2017-09-27 FMG concall

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HL7 TSC FMG Meeting Minutes

Location:
https://global.gotomeeting.com/join/279790597

(voice and screen)

Date: 2017-09-27
Time: 4:00 PM U.S. Eastern
Chair: Note taker(s): Anne W.
Quorum = chair + 4 yes/no
Co chairs x David Hay x Lloyd McKenzie
ex-officio Lorraine Constable,
Dave Shaver
FGB Co-chairs
. Wayne Kubick, CTO
Members Members Members Observers/Guests
x Hans Buitendijk x Brian Postlethwaite x Paul Knapp x Anne W., scribe
x Josh Mandel x John Moehrke x Brian Pech
Grahame Grieve x Brett Marquard, John Loonsk, Peter Jordan, Eric Haas

Agenda

  • Roll Call
  • Agenda Check
  • Minutes from 2017-09-20_FMG_concall
  • Action items
    • Lloyd to put together a draft template for IG proposals and clean up some of the profile proposal template
    • Josh and Grahame to document process of hosting materials for ballot review on Github
    • Paul to take proposal on publishing ballot content on Github/other tools to TSC when available
    • Hans to follow up with Lorraine/Eric/Claude re: attending upcoming meeting to update on CatalogEntry
    • FHIR-I to review TestReport proposal and bring back to FMG
    • Anne to notify CQI of errors that need to be fixed on HL7 FHIR® Profile: Quality, Release 1 - US Realm before it can go forward
      • Complete
    • Anne to go through WGs to see who doesn’t have PSSs for R4 development.
    • Grahame to invite Peter Jordan to FMG call to discuss HL7 International Council wiki page listing FHIR artifacts
  • Review Items
  • Discussion
    • Question of payer representation on FMG
  • Reports
  • Process management
  • AOB (Any Other Business)

