HL7 · ErikMoll · Jul 30, 2025 · Jul 30, 2025
diff --git a/.cspell/custom-dictionary-workspace.txt b/.cspell/custom-dictionary-workspace.txt
@@ -1,4 +1,6 @@
 # Custom Dictionary Words
+bitstring
+bitstrings
 codeable
 FHIR
 LOINC
@@ -11,6 +13,7 @@ plethysmograph
 RTMMS
 SFLOAT
 SNOMED
+thresholding
 timestamping
 UCUM
 unsynchronized

diff --git a/input/PhdImplementationGuide.xml b/input/PhdImplementationGuide.xml
@@ -627,10 +627,9 @@ In this example there are only xml structure definitions, value sets, code syste
       <code value="special-url"/>
       <value value="http://terminology.hl7.org/CodeSystem/ASN1ToHL7"/>
     </parameter>
-        <parameter>
+    <parameter>
       <code value="special-url"/>
-      <value value="http://terminology.hl7.org/ValueSet/ASN1ClockBits"/>
+      <value value="http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers"/>
     </parameter>
   </definition>
-
 </ImplementationGuide>
diff --git a/input/examples/bundle-example-1.json b/input/examples/bundle-example-1.json
@@ -58,7 +58,7 @@
             "type": {
               "coding": [
                 {
-                  "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                  "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                   "code": "SYSID",
                   "display": "IEEE 11073 System Identifier"
                 }
@@ -333,7 +333,7 @@
             "type": {
               "coding": [
                 {
-                  "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                  "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                   "code": "SYSID",
                   "display": "IEEE 11073 System Identifier"
                 }
@@ -346,7 +346,7 @@
             "type": {
               "coding": [
                 {
-                  "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                  "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                   "code": "BTMAC",
                   "display": "Bluetooth MAC Address"
                 }

diff --git a/input/examples/phd-00601900010E9234.F45EABA80832.json b/input/examples/phd-00601900010E9234.F45EABA80832.json
@@ -11,7 +11,7 @@
             "type": {
                 "coding": [
                     {
-                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                        "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                         "code": "SYSID"
                     }
                 ]
@@ -23,7 +23,7 @@
             "type": {
                 "coding": [
                     {
-                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                        "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                         "code": "BTMAC"
                     }
                 ]
@@ -153,7 +153,7 @@
             "type": {
                 "coding": [
                     {
-                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                        "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                         "code": "USB"
                     }
                 ]

diff --git a/input/examples/phd-711000FEFF5F49B0.B0495F001071.json b/input/examples/phd-711000FEFF5F49B0.B0495F001071.json
@@ -11,7 +11,7 @@
             "type": {
                 "coding": [
                     {
-                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                        "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                         "code": "SYSID"
                     }
                 ]
@@ -23,7 +23,7 @@
             "type": {
                 "coding": [
                     {
-                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                        "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                         "code": "BTMAC"
                     }
                 ]

diff --git a/input/examples/phd-74E8FFFEFF051C00.001C05FFE874.json b/input/examples/phd-74E8FFFEFF051C00.001C05FFE874.json
@@ -11,7 +11,7 @@
             "type": {
                 "coding": [
                     {
-                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                        "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                         "code": "SYSID",
                         "display": "IEEE 11073 System Identifier"
                     }
@@ -24,7 +24,7 @@
             "type": {
                 "coding": [
                     {
-                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                        "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                         "code": "BTMAC",
                         "display": "Bluetooth MAC address"
                     }

diff --git a/input/examples/phg-ecde3d4e58532d31.000000000000.json b/input/examples/phg-ecde3d4e58532d31.000000000000.json
@@ -11,7 +11,7 @@
             "type": {
                 "coding": [
                     {
-                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                        "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                         "code": "SYSID"
                     }
                 ]
@@ -23,7 +23,7 @@
             "type": {
                 "coding": [
                     {
-                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                        "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                         "code": "BTMAC"
                     }
                 ]
@@ -35,7 +35,7 @@
             "type": {
                 "coding": [
                     {
-                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+                        "system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
                         "code": "ETHMAC"
                     }
                 ]

diff --git a/input/examples/phg-example.json b/input/examples/phg-example.json
@@ -11,7 +11,7 @@
 			"type": {
 				"coding": [
 					{
-						"system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
+						"system": "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers",
 						"code": "SYSID"
 					}
 				]

