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MnM Minutes WGM 200709

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Sunday Q3

Agenda Topics Review/Hot Topics Triage

Grahame suggested that we address the following issues:

  • Incomplete Static Models (already a Hot Topic)
  • Templates as Semantic Markers
  • Translations in Data Types -- should we have a pattern for handling translations in the RIM
  • Add "topic" to II

Note: There is interest in replacing CD qualifier and group with an expression. This will be addressed in Vocab.

We prioritized and scheduled Hot Topics. See updated schedule posted to the list server.

The following items were decided to be addressed on conference calls:

  • ActReference - Aim to close on a conference call pending Grahame's confirmation that it is truly closed.
  • Datatype Substitution Issues
  • Model support for by reference
  • Participation
  • RIM Stewardship and Harmonization Representation -- Woody will document the resolution.
  • Serialization - Action: The reference to the document needs to be added to the HDF.

Action: Resolve outstanding action items. We will discuss this in more detail on Friday Q2.

Action: Lloyd will talk about Observation Grab Bags at the Facilitators' Roundtable.

Motion: Grahame/Charlie - MnM recognizes that the infrastructureRoot attributes may be given special treatment in the ITS. (10:0:0) -- See "TemplateId as a token" Hot Topic

Action: Craig to notify MnM about this motion and we will finalize it at roundtable.

Sunday Q4

No meeting.

Monday Q1 and Q2

No meeting - HL7 Plenary Session

Monday Q3

Joint with INM: wrappers and dynamic model

We reviewed the dynamic model discussion from the last Harmonization meeting.

Charlie presented MCAI_DM700200UV02. We discussed the addition of ConversationId. The need for ConversationId was generally agreed upon.

Conclusion #1 from INM_assumptions_with_regards_to_CPM:

INM will introduce the concept of "conversation ID" in the new controlAct wrapper to link all interactions in a conversation.

Motion: Grahame/Charlie -Move accept Conclusion #1 from INM_assumptions_with_regards_to_CPM. (motion passes, 14:0:2)

Conclusion #2 from INM_assumptions_with_regards_to_CPM:

INM will introduce the concept of "conversation code" in the new controlAct wrapper to identify the type of conversation.

Motion: Grahame/Charlie - Move to accept Conclusion #2 from INM_assumptions_with_regards_to_CPM. (motion passes, 15:0:1)

The question was raised as to wether MnM would support an ITS introducing grouping mechanisms that are not explicitly modeled at the ITS-independent level.

Motion: Charlie/Woody - MnM endorses the idea that an ITS can provide a mechanism for reducing duplication of data so long as its behavior is not predicated on the semantic model. (motion passes, 12:0:3)

Monday Q4

Joint with Templates: Ballot resolution (Incomplete Static Models; Template references by type; TemplateId for Semantic Markers)

Incomplete Static Models

There are times when we want to specify a template that enforces only a small part of a large model.

There was discussion of the whether it is appropriate to use the words "derivation" and "extension" in how the MIF relates models to each other.

Action: Craig to create a Hot Topic on "Derivation".

Motion: Grahame/Ian - Agree to the updated wording in the Extension section of the Incomplete Static Models Hot Topic (included below) (motion passes, 5:0:7)

From the Incomplete Static Models Hot Topic


  • Derivation - [no consistent existing understanding or definition]
  • Constraint/Extension - models may be constraints or extensions of other models. (models may also be incompatible)


  • Templates may be derived from a particular model, and may be related to other models as identical, constraints, extensions, or incompatible


  1. Incomplete templates are always *derived* from the RIM and are also always constraints on the RIM.
  2. A model may be applied as a template on another model if it is either a constraint or an extension (or, most usefully, both) but not if it is incompatible.
  3. Only LIMs are allowed to contain incomplete classes (for now).
  4. Incomplete templates cannot be used as expressed models

[Note that there is an pending outstanding hot topic that Lloyd will create that will further discuss the relationship between derivation, constraint and extension, but for now these rules are adopted in the interim period)

Tuesday Q1

No meeting.

