20150706 FGB concall

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HL7 TSC FGB Meeting Minutes

Location: call 770-657-9270 using code 985371#
GoToMeeting ID: 136-494-157

Date: 2015-07-06
Time: 4:00 PM U.S. Eastern
Facilitator: Note taker(s): Anne W.
Quorum = Chair plus 2 yes/no
Co-Chair/CTO Members
Woody Beeler x Lorraine Constable Grahame Grieve David Hay
Regrets Dave Shaver x Ewout Kramer Cecil Lynch (ArB) x Lloyd McKenzie (FMG)
x John Quinn x Calvin Beebe .
observers/guests Austin Kreisler
Anne W., scribe


  • Roll call -
  • Agenda Review
  • Approve minutes of 20150629 FGB concall
  • Action Item review:
    • Lloyd to forward DSTU numbering policy revision request to FGB once the document is ready
    • Anne to circulate precepts and governance document to group for revisions
    • Anne to look through past minutes regarding what "conformity assessment" means
  • Discussion Topics
    • Discrepency over the nature of FHIR.org
  • FMG update -
  • Methodology update-
  • Review precepts, associated governance points and risks
  • Next steps: Define and Resource other Governance processes.
    1. Conformity Assessment


  • Convened at 4:06
  • Agenda review. Additions? Lloyd: proposed plan for deadline around resources; will discuss under FMG update. MOTION by Lloyd to approve agenda; Calvin seconds. VOTE: Opposed: none. Abstained: none. In favor: all.
  • Minutes from last week: MOTION by Lloyd to approve; second by Calvin. VOTE: Opposed: none. Abstained: none. In favor: all.
  • Action items:
    • DSTU numbering policy revision: ongoing discussions about internal numbering.
    • Group will review precepts document this week
    • Conformity assessment: Anne dug out some minutes from last June discussing conformance testing. John Q. says this could be related to government/ONC rules. Lorraine states conformity assessment means something to her in terms of SAIF. Group agrees to leave it off the agenda for now until it becomes potentially necessary to add back in at a later date.
    • FHIR.org discrepancy: Confusion from TSC when Lloyd gave a different account than Chuck did regarding scope of FHIR.org. Will be discussed at retreat and brought back to this group in August.
  • FMG update: Lloyd states that FMG is looking at resources and profiles that don’t have proposal submissions behind them. In changing deadline to August 31, there was recognition that not all resources in all WGs would be complete by then (with reconciliation or changes applied). We did flip expectations on QA; QA is an expectation to meet FMM level 3, but reconciliation and resulting changes need to be completed. Some WGs may not get there with all of their resources. Those resources would be dropped to draft status in the publication and have them considered for future use. Is there comfort within FGB regarding this approach? WGs in trouble include Patient Care, O&O, and FIWG. Calvin wonders if any of the resources that Argonaut is focusing on those that are potentially at risk? Lloyd states that DAF is relatively safe, QI core is less so. May be a few resources like diagnostic request that will end up being draft on the ground that they are orders related. Orders resources are subject to significant revamping in 2.1. Lorraine: there are key resources that we need to have out of the draft stage before we publish. Lloyd: we have to figure out order workflow, which isn’t scheduled to be dealt with until 2.1. Cannot stabilize prescription without dealing with order fulfillment. Grahame is unsure why medication prescription must be included in that. Lloyd states that WGs are dealing with the issue differently. Prescription may change less than some of the other resources, but that remains to be seen. Grahame disagrees on the approach.
    • The agreed scope for 2.1 draft material was all of the financial resources (most won’t be ready), the consent directive piece (which will be completely removed), and all of the resources involved in orders and workflow, which include (Anne missed a few): referralrequest, prodcedurerequest, medicationprescription, order and orderresponse, supplyrequest, deviceuserequest, communicationrequest, and visionprescription. Lorraine states this seems like a major part of the clinical space. Grahame states that medicationprescription is separate process-wise. Lloyd states that the clinical portion of medicationprescription is not volatile. The status on prescription is volatile and the way prescriptions differentiate themselves as being actual orders vs. proposals vs. plans and the way you distinguish between order types are all very up in the air. It may be that 2.1 gets handled by a wrapper, or that it gets handled by additional elements on medicationprescription. And it may be renamed in 2.1 as it does not make sense to implementers as a proposal or a plan. Grahame states that this is a major problem if prescription is not stable. 2.0 may not be useful if workflow piece isn’t stable. Lorraine: should we ask for prioritization on this? Lloyd: we’d have to slip the schedule for 2.0 to include at least the workflow portion of 2.1 and publishing 2.0 later.
    • How much later would that be, and what are the impacts? Lloyd: the intention has been to test a little bit of workflow around the scheduling piece, but that’s a different fulfillment model. 1) Do we want to make workflow changes and then publish without balloting, and 2) Do we want to make workflow changes and publish without doing a Connectathon. We’ve had notional concepts of these issues but there are too many inconsistencies. Lloyd thinks we should proceed with 2.0 and 2.1. 2.1 will need Connectathon and ballot cycle. In the meantime you’re free to implement prescription and referral for non-workflow purposes and the workflow portions of them are subject to change. Grahame to research prescription to look for workable compromise. Lloyd cautions against having the workflow of prescription ending up different than other workflows.
    • FMG updated assignment sheets.
  • USR-SC discussion re: FHIR resources, etc. Anne displays minutes from last call where they started to address the issue. Group agrees it does not entirely address the issue. Will be discussed on future calls.
  • One question as we look at the circulated precepts document is changes based on current events.
  • Call adjourned at 4:58

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