diff --git a/input/intro-notes/CodeSystem-ASN1ToHL7-intro.md b/input/intro-notes/CodeSystem-ASN1ToHL7-intro.md
index 921a383..ecbfd08 100644
--- a/input/intro-notes/CodeSystem-ASN1ToHL7-intro.md
+++ b/input/intro-notes/CodeSystem-ASN1ToHL7-intro.md
@@ -4,13 +4,13 @@ The bit may either represent an event or a state. When an event, the defined eve
The code values for the properties are included here as well, since the valueset extension for properties is not supported for FHIR R4.
-The uploader can generate the code from the data received from the PHD. No external information is necessary unless the uploader wants to populate the `display` element of the CodeableConcept data type. It is recommended that the uploader populates the display element as defined by the CodeSystem if known, or otherwise populates the `text` element with the Reference Id or the MDC code as decimal string followed by "bit *n*". It is not required because it is desired to have an uploader that can still work with future specializations and in that case, it is not possible for the uploader to know what to use as `display` as it is not sent over the wire; it is only available from the specialization documents.
+The uploader can generate the code from the data received from the PHD. No external information is necessary unless the uploader wants to populate the `display` element of the CodeableConcept data type. It is recommended that the uploader populates the `display` element as defined by the CodeSystem if known, or otherwise populates the `text` element with the Reference Id or the MDC code as decimal string followed by "bit *n*". It is not required because it is desired to have an uploader that can still work with future specializations and in that case, it is not possible for the uploader to know what to use as `display` as it is not sent over the wire; it is only available from the specialization documents.
To generate the code, the uploader obtains the code for the type of measurement which is used to populate the `Observation.code.coding.code` –element. Then for each bit to be reported, a new code is generated by appending a period followed by the bit position being mapped.
A bit can only have two values, set or cleared. Thus the value is reported in the `Observation.component.valueBoolean` –element using `true` for set and `false` for cleared.
- - As an example, the continuous glucose monitor specialization has a Device status measurement whose type is given by the code 8418060. If the value reported is 0001 1000 0000 0000 the bits set are bits 3 and 4. Note that bit 0 is the HIGH order bit. Bit 3 means 'sensor malfunction' and bit 4 means 'device specific alert'. This measurement would require two component elements and one would be 8418060.3 and the other would be 8418060.4. Note these are alpha-numeric strings and not decimal numbers. If one took the code 8418060.3 and looked it up in the ASN.1 Bits vocabulary one would find it meant 'sensor malfunctioned'.
+ - As an example, the continuous glucose monitor specialization has a Device status measurement whose type is given by the code 8418060. If the value reported is 0001 1000 0000 0000 the bits set are bits 3 and 4. Note that bit 0 is the HIGH order bit. Bit 3 means 'sensor malfunction' and bit 4 means 'device specific alert'. This measurement would require two `component` elements and one with code 8418060.3 and the other with code 8418060.4. Note these are alpha-numeric strings and not decimal numbers. If one took the code 8418060.3 and looked it up in the ASN.1 Bits vocabulary one would find it meant 'sensor malfunctioned'.
## Reporting Requirements
If the ASN.1 bit represents an event, only the set condition needs to be reported. If the ASN.1 bit represents a state, both the set and cleared conditions need to be reported. If the device does not support the bit, it is not required to report the value. If the uploader would, nevertheless, desire to report the unsupported situation it is done in an `Observation.component.dataAbsentReason.coding.code` –element with code "unsupported". The `Observation.component.value[x]` element is absent. Undefined bits are never reported.
diff --git a/input/intro-notes/Observation-coin-example-1-intro.md b/input/intro-notes/Observation-coin-example-1-intro.md
index d6f6efe..a18fb7f 100644
--- a/input/intro-notes/Observation-coin-example-1-intro.md
+++ b/input/intro-notes/Observation-coin-example-1-intro.md
@@ -1 +1 @@
-This example shows a standard coincident timestamp where the PHG has superior time synchronization to the PHD. There is no identifier element in this Observation as Coincident Timestamps are never duplicates and are always 'created'.
