FHIR Escalation Processes
This page documents escalation processes related to FHIR artifacts and processes. Note that this structure is not rigid. Different groups within this hierarchy may direct issues up, down and around and may also discuss items jointly as they deem appropriate based on the nature of a given issue.
While bypassing levels in this hierarchy is possible, it is not encouraged and will likely result in a delay to the resolution of a given issue as, in most circumstances, the issue will simply be redirected to the appropriate lower level for consideration and recommendation before a higher level will consider the issue. Every effort should be made to resolve an issue within a given level prior to escallation)
The various contact points (list servers, conference call times, co-chair email addresses, etc.) for the groups listed below can all be found here: 
From lowest to highest. (Groups at the same level are peers and have the same escalation path.)
Work Group(s) FHIR Management Group (FMG) Modeling and Methodology (MnM) Steering Division(s) FHIR Governance Board (FGB) Technical Steering Committee (TSC) HL7 Board
Most FHIR artifacts and decisions are made at the work group level. Work groups are the bodies with responsibility for the artifacts produced by HL7 and typically have the broadest representation and knowledge of a particular healthcare domain. Whenever possible, issues should be addressed within the work group(s) responsible for a particular piece of content or decision. Even if a decision has already been made, a request to revisit a decision can be made provided that new information is introduced.
In circumstances where an issue spans work groups, the work groups should attempt to come to consensus through discussion amongst the co-chairs. Escalation should only occur if opportunities for resolution at the work group level have been exhausted.
FHIR Management Group
The FHIR Management Group is responsible for coordination of FHIR work across all work groups, determining timelines and scope for ballots and publications and identifying publication targets such as desired content and level of quality. They have the power to approve requests to develop resources and profiles and to determine whether profile content should be published as part of the FHIR core specification or separately.
The FMG is the first line of escalation for issues relating to FMGs scope or other issues related to FHIR process or content
Modeling and Methodology
The MnM group is responsible for the methodology around FHIR including rules, quality criteria and best practices around the design and maintenance of resources, profiles and other FHIR artifacts.
MnM should be the escalation point for issues related to any of these topics.
The various steering divisions are responsible for coordinating the activities of all work groups within their division. They should be involved in disputes between work groups that are not specifically related to FHIR scope.
FHIR Governance Board
The FGB is responsible for establishing the precepts and principles under which the FMG operates and the methodology maintained by MnM is structured. They are also responsible for the governance structures related to FHIR (including the contents of this wiki page).
The FGB is the appropriate escalation point for questions about governance processes or adherence of artifacts and other decisions to FHIR precepts and principles as well as for issues related to the precepts and principles themselves.
Technical Steering Committee
This group is the final escalation point for most technical and cross-work group issues. They are responsible for all content brought to ballot by HL7 and for coordination across work groups.
The board will consider issues related to external stakeholder groups or organizational policy. They also have oversight over the TSC with responsibility to ensure the TSC is following appropriate processes.