Tuesday Q2

No meeting.

Tuesday Q3

No meeting.

Tuesday Q4

Hot Topics


  • Lloyd
  • Graham
  • Dick Harding
  • Kevin Coonan
  • Craig Parker
  • Woody Beeler

TemplateId for Semantic Markers

Can templateId be used to infer meaning?

Current position: No. Meaning must be understandable from structuralCodes, other vocabulary and the construction of the message. I.e., An application must not use templateId to avoid sending elements within an instance that would otherwise normally be sent to convey the semantics represented by the template.

you should gain no further understanding from a message instance by reviewing the content of the message instance than you would by looking up the templateId.

Proposed Resolution: Retain the current position.

Motion: (Grahame/Craig) Accept the proposed resolution. (5:0:0)

Can designs require that templateId be asserted?

Current position:

  • In CDA; yes.
  • In messaging; no (at least so far). Expectation is implementers must implement the full message structure. Support for templates is always optional.
  • In SOA; ???

Issues: NHS currently requires this to ensure efficient processing.

Discussion: There's no real harm in allowing implementations to require that templateIds be present. However, this must be done in the "normative" specification. Private implementations that fail to process messages no aserting local templates would be considered non-compliant.

Proposed Resolution: We will allow committees and affiliates to require that certain templates be asserted in instances. We will also allow implementations to require templateId to be asserted in instances, though such applications may be deemed to have a "reduced" level of conformance (discussions of "conformance levels" and what they constitute will be deferred to a future meeting).

Motion: (Grahame/Dick) Accept the above proposed resolution. (4:1:0)

Can designs prohibit that unknown templateIds from being present?

Current position: No. Unrecognized templates must be ignored.

Proposed Resolution: Retain the current position.

Motion: (Grahame/Craig) Accept the proposed resolution. (4:0:1)

Can implementers use templateId as a shortcut to understanding the semantics of an instance?

Current position: Unclear.

Proposed Resolution: Yes. TemplateId can be used in a similar manner to typeId, flavor and other instance markers to allow invocation of tuned processing specific to the template, message type or datatype flavor.

Motion: (Grahame/Kevin) Accept the proposed resolution. (5:0:0)

How can a template say "any template matching criteria X can go here?

Current state: We have MIF support saying "this template" or "one of these templates" must go here by using CMESs and choices of CMETs.

Proposed Resolution: Make use of the existing "stub" capability in the MIF. However, add the ability when referencing a stub to assert a "model constraint". (E.g. must have an Act.code constrained to Domain Y or some specialization.) This will limit the set of models (e.g. templates) that can be bound to the stub to be those that match both the kind of stub and those for which the model constraint is true. The addition of the model constraint will require a MIF change and will require selection of an appropriate meta-level constrain language.

Motion: (Grahame/Kevin) Accept the proposed resolution. (5:0:0)

Wednesday Q1 & Q2

Joint with Vocabulary

Requirement to submit harmonization proposals via “Russ’s Tool”

MnM Motion: MnM endorses the requirement that vocabulary “encoded” submissions be submitted using the HL7 Harmonization Tooling. Exceptions will be granted for submitters who document why it was not possible to use the tool (e.g. unable to install or make the tool run, didn’t understand how to capture their proposal, tool had a defect, etc.). If the tool does not meet entry requirements, manual XML would also be accepted. Russ to provide a template (possibly in g-Forge) indicating the type of documentation desired for capturing reasons. Technical support (Russ, Woody & Jane) will be available for members. Russ will document system requirements for installation.