\ No newline at end of file
+This example shows a standard coincident timestamp where the PHG has superior time synchronization to the PHD. There is no `identifier` element in this Observation as Coincident Timestamps are never duplicates and are always 'created'.
\ No newline at end of file
diff --git a/input/intro-notes/Observation-compound-numeric-observation-intro.md b/input/intro-notes/Observation-compound-numeric-observation-intro.md
index d6d7cd5..ce6252e 100644
--- a/input/intro-notes/Observation-compound-numeric-observation-intro.md
+++ b/input/intro-notes/Observation-compound-numeric-observation-intro.md
@@ -1,3 +1,3 @@
-This example shows a compound (numeric) observation. The most common type of compound observation is the Blood Pressure. The systolic, diastolic, and mean values are treated as parts of the same observation. The compound elements are reported in `Observation.component` elements and that there is **no** `value[x]` in the 'primary' observation. In addition, the 'mean' component is not considered as one of FHIR's vital signs and no LOINC code is present for that component code.
+This example shows a compound (numeric) observation. The prototypical compound observation is the Blood Pressure. The systolic, diastolic, and mean values are treated as parts of the same observation. The compound elements are reported in `Observation.component` elements and that there is **no** `value[x]` in the 'primary' observation. In addition, the 'mean' component is not considered as one of FHIR's vital signs and no LOINC code is present for that component code.
Note that the referenced resources - Patient, PHG, PHD, and coincident timestamp - are assumed to be present on the server already.
\ No newline at end of file
diff --git a/input/intro-notes/Observation-numeric-observation-not-a-number-intro.md b/input/intro-notes/Observation-numeric-observation-not-a-number-intro.md
index 05240f4..fd0ea23 100644
--- a/input/intro-notes/Observation-numeric-observation-not-a-number-intro.md
+++ b/input/intro-notes/Observation-numeric-observation-not-a-number-intro.md
@@ -1,4 +1,4 @@
-This is an example of a device reporting a NaN (not a number). The important aspect of this case is that the value element is absent and replaced by a dataAbsentReason element.
+This is an example of a device reporting a NaN (not a number). The important aspect of this case is that the `value[x]` element is absent and replaced by a `dataAbsentReason` element.
-There is no logical id in this resource as this resource is being uploaded to the server in a create operation. The server will create the logical id and return it to the sender in the response. There is also no reference to the coincident timestamp since this observation is generated by a device that is streaming data and reporting no timestamp. The timestamp is taken to be the time of reception by the gateway.
+There is no logical id in this resource as this resource is being uploaded to the server in a create operation. The server will create the logical id and return it to the sender in the response. There is also no reference to the coincident timestamp since this observation is generated by a device that is streaming data as it is generated and without a timestamp. The timestamp is taken to be the time of reception by the gateway.
diff --git a/input/intro-notes/Observation-numeric-spotnumeric-intro.md b/input/intro-notes/Observation-numeric-spotnumeric-intro.md
index a9c6734..7a20ce0 100644
--- a/input/intro-notes/Observation-numeric-spotnumeric-intro.md
+++ b/input/intro-notes/Observation-numeric-spotnumeric-intro.md
@@ -1,5 +1,5 @@
-This example shows a basic numeric observation. It does have a single component element as the measurement also contained a Supplemental Information attribute indicating the measurement is a SPOT (stable average).
+This example shows a basic numeric observation. It does have an additional component as the measurement also contained a Supplemental Information attribute indicating the measurement is a SPOT (stable average).
-Note there is no logical id in this resource as this resource is being uploaded to the server in a conditional create operation. The server will use the identifier to check that no other Observation resource exists on the server with the same identifier. If there is not such resource present, the server will create the logical id and return it to the sender in the response. Pulse oximeters reporting a SPOT measurement have a timestamp thus there is a reference to the coincident timestamp.
