner","http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole","http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization","http://hl7.org/fhir/StructureDefinition/RelatedPerson"] → ["http://hl7.org/fhir/StructureDefinition/Device","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient","http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner","http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-practitionerrole","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization","http://hl7.org/fhir/StructureDefinition/RelatedPerson"]
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse|QuestionnaireResponse.subject||TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse`
  - element: `QuestionnaireResponse.subject` · target profile narrowed · critical
  - ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"] → ["http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient"]
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-std-questionnaire|Questionnaire.item.text||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-std-questionnaire`
  - element: `Questionnaire.item.text` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-std-questionnaire|Questionnaire.item||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-std-questionnaire`
  - element: `Questionnaire.item` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context|Extension.value[x]||TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context`
  - element: `Extension.value[x]` · target profile narrowed · critical
  - ["http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-coverage","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-devicerequest","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medicationrequest","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-nutritionorder","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment"] → ["http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-devicerequest|2.2.1","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medicationrequest|2.2.1","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-nutritionorder|2.2.1","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest|2.2.1","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter|2.2.1","http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-base|2.2.1"]
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QPackageBundle|Bundle.entry.resource|library|TYPE||:UNKNOWN`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QPackageBundle`
  - element: `Bundle.entry.resource` · unknown · needs review
  - ["Resource"] → ["Library"]
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QPackageBundle|Bundle.entry|library|SLICING|library|:SLICE_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTR-QPackageBundle`
  - element: `Bundle.entry` · slice added · needs review
  - — → {"sliceName":"library","min":0,"max":"*"}
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData|DTRMetricData.action.actionDetail||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData`
  - element: `DTRMetricData.action.actionDetail` · valueset reference changed · needs review
  - {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-Action"} → {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-dtr/ValueSet/metric-Action|2.2.0"}
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData|DTRMetricData.coverageInfo.covered||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData`
  - element: `DTRMetricData.coverageInfo.covered` · valueset reference changed · needs review
  - {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo"} → {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo|2.2.1"}
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData|DTRMetricData||INVARIANT|dtrl-1|:INVARIANT_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData`
  - element: `DTRMetricData` · invariant added · needs review
  - — → {"key":"dtrl-1","severity":"error","human":"if source is not 'payer-src', then providerId and groupId are required","expression":"(source!='payer-src') implies (providerId.exists() and groupId.exists())","source":"http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData|2.2.0"}
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters|Parameters.parameter|outcome|MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters`
  - element: `Parameters.parameter` · new support expectation · needs review
  - false → true
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters|Parameters.parameter|questionnaire|MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters`
  - element: `Parameters.parameter` · new support expectation · needs review
  - false → true
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-qpackage-input-parameters|Parameters.parameter|coverage|MAX_CARDINALITY||:INFORMATIONAL_CHANGE`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-qpackage-input-parameters`
  - element: `Parameters.parameter` · informational change · needs review
  - * → 1
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-qpackage-output-parameters|Parameters.parameter.value[x]|outcome|MAX_CARDINALITY||:INFORMATIONAL_CHANGE`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-qpackage-output-parameters`
  - element: `Parameters.parameter.value[x]` · informational change · needs review
  - 1 → 0
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search|Questionnaire.item.linkId||INVARIANT|que-15|:INVARIANT_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search`
  - element: `Questionnaire.item.linkId` · invariant added · needs review
  - — → {"key":"que-15","severity":"error","human":"Link ids must be 255 characters or less","expression":"$this.length() <= 255","xpath":"string-length(@value) <= 255","source":"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnairecommon"}
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin|Extension.extension.extension.value[x]|author/practitioner|TARGET_PROFILE||:REFERENCE_REQUIREMENT_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin`
  - element: `Extension.extension.extension.value[x]` · reference requirement changed · needs review
  - ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"] → ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|7.0.0"]
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/intendedUse|Extension.value[x]||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/intendedUse`
  - element: `Extension.value[x]` · valueset reference changed · needs review
  - {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-crd/ValueSet/DocReason"} → {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-crd/ValueSet/DocReason|2.2.1"}
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData|DTRMetricData.groupId||MIN_CARDINALITY||:NO_LONGER_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData`
  - element: `DTRMetricData.groupId` · no longer required · informational
  - 1 → 0
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData|DTRMetricData.providerId||MIN_CARDINALITY||:NO_LONGER_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/DTRMetricData`
  - element: `DTRMetricData.providerId` · no longer required · informational
  - 1 → 0
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters|Parameters.parameter.resource|outcome|MUST_SUPPORT||:SUPPORT_EXPECTATION_REMOVED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-log-errors-input-parameters`
  - element: `Parameters.parameter.resource` · support expectation removed · informational
  - true → false
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search|Questionnaire.item.maxLength||MUST_SUPPORT||:SUPPORT_EXPECTATION_REMOVED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt-search`
  - element: `Questionnaire.item.maxLength` · support expectation removed · informational
  - true → false
- `req:http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/activeRole|Extension.value[x]||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/activeRole`
  - element: `Extension.value[x]` · valueset reference changed · informational
  - {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role"} → {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role|3.1.1"}

## Where rules we track mention this guide

Context only, quoted from our mandate register. None of it changes the comparison above, which depends on the two packages and nothing else.

- CMS-0057-F (by 2027-01-01) — register records a recommended version of `2.2.0` — compliance 2027-01-01 — https://www.cms.gov/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f
- CMS-0062-P (proposed — no adopted date) — PROPOSED 2026-04-14, comments closed 2026-06-15 — not final as of 2026-07-26, no adopted compliance date — https://www.federalregister.gov/documents/2026/04/14/2026-07205/medicare-and-medicaid-programs-patient-protection-and-affordable-care-act-interoperability-standards · https://www.cms.gov/priorities/burden-reduction/overview/interoperability/policies-regulations/cms-interoperability-standards-prior-authorization-drugs-proposed-rule-cms-0062-p

## Who maintains this guide, per our register

Where standards work on this guide happens — the room a ballot comment or a question should go to. Quoted from our workgroup register; sourced from the guide's own published footer attribution.

- HL7 International / Clinical Decision Support (owner) — https://www.hl7.org/Special/committees/dss · https://hl7.org/fhir/us/davinci-dtr/en/index.html — reviewed 2026-07-26

## What this pack is not

Not a compliance assessment. The comparison carries no deadline and renders no verdict about any organization or implementation. Observed validator differences are not automatic proof of official IG requirement changes.