2017-08-14 FGBSGB concall

HL7 TSC FGB Meeting Minutes Location: cGoToMeeting ID: 136-494-157		Date: 2017-08-14 Time: 4:30 PM U.S. Eastern
Facilitator:		Note taker(s): Anne W.

Quorum = Chair plus 2				yes/no
Co-Chair/CTO		Members
x	Lorraine Constable	x	Grahame Grieve		David Hay		Lloyd McKenzie (FMG)
	Dave Shaver		Ewout Kramer		Cecil Lynch (ArB)	x	Paul Knapp
	Wayne Kubick	x	Calvin Beebe	x	Austin Kreisler	x	Mary Kay McDaniel
x	Thom Kuhn
observers/guests
			Anne W., scribe

Agenda

• Roll call -
• Agenda Review
• Discussion Topics
  • State Machine Alignment Issue
    • Problem Statement -
      • CDA recognizes both instance (record) status and business status.
      • Lisa's mapping from CDA to FHIR identified that the status element in resources maps to on or the other, and sometimes both
    • CDA perspective
    • FHIR perspective
    • SGB perspective
    • Recommendations / next Steps

Minutes

• Called to order at 4:37 pm Eastern
• Discussion Topics
  • State Machine Alignment Issue
    • Problem Statement -
      • CDA recognizes both instance (record) status and business status.
      • Lisa's mapping from CDA to FHIR identified that the status element in resources maps to one or the other, and sometimes both
    • CDA perspective
    • FHIR perspective
    • SGB perspective
    • Discussion:
      • Concern about safety or loss of information when mapping. SGB concern is that there would be a clear and safe understanding of how one implements these concepts, and how we do so in a manner that is safe and easy for people to consume. If we can't have rigid patterns, then we need to make that clear to people, with good documentation of what is possible. Would like to see translatability between standards families. Is there a patterning that people are using or should be using around Status?
      • No particular rules around Status, although we give it a high level of inspection. There is a canonical code system. Every Status code has an equivalent mapping to the canonical list of Status codes, although there are problems with that mapping. When you define a status code, you create localized mappings. Grahame wants to review the list of resources for elements that should be brought into that system but aren't named as Status. Committees have some constraints but they have freedoms as well. Committees must describe how things entered in error are handled.
      • Discussion over whether all resources have a status. Grahame notes that Specimen doesn't. The main pattern variation is to have a single status code of whether it's active or not.
      • Grahame presents and reviews canonical status codes for FHIR resources. Regarding Lisa's concerns - we don't want to be in a position where there's an obvious mapping between CDA status codes and FHIR status codes. But any real requirements that are implemented on status codes in CDA are real requirements for the FHIR resources. The business goal is that the requirement is met but there's not necessarily a simple mapping. Anything that is a real use care for CDA is a use case for FHIR and must be met somehow. Because CDA has 8 clinical statement-based resources and FHIR has 30-40 resources, there's not a 1 to 1 mapping. No definitive mapping from medication, for example, because pharmacy split it in FHIR. Paul: Perhaps it has to come down closer to the use case rather than at the higher level. Grahame: In CDA you need to do the mapping at the template level to a FHIR resource. Sometimes you need to do a profile and then map to that.
      • Discussion over RIM mappings; will probably only map backbone elements.
      • Need to help guide Lisa to continue her work, giving her the guidelines on what is rigid and what isn't. Grahame: At the mapping level, we provide a bunch of resources to help with your mapping. Issues can be brought back to methodology.
        • ACTION: Grahame will create position statement for review and eventually publication on the CDA page under interoperability considerations on the FHIR page.
        • ACTION: Anne to add to Monday FGB lunch agenda and invite Lisa to that meeting.
• For next call: FHIR life cycle

Next Steps

Actions (Include Owner, Action Item, and due date)

Next Meeting/Preliminary Agenda Items 2017-08-28 FGB concall

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