2017-12-20 FMG concall

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HL7 TSC FMG Meeting Minutes


(voice and screen)

Date: 2017-12-20
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 Paul Knapp x Anne W., scribe
Josh Mandel x John Moehrke x Brian Pech
x Grahame Grieve x Peter Haug, Bryn Rhodes


  • Roll Call
  • Agenda Check
  • Minutes from 2017-12-13_FMG_concall
  • Action items
    • David to give Todd Cooper a deadline on updating Devices on FHIR track
    • John Moehrk will flesh out the scenarios for IHE on FHIR
    • Paul to complete financial track
    • David to foward questions on OccupationalDataforHealth Resource proposal to WG for discussion on upcoming call or in New Orleans
  • Review Items
  • Discussion Topics
    • Upcoming holiday call schedule
  • Reports
  • Process management
  • Parking Lot
    • 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 in January
  • AOB (Any Other Business)


  • Roll Call
  • Agenda Check
    • Grahame adds publishing-related items
    • MOTION to accept: Lloyd/Grahame
  • Minutes from 2017-12-13_FMG_concall
    • MOTION to accept with IHE on FHIR issue marked as complete: John/Brian Post
  • Action items
    • David to give Todd Cooper a deadline on updating Devices on FHIR track
      • Reached out again; haven't heard back. Is virtually empty.
        • ACTION: David to tell Todd that it will be completed by someone else if it isn't completed.
    • Paul to complete financial track
      • Carry forward
    • David to forward questions on OccupationalDataforHealth Resource proposal to WG for discussion on upcoming call or in New Orleans
      • Has heard back; they said that they are going to discuss it further and would like to discuss in New Orleans. Carry forward.
  • Review Items
    • Arden Syntax for Medical Logic Systems v3.0 - Peter Haug to join to address previous questions/concerns
      • Peter Haug and Bryn Rhodes here to discuss. Lloyd: The primary question is how this relates to the other clinical decision support work represented in FHIR, and what degree of overlap there is between the two approaches; if there is overlap, why both? Peter: This project is not about the internal logic, the essential arden syntax; it's about the curly braces. We do need to have a discussion about harmonization. Lloyd: We understood that this project didn't include that exercise, but if FHIR is identified as the solution to the curly braces, which then creates a problem where we have two clinical decision support mechanisms in FHIR. Discussion over how to approach the issue. Peter suggests working on them as independent problems, creating a separate PSS to deal with the harmonization problem. Hans: to fix the problem with FHIR, we then have two variants in the same states; would have to solve the problem of what the roles of each variant is. Lloyd: the question is what is the benefit to industry of us adding Arden Syntax into the FHIR mix, and we need to have a clear understanding of that. Peter: There are a number of implementations of Arden, and those folks would like to have a standardized description of how to use FHIR. Lloyd states we need to only do Arden or only do CDS rather than have two competing alternatives that don't interoperate. Peter states that they are looking to take advantage of other standards from HL7 and other organizations to enrich the Arden environment; they've been focusing on FHIR lately to solve the curly braces issue, but it might be valuable to do a little brainstorming to see what the best way is to get a harmonized model across the different standards organizations. Would like to do it in a step-wise manner. Grahame: How many Arden implementations are there? Peter: There is one in the Siemens world, an Austrian one, a few open source ones, the Regenstrief ones have used one, and there are a couple of others around; they are well appreciated by the users. Grahame suggests adding CDS as a cosponsor as Arden is essentially a subgroup of CDS. Bryn: When we did the CQL work, we did create a mapping from CQL to Arden. The primary motivation of not using Arden were issues with readability. Are you asking for CDS and Arden WGs to get together and figure out the best way forward? Lloyd: That would be my preference, so we can provide clarity to the implementer community. Peter proposes that we move this PSS forward with the intention of including those explanatory paragraphs and that we create a project with the goal of downstream harmonization of the various standards expressing logic in this environment. Lloyd asks to amend the PSS: note in the scope section that it will include an exploration of the inter-relationship of Arden syntax and the CDS FHIR artifacts, and include CDS as a cosponsor.