diff --git a/input/fsh/CodeSystem.ContinuaDeviceIdentifiers.fsh b/input/fsh/CodeSystem.ContinuaDeviceIdentifiers.fsh
@@ -3,7 +3,7 @@ Id: ContinuaDeviceIdentifiers
 Title: "Continua Device Identifiers"
 Description: "Codes used to describe the Device (PHD or PHG) Identifiers, such as the system id or Bluetooth Address. More codes maybe added to this list in the future."
 * ^meta.profile = "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"
-* ^url = "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers"
+* ^url = "http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers"
 * ^version = "current"
 // * ^status = #draft
 * ^experimental = false

diff --git a/input/fsh/StructureDefinition.PhdDevice.fsh b/input/fsh/StructureDefinition.PhdDevice.fsh
@@ -28,7 +28,7 @@ Description: "Profile for the Device Resource for a PHD"
   * ^definition = "This entry contains the IEEE EUI-64."
   * ^alias = "11073-10206 System id"
   * type 1..
-  * type = http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers#SYSID
+  * type = http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers#SYSID
     * ^short = "Required IEEE 11073-10206 System Id code system coding"
   * system 1..
   * system = "urn:oid:1.2.840.10004.1.1.1.0.0.1.0.0.1.2680" (exactly)
@@ -42,7 +42,7 @@ Description: "Profile for the Device Resource for a PHD"
   * ^definition = "This entry contains the Bluetooth MAC transport address."
   * ^alias = "Bluetooth MAC Transport address"
   * type 1..
-  * type = http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers#BTMAC
+  * type = http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers#BTMAC
     * ^short = "Required Bluetooth MAC address code system coding"
   * system 1..
   * system = "http://hl7.org/fhir/sid/eui-48/bluetooth" (exactly)
@@ -53,7 +53,7 @@ Description: "Profile for the Device Resource for a PHD"
   * ^definition = "This entry contains the MAC transport address."
   * ^alias = "MAC Transport address"
   * type 1..
-  * type = http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers#ETHMAC
+  * type = http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers#ETHMAC
     * ^short = "Required Ethernet MAC address code system coding"
   * system 1..
   * system = "http://hl7.org/fhir/sid/eui-48/ethernet" (exactly)

diff --git a/input/fsh/StructureDefinition.PhgDevice.fsh b/input/fsh/StructureDefinition.PhgDevice.fsh
@@ -27,7 +27,7 @@ Description: "Profile for the Device Resource for a PHG"
   * ^definition = "This entry contains the IEEE EUI-64."
   * ^alias = "11073-10206 System id"
   * type 1..
-  * type = http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers#SYSID
+  * type = http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers#SYSID
     * ^short = "Required IEEE 11073-10206 System Id code system coding"
   * system 1..
   * system = "urn:oid:1.2.840.10004.1.1.1.0.0.1.0.0.1.2680" (exactly)
@@ -41,7 +41,7 @@ Description: "Profile for the Device Resource for a PHG"
   * ^definition = "This entry contains the Bluetooth MAC transport address."
   * ^alias = "Bluetooth MAC Transport address"
   * type 1..
-  * type = http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers#BTMAC
+  * type = http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers#BTMAC
     * ^short = "Required Bluetooth MAC address code system coding"
   * system 1..
   * system = "http://hl7.org/fhir/sid/eui-48/bluetooth" (exactly)
@@ -52,7 +52,7 @@ Description: "Profile for the Device Resource for a PHG"
   * ^definition = "This entry contains the MAC transport address."
   * ^alias = "MAC Transport address"
   * type 1..
-  * type = http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers#ETHMAC
+  * type = http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers#ETHMAC
     * ^short = "Required Ethernet MAC address code system coding"
   * system 1..
   * system = "http://hl7.org/fhir/sid/eui-48/ethernet" (exactly)

diff --git a/input/fsh/ValueSet.ASN1ClockBits.fsh b/input/fsh/ValueSet.ASN1ClockBits.fsh
@@ -3,7 +3,7 @@ Id: ASN1ClockBits
 Title: "ANS1ToHL7 codes defined for Boolean Clock attributes"
 Description: "ValueSet for the ANS1ToHL7 codes that are not derived from enumeration measurements."
 * ^meta.profile = "http://hl7.org/fhir/StructureDefinition/shareablevalueset"
-* ^url = "http://terminology.hl7.org/ValueSet/ASN1ClockBits"
+* ^url = "http://hl7.org/fhir/uv/phd/ValueSet/ASN1ClockBits"
 * ^version = "current"
 // * ^status = #draft
 * ^experimental = false

