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2017-05-18 CIMI Telecom Minutes

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<<< Approved >>>
  • 2017 Minutes: http://wiki.hl7.org/index.php?title=CIMI_Minutes
  • Screen Sharing & Telecom Information: IHTSDO has generously provided a GoToMeeting connection for CIMI use.
  • Co-Chairs: Stan Huff, Linda Bird, Galen Mulrooney, Richard Esmond; where, quorum requires 2 co-chairs
  • REQUESTED ACTION: Directly edit this WIKI page or send your feedback to CIMI@lists.HL7.org with your comments, questions, suggested updates.


Minutes (Annotated Agenda)

  • Record this call
  • Agenda review
  • Review and approval of minutes
  • Meeting days for San Diego WGM – Galen
    • We will plan to meet Sunday thru Thursday
  • Proposals for SNOMED CT Expo 2017 were submitted – Richard, Steve, Jay
  • Brief updates on active projects (standing item)
    • Brief update on VA KNART effort – Claude
      • Working with Keith Campbell and folks at the VA
      • Analysis Normal Form
      • Clinical Input Form
    • Skin and wound assessments – Jay and Susan
      • Review proposal about terminology bindings about observation
    • Conversion of CIMI archetypes to FHIR logical models to FHIR profiles – Claude
      • Converted CIMI BMM reference models to generate FHIR logical models during the FHIR Connectathon
    • FHIR resource profile from FHIR logical profiles – Claude and Richard are collaborating
    • Tools to model things that get represented in BMM - Claude
    • Creating ADL models from CEMs – Joey
    • LOKI – Patrick Langford
    • CIMI Website – Patrick Langford
    • Tool that takes the BMM patterns and produces FHIR profiles [Richard, Michael van der Zel]
    • MDMI tools – Steve and Richard to follow up
    • Help to create documentation tool that reads a model and generates wiki pages (a document generation tool) [Claude, Michael van der Zel]
    • Review Argonauts profiles and FHIM classes for vital signs – Susan, Galen, All
    • FHIM – CIMI integration – Galen
    • Regeneration of lab models – Patrick, Joey, Stan
  • Plans and responsibilities for CIMI webinar to FHIR Infrastructure
    • Date? Monday 22, 3:00 pm EDT, plan for 60 minutes
    • Presentations? Reference models - Claude
  • Review of updates to CIMI Reference Model - Claude
  • Introduction to Adverse Event/Reaction - Claude
  • CIMI and FHIM relationship and plan – Claude
    • FHIM will continue to be published as a separate set of models from CIMI.
    • It may be that FHIM could become an HL7 activity in the future.
    • In the short to medium term, FHIM will remain an isosemantic model to CIMI for the parts where the two models overlap, and it would support bi-directional mappings.
    • Longer term view, the two models would converge into one where the two models overlap.
    • Both groups are committed to making the models isosemantic for the area of overlap, with bi-directional transformations. When all of the work has been done to make the models isosemantic for all areas of overlap, that essentially constitutes convergence, and then the models can be published in whatever form best suits the CIMI or FHIM constituencies.
    • Should consider converging UML modeling tools.
  • Need to formally approve the licensing for CIMI models and terminology. David Booth suggests Creative Commons, CC-0.
    • We have previously agreed to use the Apache 2 license. We will keep the previous decision.
  • Proposals for additional principles:
    • The proof of the architecture is in the results. Architects may apply principles as needed, but if the architecture has to contain inconsistencies in order to deliver clinically correct archetypes, that is appropriate.
      • Corollary: Use the architecture to make models and test the architecture by making the content that we need. The architecture does not need to be perfect before we make models and try them out in implementations.
    • It is strategically important to assign stable and unambiguous concept identifiers to coded elements in CIMI resources. It will also be important to ensure that these concepts are modeled appropriately to support logical classification, but this requirement can be deferred, and should not hold up CIMI development.
      • Models and model elements will have unique identifiers that can be used for creating relationships in an ontology. However, the complete positioning of the models in the ontology should not hold up CIMI development.
    • While CIMI does not need to ensure the correctness of the SNOMED CT graph, we do need to lay the foundations to support accurate logical classification in the future. [This general principle should form the requirement underpinning specific proposals for semantic model alignment, e.g. Evaluation Result.]
    • It is okay to declare an attribute in the parent class and refine its semantics in downstream classes if the semantic restrictions represent subsets of the ancestor attribute's domain. The children should be created by restrictions on the range and domain of attributes in the parent. Attributes that are specific to the child only would just be added in the child. (Example: specializations of devices.)