+Note there is no logical id in this resource as this resource is being uploaded to the server in a conditional create operation. The server will use the conditional create identifier to check that no other Observation resource exists on the server with the same identifier. If there is not such resource present, the server will create the logical id and return it to the sender in the response. Pulse oximeters reporting a SPOT measurement have a timestamp thus there is a reference to the coincident timestamp.
The referenced resources are assumed to have been uploaded to the server before - Patient, PHD, PHG and coincident timestamp.
\ No newline at end of file
diff --git a/input/intro-notes/StructureDefinition-PhdBITsEnumerationObservation-notes.md b/input/intro-notes/StructureDefinition-PhdBITsEnumerationObservation-notes.md
index c1c89b7..dfb1f72 100644
--- a/input/intro-notes/StructureDefinition-PhdBITsEnumerationObservation-notes.md
+++ b/input/intro-notes/StructureDefinition-PhdBITsEnumerationObservation-notes.md
@@ -1,9 +1,9 @@
The following section gives more details on the mapping of BITS to a FHIR Observation resource.
### Mapping BITs Enumerations to FHIR
-FHIR has no data type that corresponds to this kind of measurement. Consequently we developed a code system which maps the BITs measurement to a set of codes. The details of the mapping and how these codes are generated from data received from the PHD are given in [ASN1 To HL7 CodeSystem](CodeSystem-ASN1ToHL7.html). Basically each component has a code consisting of the MDC code followed by the bit number. In FHIR there is one component per reported bit setting. And similar to the compound measurement, there is no Observation.value[x] element. Each component has a value of `true` or `false`, corresponding to the bit being set or cleared.
+FHIR has no data type that corresponds to this kind of measurement. Consequently we developed a code system which maps the BITs measurement to a set of codes. The details of the mapping and how these codes are generated from data received from the PHD are given in [ASN1 To HL7 CodeSystem](CodeSystem-ASN1ToHL7.html). Basically each `component` has a code consisting of the MDC code followed by the bit number. In FHIR there is one `component` per reported bit setting. And similar to the compound measurement, there is no `Observation.value[x]` element. Each `component` has a value of `true` or `false`, corresponding to the bit being set or cleared.
-There may be an `Observation.dataAbsentReason` element if a measurement status indicates a measurement failure in which case no component elements representing the BITs setting are reported.
+There may be an `Observation.dataAbsentReason` element if a measurement status indicates a measurement failure in which case no `component` elements representing the BITs setting are reported.
When mapping Bluetooth GHS bitstring Observation values only supported bits are reported. For bits of type 'event' only set bits need to be reported. If of type 'state' both set and cleared states need to be reported. This means that some bits can be skipped and that the number FHIR Observation can be smaller than the number of bits in the GHS bitstring.
