CGIT concall 20151102

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Meeting Information

Proposed Agenda Topics

  • Standards Development Organization Collaboration to Enhance Standards Alignment, Testing, and Measurement
  • Review of open issues

Meeting Minutes


  • David Hamill
  • Nathan Bunker
  • Rob Snelick
  • Frank Oemig
  • Karen Van Hentenryck

Items Discussed

  • Expand on a project that Dave is leading on a project through ONC (US Federal Government).
    • Looking at gaps in conformance tools.
    • Perform a conformance tool gap analysis. Touch base with this workgroup to get us involved as an RFP is developed to do the work. Both internal and external conformance tools.
    • Discussing with HL7 members about internal tools and also know there are external tools. Want to understand were we are.
    • RFP will identify all the tools, their usefullness, gaps, and recommendations on how to fill these gaps.
    • Questions:
      • (Q) What standards groups does this include? IHE, DICOM, HL7? Has ONC identified certain standards? Only the ones in the MU rule? Or a broader scope? That will change these for the scope. (A) Scope will be US Domain standards, that is what they want in the catalogue. Probably focused on MU. Potentially what they see on the roadmap? Probably anything in the S&I framework is probably in their scope. Lab was not named, but they are certainly on the roadmap with or without incentives.
      • (Q) You call this a testing infrastructure. Is this multiple systems or monolithic? A common infrastructure might be difficult to obtain. Maybe multiple infrastructures? (A)Dave would have to agree that it would be multiple. ONC is using "infrastructure" as a net to grab all of the components of testing. In the report we can provide recommendations on the infrastructure. Pulling this together is daunting. Things have to remain separate, can pull the execution together with a tool. But the basic testing infrastructure is separate. There is also things like external validation services that can be accessed as a core functionality. Things can be put on top of that.
    • Recommendations for Report from CGIT
      • Keep track of the quality of the standard specification and the quality of the conformance tools of themselves. How well you can do it depends on the quality of the standard. In our experience the standards vary significantly. HL7 is generally a framework in which further constraints are being developed to create specific standards.
      • A general direction that organizations should be going is to create standards with tools that codify requirements from the start. In v2 there was the Message Work Bench. NIST is building the Implementation Guide Authoring Management Tool. If you can create standards using these tools then validation comes for free. Assuming that FHIR is going in this same direction as well. Should be built into it, but not quite sure with FHIR.
      • The need for FHIR is much higher because of extensibility, much more than V2. There needs to be more work in this direction. The way we are testing today is not deep enough, we are still on the surface.
    • Quality of Standards
      • Want to piggy back on an Hans Buitendijk's work on the Standards Maturity model. Lots of metrics that go into consideration. Have to be careful on metrics when trying to quantify maturity.
      • Hans wants to conduct a survey. Based on the timing, might add some questions to his survey. Would like CGIT to help draft some survey questions for this.
      • If assertions have to be written by hand then maintenance will be a nightmare. This is a key factor of determining the capability and quality of the testing infrastructure.
    • Dave's thoughts:
      • At some point we will have to issue an RFP. Karen and Dave will work on RFP and then have CGIT help refine the plan. Karen and Dave will take first pass on this.
      • Talk about drafting some survey questions. Not sure how many we would want to create. It would be easier for CGIT to react to a strawman document. Dave will start this.
    • The big reason is so we know this is coming down the pipeline, and want CGIT to be part of the scoping of this.
    • Timeline: 12 month project. April of next year need to provide ONC with a draft of recommendation report. With this particular work we are hoping to get RFP out in the next month or so. Need to have someone onboard working on RFP in mid-December.
    • The report has more than the gap analysis. Three different components.
  • Open Issues
    • RNCnL is now out-of-scope, Nathan will work to close it.
    • Project with Vocabulary.
      • Binding Syntax: ongoing work Rob and Frank attend this meeting.
      • V2 Code Table project: ongoing work, Frank is doing the heavy work on this.
      • Terminology Quality Assurance: Rob Snelick participates in this, there has been two calls, just getting started.
    • Organization of HL7 v2 chapters. Don't have time and resources to move too much forward on this. Conclusion was that as Frank creates HL7 2+ then this would be the timeframe in which we would do this. Still a little bit out there? After closing HL7 2.9, this will take until May 2016. Then we go to ballot. Using the same timeframe to prepare what comes next after that. Frank is thinking about generating what is needed out of his database.
    • Conformance concepts in FHIR. Need to discuss, not now, but later. They have changed how this works. We need an eye on this to make sure they are doing this right. Frank is currently looking at this.
    • Health Group Maintenance: Need to resolve RCnL status and cleanup others as well.
  • Next call we should revisit our January WGM agenda. Need to re-arrange the demonstration of tools.
  • Discussing the utility of the tool gap RFP. A small step in the direction. Discussion about registries for standards.

Todo Items

  • Nathan
    • Locate and/or prepare SWOT for review at Jan WGM
    • Continue to work on resolution to workgroup health items, look at RCnL and other projects
    • Close RCnL project
    • Work on website, clean it up
    • Add review January WGM agenda for next week meeting

List of Open Issues

  • RCnL Update (out-of-scope, so remove)
  • Review of projects with Vocabulary
  • Separating conformance in Chapter 2 so it can be tracked separately from the HL7 version releases
  • Conformance concepts in FHIR (current status is available as Wiki page)