2018-02-01 FMG FGB WGM

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HL7 TSC FGB/FMG Meeting Minutes

Location: Parish - 3rd Floor

Date: 2018-02-01
Time: 3:30 PM
Note taker(s): Anne
FGB Co-Chair/CTO Members
Lorraine Constable x Grahame Grieve David Hay
Dave Shaver x Ewout Kramer x Lloyd McKenzie (FMG)
Wayne Kubick Calvin Beebe Cecil Lynch
FMG Members
Hans Buitendijk x Brian Postlethwaite x Paul Knapp
x Josh Mandel x John Moehrke x Brian Pech
observers/guests x Bob Bishop, Richard Ettema, Dennis Patterson

Drew Torres, Amnon Shabo, Rick Geimer
Phil Lanthorne, Reinhard Egelkraut, Linda Michaelson
Eric Haas, Michel Rutten, Christiaan Knaap



  • Roll Call
    • Guests listed above
  • Agenda Review
    • Agenda approved
  • Discussion topics
    • Resolution of pharmacy / BR&R resource discussion
      • BR&R and pharmacy submitted PSSs to support IDMP and medication knowledge. The groups got together and found areas of commonality. BR&R are going to refactor resources they have into smaller components. Will be resubmitting proposals for evaluation.
    • PatientAnimal
      • Brian Post states they’re looking at the PatientAnimal; PA wants to take it out as an extension. It’s not actually a modifier of the Patient resource. Do support the concept that we want to retain the definition and properties as a standard complex extension and want to include an additional notes section to describe how the animal resources fit in with Patient. Grahame: Do have to go to community consultation. Will publish on Monday and give people two weeks to comment. Brian will write it up. Brian notes that the default value is affected as well. Lloyd: People are making different interpretations, and there’s not a clear way to assert the patient is human. If data if coming from a system where it’s relevant, they don’t have the necessary information. Grahame asked if they considered collapsing the information into a species field? Brian states they haven’t. There’s a v2 field for species. Grahame will ask people to submit comments; he’ll collect them and pass them on to the chairs. The committees will respond in minutes and Grahame will pass the information back. Lloyd would like to see veterinary medicine stay in scope and make it clear what species the patient is. Shifting animal to be a single element is a legitimate thing to do. Discussion over whether it would be carved out of Normative content. John states an opinion that it should really be an extension.
        • ACTION: Brian to write up proposal for community consultation
        • ACTION: PA to consider other alternatives for Animal
    • Consent resource
      • John states that Brian added a CR to remove Patient from Consent. Lloyd: Subject could be optional. Brian has a use case where he doesn’t want to specify a patient. Happy to have a subject but it won’t be a patient. Lloyd; Allowing the scope to broaden seems reasonable. John notes that the original scope of the Consent resource was privacy consent, advance directives, consent to treat, etc. Ramification is that Consent becomes a resource which has data access use rules. May need a common rules section used in multiple places. Discussion over solutions. Lloyd: Does anyone have concerns about expanding the scope of consent to include non-patient subjects? Grahame expresses concerns.
        • John and Brian to work together to figure out how to express what Brian wants and compare it to what is already in Consent for review with Grahame and then FMG if necessary.
    • Next steps towards ballot
      • Grahame: All committees that have FMM 4 or 5 content will be consulted if they have substantive/breaking changes. Discussion over Patient Multiple Birth and Gender. Lloyd: Proposed documentation will help a lot of balloters, although some will still have issues. Brian notes that he expects the voters to vote the same way in the next one. Need to look at where the votes are coming from and anticipate what might be coming in May.
    • Highlights from the week
      • Grahame will be putting out a round of consultation on Monday with FHIR-I and PA issues. Ewout: FHIR-I dealing with questions around terminology. Managed to decide upon a solution. Another issue is methodological around default values. Need to remove defaults from the specification altogether to avoid incorrect implementations and query results. Will now require community consultation. Will be reviewed on FHIR-I call the week after next. Lots of conversation this week around versioning.
      • Grahame: Extensive conversation this week around clinical notes. Will be looking to drive practical experience with clinical notes in Cologne, Dev Days, and Baltimore. Customer and ONC indicate it is a top priority. The meeting was very focused on moving forward; no major turf battles. Publishing and Methodology groups for V2 and V3 spoke to Grahame about using FHIR publication tooling and techniques to do profiling in version 2 and templating in version 3. Will have ongoing work with V2 and CDA communities. By Cologne we should have made some progress. Would like to see all the tools converge to a single stack.
      • FGB voted to dissolve itself. Made the decision to honor Wayne’s guidance around minimalism and merge into SGB. Brian: Will this session continue in some fashion? Lloyd: We have the roundtable starting in a half an hour; it’s a valid question as to what the distinct purpose is between this session and that session. Grahame: It’s right to have a formal FMG session at the end of the week.
  • Review items
    • Structured Data Capture Update
      • Lloyd describes. The original project ended; this new version is being sponsored by the NLM with a focus on updating the IG to align with r4, to add some additional capabilities to questionnaire rendering, and better enable the pre-population portion and data extraction to leverage FHIR. Will migrate original project from US-specific to international. Discussion over relationship with corresponding IHE project – will be reaching out. Timeline will be evaluated – not sure May ballot is reasonable at this point.
        • MOTION to approve: Grahame/Brian Pech
        • VOTE: All in favor
    • International Patient Summary
      • Grahame asks if this project is planning a Connectathon stream in Cologne? Rick Geimer isn’t sure but will suggest to WG. Lloyd: IN terms of FHIR content, will there be engagement with the respective WGs who own those areas? Rick states that is his understanding. They also want to look heavily at US Core and remove terminology bindings. Lloyd notes that Patient Care is the only content group there that owns any resources. Would like to see more resource-owning cosponsors. Would like to see Pharmacy as an interested party at least. Expectation is that the profiles need to be reviewed by the owners of the resources that they’re profiling as per general FMM requirements.
        • MOTION to approve contingent upon them seeking the participation of Pharmacy: Paul/John
        • VOTE: All in favor
    • US Medications Implementation Guide Update – Prescription Drug Monitoring Program
      • Carry forward to next call
  • Adjourned at 5:09 pm