diff --git a/input/intro-notes/StructureDefinition-PhdBaseObservation-intro.md b/input/intro-notes/StructureDefinition-PhdBaseObservation-intro.md
index 96a34a2..4111091 100644
--- a/input/intro-notes/StructureDefinition-PhdBaseObservation-intro.md
+++ b/input/intro-notes/StructureDefinition-PhdBaseObservation-intro.md
@@ -1,15 +1,15 @@
The PHD Base Observation profile contains the elements that are common to all PHD Observation profiles describing measurements. These element are:
- - code: what the measurement is
- - subject: the patient this measurement refers to
- - effective[x]: the timestamp and perhaps duration of the measurement
- - device: reference to the PHD taking the measurement
- - derivedFrom / memberOf: references to related observations
- - components: contains any additional measurement descriptions (Supplemental Information)
- - category: a fixed value identifying observations generated by PHDs
- - measurement status
- - gatewayDevice extension: reference to the PHG responsible for generating the upload
- - coincidentTimestamp extension: reference to the coincidentTimestamp observation that relates PHD time and PHG time
- - performer: optional, when the patient is known to be the performer this may refer to the patient
- - identifier: the PHD conditional-create identifier for this measurement to avoid duplicate uploads
+ - `code`: what the measurement is
+ - `subject`: the patient this measurement refers to
+ - `effective[x]`: the timestamp and perhaps duration of the measurement
+ - `device`: reference to the PHD taking the measurement
+ - `derivedFrom / memberOf`: references to related observations
+ - `components`: contains any additional measurement descriptions (Supplemental Information)
+ - `category`: a fixed value identifying observations generated by PHDs
+ - `measurementStatus`: the status of the measurement
+ - `gatewayDevice` extension: reference to the PHG responsible for generating the upload
+ - `coincidentTimestamp` extension: reference to the coincidentTimestamp observation that relates PHD time and PHG time
+ - `performer`: optional, when the patient is known to be the performer this may refer to the patient
+ - `identifier`: the PHD conditional-create identifier for this measurement to avoid duplicate uploads
diff --git a/input/intro-notes/StructureDefinition-PhdBaseObservation-notes.md b/input/intro-notes/StructureDefinition-PhdBaseObservation-notes.md
index 91ef9d4..7e123e6 100644
--- a/input/intro-notes/StructureDefinition-PhdBaseObservation-notes.md
+++ b/input/intro-notes/StructureDefinition-PhdBaseObservation-notes.md
@@ -29,15 +29,15 @@ An example of the this identifier from [this example](Observation-numeric-spotnu
{% fragment Observation/numeric-spotnumeric JSON EXCEPT:identifier %}
### Obtaining the Type of observation
-One obtains the IEEE 11073-10101 observation type for the code element in the same manner for all metric observations. See the section [MDC Nomenclature codes](Nomenclaturecodes.html) for the details.
+One obtains the IEEE 11073-10101 observation type for the `code` element in the same manner for all metric observations. See the section [MDC Nomenclature codes](Nomenclaturecodes.html) for the details.
### Subject
-The subject element normally points to the PhdPatient resource using the logical id of the Patient resource, for example 'Patient/123546'. For device settings known to the PHG it should point to the PHD.
+The `subject` element normally points to the PhdPatient resource using the logical id of the Patient resource, for example 'Patient/123546'. For device settings known to the PHG it should point to the PHD.
### Performer
-In situations where the gateway knows that the patient is the person performing the measurement, a `Observation.performer` element can also point to the PhdPatient resource. However, in most situations this is unknown and the performer is not filled in. And for coincident timestamp observations, the performer should not be provided. This profile puts no constraints on the performer element.
+In situations where the gateway knows that the patient is the person performing the measurement, a `Observation.performer` element can also point to the PhdPatient resource. However, in most situations this is unknown and the `performer` is not filled in. And for coincident timestamp observations, the `performer` should not be provided. This profile puts no constraints on the `performer` element.
-### Timestamp: effective[x]
+### Timestamp: `effective[x]`
PHDs report timestamps in various methods and may not report timestamps at all. The PHG will include a timestamp in every observation that is uploaded using a conversion as needed based on the timestamp data received from the PHD. The timestamp types and corresponding PHG conversions are summarized below:
|ACOM clock type|`Observation.code.coding`|
diff --git a/input/intro-notes/StructureDefinition-PhdDevice-notes.md b/input/intro-notes/StructureDefinition-PhdDevice-notes.md
index b84263d..205a827 100644
--- a/input/intro-notes/StructureDefinition-PhdDevice-notes.md
+++ b/input/intro-notes/StructureDefinition-PhdDevice-notes.md
@@ -7,7 +7,7 @@ In order to discriminate between an identifier that is a system id and that whic
When in the future other system identifiers such as ETSI-ICCID (International Circuit Card Identifier) are used, this coding scheme will need to be extended.