Minutes

  • Roll Call
    • Guests: John Loonsk, Brett Marquard, Peter Jordan
  • Agenda Check
    • MOTION to accept: Lloyd/John
  • Minutes from 2017-09-20_FMG_concall
    • MOTION to accept: Lloyd/Brian Post
    • VOTE: All in favor
  • Action items
    • Lloyd to put together a draft template for IG proposals and clean up some of the profile proposal template
      • Add for next week
    • Josh and Grahame to document process of hosting materials for ballot review on Github
      • Add for next week
    • Paul to take proposal on publishing ballot content on Github/other tools to TSC when available
      • Add for next week
    • Hans to follow up with Lorraine/Eric/Claude re: attending upcoming meeting to update on CatalogEntry
      • Add for next week
    • FHIR-I to review TestReport proposal and bring back to FMG
      • Add for next week
    • Anne to notify CQI of errors that need to be fixed on HL7 FHIR® Profile: Quality, Release 1 - US Realm before it can go forward
      • Complete
    • Anne to go through WGs to see who doesn’t have PSSs for R4 development.
      • All to review. Anne to add project end dates.
    • Grahame to invite Peter Jordan to FMG call to discuss HL7 International Council wiki page listing FHIR artifacts
  • Review Items
    • US FHIR Core PSS
      • This update adds three new profiles.
      • Advised to describe compatibility issues
        • MOTION to accept: Lloyd/Brian Post
        • VOTE: All in favor
    • Cross Paradigm UDI Harmonization PSS
      • Hans describes project. David suggests spelling out UDI in the first instance.
        • MOTION to accept: Hans/Brian Post
        • VOTE: All in favor
    • Transplant on FHIR PSS
      • Hans describes project. Needs repository link. Also tracking down external vocabularies. Discussion over project intent section - is it revising a current standard?
        • MOTION to approve: Lloyd/Hans
        • VOTE: All in favor
    • FHIR Electronic Case Reporting (eCR) PSS
      • John Loonsk here to represent project.
      • Lloyd notes that any dates in the 2020/2021 space are highly subject to change. Discussion over whether an updated PSS might be preferable for that time frame. Decision to leave it for the time being.
        • MOTION to approve: Lloyd/Hans
        • VOTE: Josh abstains. Remaining in favor.
    • OASIS HAVE 2.0 Alignment with HL7 PSS
      • ACTION: Add for next week
    • MedicationKnowledge Resource Proposal
      • ACTION: Add for next week
    • SubstanceSpecification Resource Proposal
      • ACTION: Add for next week
  • Discussion
    • Peter Jordan here to discuss the Affiliate Governance of Localised FHIR Artefacts page that FMG reviewed last week.
      • Lloyd: We want to be sure that people don't think this suggests constraints on development. There can be policies around having things blessed/endorsed/enforced if there is regulatory pressure to do that, but one of FHIR's primary benefits is if you need to send something, you can send that with an extension without having a lot of overhead. Peter: We're not seeking to limit the use of FHIR, but we want to have national level profiles which would be more additive than constraining. We don't want to constrain resources. We're keen that we don't see a whole lot of conflicting profiles and stuff done that would thwart interoperability. Need to look at if they're common processes. One thing that's really important is that whatever is done under the name of FHIR is actually FHIR - that the profiles are conformant with the standard. Lloyd: There are now pieces that drive people toward conformance. Even though people write whatever they want, it's much easier with FHIR to demonstrably say it is or is not conformant. Peter agrees that will help but no one really believes that you'll get guaranteed compliant implementations without some governance. Lloyd: The question is, what is the role of the affiliates in trying to guarantee compliance? There will be roles for doing compliance testing against specific IGs in specific communities, but against FHIR in general, trying to do conformance testing at that level doesn't buy you much. Peter: We don't want 15 different NZ extensions for ethnicity - we just need one. The rule is that no one but the affiliate can call something an XX localization. That's the only rule. Lloyd: We cannot and should not prevent people from creating 15 different extensions for the same thing. We have to encourage behavior from within the community rather than demanding it from the outside. David: If we make it obvious that here's the extension for ethnicity, for example, people will use it. If they don't, the fault isn't governance, it's visibility. Lloyd: FHIR Is unconstrained by design and is intended to be. From a policy perspective, the FMG would not support a notion that you can't define an extension without getting approval from your affiliate. You have to be able to create an extension at midnight on Tuesday for use in your system on Wednesday if you want to. You can define processes around recognition, endorsement, best practices; but you can't say there are bounds on creating duplicates. Hans asks why we would add more constraints now than we've had before? Peter notes issues from the past with V2. Needs to be conformity and regulation by an organization. Not trying to be prescriptive; we're looking at what's happening out there. Countries handle things differently. Lloyd: The language around localizations being the responsibility of the affiliate organization is what triggered me. If that's interpreted as defining an extension, that would be hugely problematic. Peter: That's not what we're saying. We're saying those that are published as an HL7 standard are the responsibility of the affiliate organization. Lloyd states that needs to be better defined. Peter: At the next meeting we'll discuss at International Council; will bring back this advice.
    • Question of payer representation on FMG
      • There are some vocal folks in payer community that would like a payer representative on FMG. Approached Wayne about how to make that happen. Lloyd feels that there are lots of different stakeholder groups for HL7 standards, payers being one of 10 or 20, and while it's tempting to have them all at the table, it would be challenging. Brian Pech notes that Kaiser is classified as a payer. Lloyd: FMG isn't really about external consumers of the standard; we care, but our primary purpose is to manage the internal organization. Our focus is making sure we have people who are aware of and can talk to the areas of work inside HL7 so we can manage the production of the specification. Not sure FMG is the right place to look for that sort of external consumer representation, certainly not with the granularity of payers vs. EHR vendors, etc. May be appropriate for FMG to have a representative who can speak to the implementer community at large, but I think we have enough people who are directly implementing as one of their hats that we've got that relatively covered. Hans asks for the criteria for FMG members we've used in the past? Would payers fit in that criteria? Lloyd: We did put together a document that described our terms of reference. Hans: It would be helpful to reference that. Lloyd reviews Mission and Charter. All of the requirements listed are internal facing requirements regarding knowledge of and the ability to interact with the organization - not about the consumers of the FHIR spec. Wayne's emails states that Chris Johnson was nominated at one point who observed several times but didn't participate. Lloyd: FMG is about management of the standard, which is coordination of the WGs, managing publication, resolving disputes between WGs - not about needs of the external stakeholders. External stakeholders should be engaging at the WG level. John: We have not applied any prioritization to our approval or disapproval of any projects. Lloyd notes that the board has an advisory group that payers should have a seat at.
        • MOTION that FMG is focused on internal management of the products, and that external representation is most effective at the WG and Board advisory committee levels: Hans/John
        • VOTE: All in favor
          • ACTION: Anne to repost FGB mission and charter - link is broken
  • Reports
  • Process management
  • AOB (Any Other Business)


Next Steps

Actions (Include Owner, Action Item, and due date)
Next Meeting/Preliminary Agenda Items

2017-10-04 FMG concall


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