      • Separate issue is that the PSS notes a Normative FHIR standard. Lloyd notes that FHIR will start the normative process with R4, which will be Patient and Observation. Others won't go normative until at least R5 and others not until R8. Lloyd suggests they follow the STU process for awhile to make sure that it's working well before locking it into Normative. Peter agrees.
        • MOTION to approve the PSS contingent on adjustments for the scope to reflect the inclusion of a description of the relationship between Arden Syntax and other FHIR CDS artifacts; that CDS agree to be a cosponsor; and that the timeline for publication allow for STU implementation and recognize a dependency on FHIR infrastructure resources being normative before the curly braces FHIR syntax can be normative: Lloyd/John
        • VOTE: All in favor
  • Discussion Topics
    • Publishing-related issues from Grahame
      • Grahame has been busy doing publishing and there are several issues to consider.
        • At least one group of editors have been using the wrong IG publisher. Also are submitting them using a different process than we've been using. Need quality criteria for the presentation of a FHIR implementation Guide. There is also a broken link that refers to an old orphaned version of the IG publisher. Lloyd: We need to update STUs 2 and 3 to point to the current version. Discussion over whether that's a technical correction. Decision that it's not a technical correction since it's not an error in the specification itself. Lloyd states we should get Wayne's blessing that it's not a correction to the spec, it's support information and we're simply updating that information.
          • MOTION that FMG approves the update if Wayne agrees: Grahame/Brian Pech
          • VOTE: All in favor
        • Information requirements for publishing: Lloyd notes that we have an IG proposal on the site that we could adjust to reflect Grahame's stated requirements.
          • ACTION: Lloyd to update the IG proposal template to include Grahame's requirements.
        • Will not accept requests unless the IG is using the IG auto-publisher; no more submissions from Simplifier. Another issue is material that is not under the Github repository controlled by HL7. Reviewed the Simplifier-submitted IG (Personal Health Device Data IG). There needs to be visual consistency - is radically different than our usual IGs. Will have to sit down with the Simplifier team to discuss parameters. Lloyd agrees that consistent look and feel is important to the community; it's also a branding issue. There is no HL7 logo on the Simplifier material. Will meet with Simplifier folks in New Orleans.
        • Ballot artifact names: they are designed for internal process management and ANSI, rather than intuitiveness by the implementer community. FHIR is called FHIR Release 1, draft for comment 4. US Core is HL7 FHIR Profile: US Core Release 1 STU Release 2. Fundamental problem is that artifact naming ignores how things actually work. The title should make sense from a balloter perspective. Product naming scheme is based on fallacy. Need to take up with TSC. Calvin has been most deeply involved in the naming algorighm.
          • MOTION that FMG asks TSC to revise the artifact naming algorighm so people can understand it: Grahame/Lloyd
          • ACTION: Lloyd to put together a revised algorithm for review
          • VOTE: All in favor
    • New Orleans
      • Grahame would like to take the FMG Monday lunch meeting to have town hall meeting with committers. Discussion over whether the FMG meeting needs to be rescheduled. Decision to evaluate as things arise.
        • ACTION: Grahame to contact Mary Ann and Andrea with the change.
    • Upcoming holiday call schedule
      • Cancel 2017-12-27
      • Will meet 2017-01-03. Anne will be out.
        • ACTION: Anne to send GTM login information to David/Lloyd
  • Reports
    • Connectathon management (David/Brian)
      • Had a meeting with Sandra from AEGIS re: the attendee survey and a presentation for track leads encouraging them to host webinars prior to the event.
      • Currently have about 60 registered
    • FGB
      • Haven't met
    • MnM –
      • Agreed to have as STU the two datatypes that had already been published as STU rather than Normative.
    • FMG Liaisons
      • No report
  • Adjourned at 5:28 pm Eastern

Next Steps

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

2018-01-03 FMG concall

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