-Note that USB.vid (vendor id) and USB.pid (product id) pair identifies a product type from a vendor and cannot be used as system identifier. This information can be represented in a property element of the Device resource.
+Note that USB.vid (vendor id) and USB.pid (product id) pair identifies a product type from a vendor and cannot be used as system identifier. This information can be represented in a `property` element of the Device resource.
The transport addresses are as follows:
@@ -28,7 +28,7 @@ An example of a system identifier is:
{% fragment Device/phd-74E8FFFEFF051C00.001C05FFE874 JSON EXCEPT:identifier %}
### UDI → `Device.udiCarrier`
- The UDI is included as an optional attribute of a PHD in the IEEE 11073-10206 ACOM standard. It is also supported in the Bluetooth SIG Device Information Service and the GHS Profile. The UDI elements supported are issuer, jurisdiction, Device Identifier, and the Human Readable Barcode String. The udiCarrier does have elements for each of these entries. The entryType code for this sourcing of the UDI `electronic-transmission` is used as the UDI is transmitted electronically.
+ The UDI is included as an optional attribute of a PHD in the IEEE 11073-10206 ACOM standard. It is also supported in the Bluetooth SIG Device Information Service and the GHS Profile. The UDI attributes supported are issuer, jurisdiction, Device Identifier, and the Human Readable Barcode String. The `udiCarrier` does have elements for each of these entries. The entryType code for this sourcing of the UDI `electronic-transmission` is used as the UDI is transmitted electronically.
The UDI of a device consists of a Device Identifier (DI) and a Production Identifier (PI). The DI is the part of the UDI that identifies the specific model of the device. The PI is used to identify the specific instance of the device, such as its serial number or lot number. When the PI includes a serial number it identifies a specific instance of the devices of the model as specified by the DI.
@@ -66,7 +66,7 @@ It contains the Continua version, list of certified PHD interfaces, and the regu
The interface codes are mapped to a list of properties where the `property.valueCode` element carries a single PHD interface code. The `property.type` element, which identifies the property, is given by the MDC code `532353`. Its reference id is `MDC_REG_CERT_DATA_CONTINUA_CERT_DEV_LIST`.
#### Reg-Cert-Data-List Regulation Status
-The regulation status element has MDC code `532354` and carries a 16-bit ASN1 BITs 'state' value (see [ASN1 To HL7 CodeSystem](CodeSystem-ASN1ToHL7.html)). Only bit 0 is defined. Being a state value, both set and cleared states are reported. In fact, it is the cleared state which represents that the device is regulated. The regulation status is mapped to an additional `Device.property.valueCode` element.
+The regulation status attribute has MDC code `532354` and carries a 16-bit ASN1 BITs 'state' value (see [ASN1 To HL7 CodeSystem](CodeSystem-ASN1ToHL7.html)). Only bit 0 is defined. Being a state value, both set and cleared states are reported. In fact, it is the cleared state which represents that the device is regulated. The regulation status is mapped to an additional `Device.property.valueCode` element.
A fragment:
{% fragment Device/phd-74E8FFFEFF051C00.001C05FFE874 JSON BASE:property.where(type.coding.code='532354') %}
diff --git a/input/intro-notes/StructureDefinition-PhdNumericObservation-notes.md b/input/intro-notes/StructureDefinition-PhdNumericObservation-notes.md
index 41d4015..59d9ceb 100644
--- a/input/intro-notes/StructureDefinition-PhdNumericObservation-notes.md
+++ b/input/intro-notes/StructureDefinition-PhdNumericObservation-notes.md
@@ -40,16 +40,16 @@ The above states that the Continuous Glucose Monitor PHG is 95% sure that the re
### Examples:
A basic simple numeric observation with a timestamp and a supplemental types attribute is shown in [Pulse Rate Spot Measurement](Observation-numeric-spotnumeric.html). Simple numeric measurements are common in PHDs.
-An example of a NaN (not a number) measurement is shown in [NaN Example](Observation-numeric-observation-not-a-number.html). Note that the value element is absent and replaced by a dataAbsentReason element.