diff --git a/input/fsh/ValueSet.MDCDeviceIdentifierTypes.fsh b/input/fsh/ValueSet.MDCDeviceIdentifierTypes.fsh
@@ -9,4 +9,4 @@ Description: "ValueSet for the MDC Device Identifier Types"
 * ^experimental = false
 * ^date = "2021-09-25"
 * ^publisher = "Health Level Seven International (Devices Work Group)"
-* include codes from system http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers
+* include codes from system http://terminology.hl7.org/CodeSystem/ContinuaDeviceIdentifiers
diff --git a/input/pagecontent/ContinuaHealthFitnessCodes.md b/input/pagecontent/ContinuaHealthFitnessCodes.md
diff --git a/input/pagecontent/ContinuaPersonalAreaNetworkCodes.md b/input/pagecontent/ContinuaPersonalAreaNetworkCodes.md
diff --git a/input/pagecontent/DIMtoFHIRMapping.md b/input/pagecontent/DIMtoFHIRMapping.md
@@ -1,7 +1,7 @@
 
 In the IEEE 11073-10206 Abstract Content Model (ACOM), two primary classes are relevant for data upload: the System object and the Observation object. The System object describes the overall device, including its characteristics and capabilities. The Observation object represents individual measurements or events reported by the device. A single PHD will have one System object and will generate multiple Observation objects, each corresponding to a specific measurement or event.
 
-Observation objects in ACOM can represent different types of measurements, including numeric values, enumerated (coded) values, bitfields (for multiple simultaneous states or events), strings, and sample arrays (for periodic data such as waveforms). Numeric observations cover scalar measurements, enumerated observations represent values from a defined set, bitfield observations capture multiple boolean states, and sample arrays represent sequences of numeric values over time.
+Observation objects in ACOM can represent different types of measurements, including numeric values, enumerated (coded) values, bitstrings (for multiple simultaneous states or events), strings, and sample arrays (for periodic data such as waveforms). Numeric observations cover scalar measurements, enumerated observations represent values from a defined set, bitstring observations capture multiple boolean states, and sample arrays represent sequences of numeric values over time.
 
 The static attributes of the System object are mapped to the FHIR Device resource, while the measurement-related attributes of the Observation objects are mapped to FHIR Observation resources. 
 
@@ -14,7 +14,7 @@ The IEEE 11073-10206 Observation Model supports the following measurement values
  - **Discrete values**: Discrete values are used when the measurements are described by a finite set of options such as the meal context of a glucose measurement. The options might be one of breakfast, lunch, dinner, snack, fasting, etc. A code is used for each option. Discrete values can come as single event, multiple concurrent events or as multiple concurrent boolean state or events. 
     - **Single Event value**: Single discrete values are mapped to `Observation.valueCodeableConcept` elements.
     - **Multiple Event value**: Multiple discrete values are mapped to multiple Observations each with a `Observation.valueCodeableConcept` elements.
-    - **Multiple Boolean Event/State values**: Also known as bitsrings. Bitstringss values are discrete measurements where each bit of an integer represents an event or state. An event would be something like 'marginal signal' in a pulse oximeter. An event is only of interest when it occurs and the bit is set when the event occurs. A state, on the other hand, would be something like 'averaging-on' or 'averaging-off'. Both settings of a state are of interest. Bitstrings are used when multiple events and/or states can occur simultaneously. The mapping of bitstring values uses the [ASN1 To HL7 code system](CodeSystem-ASN1ToHL7.html) where each bit position is mapped to a code. Each code is mapped to an `Observation.component.code` element and the bit setting is mapped to a `Observation.component.valueBoolean` element.
+    - **Multiple Boolean Event/State values**: Also known as bitstrings. Bitstrings values are discrete measurements where each bit of an integer represents an event or state. An event would be something like 'marginal signal' in a pulse oximeter. An event is only of interest when it occurs and the bit is set when the event occurs. A state, on the other hand, would be something like 'averaging-on' or 'averaging-off'. Both settings of a state are of interest. Bitstrings are used when multiple events and/or states can occur simultaneously. The mapping of bitstring values uses the [ASN1 To HL7 code system](CodeSystem-ASN1ToHL7.html) where each bit position is mapped to a code. Each code is mapped to an `Observation.component.code` element and the bit setting is mapped to a `Observation.component.valueBoolean` element.
  - **String values**: String values are just that; a line of arbitrary text. These rarely used values cannot be generically processed by a machine but are only meant for display. An example of such a measurement would be the program name of a workout on a piece of cardio equipment at a gym. String values are mapped to `Observation.valueString` elements.
  - **Sample Array values**: Sequences of periodic numeric values. These are used to report waveform traces of a given frequency such as 1000 samples per second. An example of such a measurement would be a digitized ECG trace. Sample array values are mapped to `Observation.valueSampledData` elements.
  - **Compound values**: Compound values are measurements that need more than one value to describe, such as the x, y and z components of an acceleration or the systolic, diastolic, and MAP components of a blood pressure. Each sub-value is mapped to an `Observation.component` element. Each component comes with a type and a value. 