      • We previously agreed that the semantic binding of the attribute (i.e. device, or body location) would be carried from parent to child, but the attributes could be renamed using the binding capabilities of ADL. Tooling can leverage the common binding to know that the name in the child is related to the name in the parent to know that “dispense device” is a device.
    • We make the assumption (requirement?) that implementation platforms have the responsibility to provide a direct path for retrieval of IndividualClinicalStatements regardless of what panel or panels contain them. The logical model provides enough information to support this behavior in the implementation. (The logical model can be different from the implementation.)
  • Continue ballot reconciliation - All
  • Review outline of Jay’s SCT paper
  • Review of updated assertion/evaluation table content – Stan
  • Graph/STAMP modeling paradigm – Richard
  • Planned work for September ballot
    • Models for lab data and regeneration of leaf node models (Stan, Joey, Galen Patrick, Susan, Katy Holck (pub health, lab), Donna Redley RN informaticist). See 2015 Models.opencimi.org as baseline
      • Work needs to be done to improve the quality (value sets)
      • Include validation (compare CEM-LOINC (axes) structures to CIMI & FHIR)
        • e.g., fetus.heart
      • Start with highest volume and most used data elements
      • Use the SNOMED description logic maps that were generated as part of the SNOMED – LOINC agreement
      • Use of the “invariant” anchor patterns, Grahame’s “dictionaries”, abilities to do transformations of instance data
      • Claude – hierarchy of types: quantitative, coded, ordinal lab, detailed clinical models
    • Vital Signs
      • CIMI models for vitals map-and-gap against FHIR models
      • Compare/validate to/with US Core/FHIR Core, Intermountain CEMs, MHS Cerner, VA
    • Document refset requirements (intensional, extensional) for CIMI binding and tooling
      • STAMP versioning, implications of versioning and model dependencies for concepts that are referenced in CIMI models – Susan Matney
    • Clarification of binding – static versus dynamic binding, and related issues, allows conformance testing, binding in abstract types – Rob McClure
    • Further flesh out core reference models – Claude
      • Allergies/Intolerance/Adverse events (Claude working with Russ)
      • Action (flesh out stub that is in the May ballot)
      • Event (flesh out stub that is in the May ballot)
      • Medications: order, administration, dispense (FHIM)
      • Devices (FHIM model very mature IAW V3 & FHIR, pull in device WG)
        • Claude: governance issue
        • Wait on devices till medications done
      • Subtyping of results for radiology and imaging
      • Care plans (Richard: CDS & CQI working on this)
        • Susan & Stan: Multiple patterns (panel on observations)
      • Harmonizing with QDM, FHIM, FHIR, CQI, VMR
    • Tooling (Claude)
      • Galen: CIMI do reference-archetype models, in BMM, and crowd-source foundational patterns & DCMs
        • BMM level 1-3, Data types, foundational models, (FHIM) clinical architypes
        • BMM “constraint” level 4: Patterns & semantic anchors (Who is responsible? (CIMI vs crowd-source)
        • BMM “constraint” level 5: DCMs
      • Generation of FHIR profiles from CIMI models
      • Model authoring tools
    • Generate BMM from harmonized FHIM, (Galen harmonized FHIM target date July 1)
    • Model request spreadsheet import (Susan & Richard)
    • Strategy for testing of models (Stan)
    • Pharm (Claude): CIMI vs. pharmacy models. Claude & Galen meet during Pharm meetings to align patterns and FHIR resources and patterns. Pharm be source of requirements and own the harmonized logical models.
    • 2018 Option (Richard): Extend process to radiology
      • Radlex orders and results/findings separate; where, findings are lower quality
      • NANCY: shared procedure file in 2018-2019.
      • Map LOINC to CIMI DCMs
      • Tooling, databases (SNOMED & versioning) and process guide for scaling concept creation, distribution, CIMI binding-and-refsets (in SOLOR),
  • Any other business
  • Future topics
    • Loading of concepts into SOLOR – Susan Matney
    • The SOLOR Conundrum – Steve Hufnagel
    • Review CIMI Observation Result pattern - Stan
    • How will CIMI coordinate with DAF? - Claude
    • Granularity of models (schematic anchors) – from Richard
    • We need a way to identify the focal concept in indivisible and group statements
      • We would probably use the new metadata element
    • New principle: Don’t include static knowledge such as terminology classifications in the model: class of drug, invasiveness of procedure, etc.
    • Proposed policy that clusters are created in their own file – Joey, Stan
    • The role of openEHR-like templating in CIMI’s processes - Stan
    • IHTSDO work for binding SNOMED CT to FHIR resources – Linda, Harold
    • Which openEHR archetypes should we consider converting to CIMI models?
    • Transform of ICD-10 CM to CIMI models – Richard
    • Others?
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