+An example of a NaN (not a number) measurement is shown in [NaN Example](Observation-numeric-observation-not-a-number.html). Note that the value element is absent and replaced by a `dataAbsentReason` element.
### Consumer of the PHD Numeric Observation Profile
The consumer of this profile does not need to concern itself with the complexities or the PHD-related entry for the `Observation.identifier` which is used by the uploader to prevent data duplication. There are some extensions introduced by this profile but the resource is consumable by any reader that understands the Observation resource. The following table summarizes the elements used describing the measurement:
| **Measurement Item** | **Element** | **Additional Information** |
|-------------------------------|------------------------------------------|-----------------------------------------------------------------------------------------------------------------|
-| Measurement type | `Observation.code.coding.code` | There shall be one coding element using the MDC coding system.
If a vital sign, there will be an additional coding element using one of the LOINC vital-signs codes. |
+| Measurement type | `Observation.code.coding.code` | There shall be one `coding` element using the MDC coding system.
If a vital sign, there will be an additional `coding` element using one of the LOINC vital-signs codes. |
| Measurement value | `Observation.valueQuantity.value` | The value has the precision of the original. measurement. |
-| Measurement units | `Observation.valueQuantity.code` | FHIR uses UCUM coding. system. |
+| Measurement units | `Observation.valueQuantity.code` | FHIR uses the UCUM coding system. |
| Error | `Observation.dataAbsentReason` | Contains error code. If present, no `Observation.valueQuantity` is present. |
| Timestamp | `Observation.effectiveDateTime`
`Observation.effectivePeriod` | If the measurement is a point in time.
If the measurement has a duration. |
| Coincident timestamp reference | `Observation.extension.valueReference` | Points to an Observation following the Coincident Timestamp Observation profile. For time quality auditing purposes. Not present if the sensor provides no timestamp. |
diff --git a/input/intro-notes/StructureDefinition-PhdPatient-notes.md b/input/intro-notes/StructureDefinition-PhdPatient-notes.md
index 6c8821a..f36c1e7 100644
--- a/input/intro-notes/StructureDefinition-PhdPatient-notes.md
+++ b/input/intro-notes/StructureDefinition-PhdPatient-notes.md
@@ -13,5 +13,5 @@ A Patient resource for a known or an unknown patient shall be created by the PHG
### Examples:
An example of a PHD generated patient for a known patient is given [here](Patient-patientExample-1.html).
An example of a PHD generated patient for an unknown patient is given [here](Patient-patientExample-2.html).
-These examples contain an optional name element.
+These examples contain an optional `name` element.
diff --git a/input/intro-notes/StructureDefinition-PhdRtsaObservation-intro.md b/input/intro-notes/StructureDefinition-PhdRtsaObservation-intro.md
index 6698272..e47a1ed 100644
--- a/input/intro-notes/StructureDefinition-PhdRtsaObservation-intro.md
+++ b/input/intro-notes/StructureDefinition-PhdRtsaObservation-intro.md
@@ -1,4 +1,4 @@
-The (Real Time) Sample Array (RTSA) Observation Profile is used when the measurement is a periodic sequences of scalars in time, typically waveforms. In theory, this measurement could be split up into a sequence of Numeric Observations but that would be inefficient especially if one is talking about a 1000 samples per second or more. Waveforms are used for spirometry, ECG, pulse oximeter pleth wave traces, etc. It is used to represent ACOM Sample Array Observations.
+The (Real Time) Sample Array (RTSA) Observation Profile is used when the measurement is a periodic sequences of scalars in time, typically waveforms. In theory, this measurement could be split up into a sequence of Numeric Observations but that would be inefficient especially if one is talking about a 1000 samples per second or more. Waveforms are used for spirometry, ECG, pulse oximeter pleth wave traces, etc. This profile is used to represent ACOM Sample Array Observations.