diff --git a/input/pagecontent/GenericModel.md b/input/pagecontent/GenericModel.md
@@ -6,5 +6,5 @@ This Implementation Guide specifies how one maps the IEEE 11073-10206 ACOM objec
 
 In the IEEE 11073-10206 Abstract information Content Model (ACOM), IEEE 11073-10101 nomenclature codes are used to indicate what the items are. Thus, a reader of FHIR resources mapped from these ACOM objects can decode any of these resources if it knows what the codes are. If a future device is deployed the reader will only need an update of its code dictionary to interpret the resource. A PHG uploader will not even need to update its dictionary to perform the mapping to FHIR as the codes are provided by the PHD through protocol. These features eliminate the need for remote updating and/or servicing of PHGs when new IEEE 11073-10206 ACOM PHDs are used.
 
-Note -- IEEE 11073-10206 ACOM does not define a protocol, but requires protocols that support it to support a representation of the objects defined in the model. The Bluetooth SIG Generic Health Sensor Profile (GHSP) defines an ACOM compliant protocol.
+Note -- IEEE 11073-10206 ACOM does not define a protocol, but requires protocols that support it to support a representation of the objects defined in the model. The Bluetooth SIG Generic Health Sensor (GHS) Profile defines an ACOM compliant protocol.
 
diff --git a/input/pagecontent/Nomenclaturecodes.md b/input/pagecontent/Nomenclaturecodes.md
@@ -32,7 +32,7 @@ This means, following the mapping above, that the `Observation.code` element is
   * `Observation.code.coding.display` optional
   * `Observation.code.text` optional
 
-If the code matches one of the [FHIR observation-vitalsigns codes]({{ site.data.fhir.path }}observation-vitalsigns.html), the corresponding LOINC code shall be present in an additional coding element.
+If the Type corresponds to one of the [FHIR Observation Vital Signs Profiles]({{ site.data.fhir.path }}observation-vitalsigns.html), the corresponding LOINC code shall be present in an additional coding element.
 
 If the application wishes to transcode the MDC code into other coding systems the application is free to do so but:
   * the MDC code shall be present in a coding element,
Original file line number	Diff line number	Diff line change
Expand Up		@@ -6,5 +6,5 @@ This Implementation Guide specifies how one maps the IEEE 11073-10206 ACOM objec

		In the IEEE 11073-10206 Abstract information Content Model (ACOM), IEEE 11073-10101 nomenclature codes are used to indicate what the items are. Thus, a reader of FHIR resources mapped from these ACOM objects can decode any of these resources if it knows what the codes are. If a future device is deployed the reader will only need an update of its code dictionary to interpret the resource. A PHG uploader will not even need to update its dictionary to perform the mapping to FHIR as the codes are provided by the PHD through protocol. These features eliminate the need for remote updating and/or servicing of PHGs when new IEEE 11073-10206 ACOM PHDs are used.

		Note -- IEEE 11073-10206 ACOM does not define a protocol, but requires protocols that support it to support a representation of the objects defined in the model. The Bluetooth SIG Generic Health Sensor Profile (GHSP) defines an ACOM compliant protocol.
		Note -- IEEE 11073-10206 ACOM does not define a protocol, but requires protocols that support it to support a representation of the objects defined in the model. The Bluetooth SIG Generic Health Sensor (GHS) Profile defines an ACOM compliant protocol.