Moved: AMS/Woody/15/0/3

Proposal to send concept id rather than mnemonic in messages except CS attributes

Significant discussion, concerns around whether it was appropriate to have rules that excluded structural attributes. Also concern about backward compatibility Straw poll: Agree to use concept id instead of mnemonic 10/3/2 Tabled for further discussion with others

Enhancements to v2 terminology to improve consistency with v3 approach to allow leveraging tools

Not MnMs mandate to decide, suggest talking to InM. However, in general “support” to use v3 vocabulary infrastructure in v2 is seen as a good thing. Strategic plan – how vocab will keep themselves entertained  - finalize & ballot conceptual model (bindings, etc.) - complete & ballot CTS 2 - US Realm work – develop valuesets - Permanent repository for value-sets - Policy & procedures for US value-set binding approval Balloting of binding rules

Issues from MIF alignment of LexGrid/CTS 2

No strategy for sorting codes and filtering print names in valueset definitions for use as picklists

Plans for next WGM

Want to do ballot resolution (at least some of it) as joint

Wednesday Q3

Technical Editing Project

Met with Jay Lyle and Sarah Ryan of the Technical Editing Project. Discussed the project's concerns with the RIM presentation. This lead to a fruitful discussion of the tension between a need to maintain complete documentation of the RIM in a single place and the editing objective to have multiple presentations for different sets of readers.

The editing project has prepared a "style guide" for the RIM that includes about points or principles. We adopted a motion to:

  1. "peer review" this document on the Wiki in coming weeks and
  2. to hold a detailed resolution of these comments during the Interim meeting in November, for which we hope that Jay and Sarah can be present.

Wednesday Q4

Joint with Publishing

See Publishing minutes.

Thursday Q1

Joint with INM & HSSP.

See INM minutes.

Thursday Q2

No meeting.

Thursday Q3

No meeting.

Thursday Q4

No meeting.

Facilitators' Roundtable

Schedule for the November Harmonization Meeting

  • Vocabulary Binding Clean-up - November 6
  • US Realm discussion, and Review of Technical Editing Project material - November 7
  • Harmonization - November 8 & 9


NLM Project

Ted Klein

Ted reported on the NLM CHI mapping project. They met with nine groups in five meetings this week. They are using the vocabulary tool that Russ Hamm has developed with very positive results. The resulting library of content will be flagged as having been through the consensus process and available for approval for HITSP binding. Ted needs time with Russ and Woody to address some repository issues.

One side effect of this effort is a “quality review” of the existing vocabulary. This may result in additional harmonization proposals to clean things up.

To this point, Ted has focused solely on content that is unique to a single working group. In the near future he will be addressing content that is common across working groups.

Woody brought up the related issue that it this project has illuminated some problems with certain versions of certain tools. He noted that we also need to take the time to review the vocabulary bindings in the repository and then present the results to the working groups for their validation.

Patient Care


The Allergy/Exposure model has achieved cross committee consensus and will go forward as a DSTU.

Some previous harmonization items from Patient Care do not appear to be available yet.


Austin Kreisler

Will bring forward some minor vocabulary harmonization proposals.

Lab and PHER would like to know if it is the right time to upgrade to Visio 2003/2007. Woody stated that there are no known problems. The only issue is that of sharing diagrams between different version of Visio.


Austin Kreisler

There will be some vocabulary proposals coming forward. There is also the possibility of a RIM harmonization proposal.

Patient Administration

Gregg Seppala

Balloted 13 CMETS, technically all passed, but 7 will be reballoted.

Balloted 1 topic. Will re-ballot out of cycle.

CDC wants a complete description of hospital locations. The will bring forward, through SD, a revision to the current list of locations as a US realm proposal. PA endorses this action.

PA is also concerned about some previous harmonization items that do not appear to be available.

PA found that the same concept is represented as RoleClass codes and Role codes. They will bring forward a harmonization proposal to remedy this.

PA will submit a vocabulary harmonization proposal to add codes for kinds of identifiers.


Woody Beeler

No planned changes for the RMIM designer (with the possibility of a small change to support templates)

There has been a request for analysis model data at the topic level. This will be added to the PubDb, but "desktop publishing" of this content will be provided a bit later.

No planned changes for RoseTree.

PubDB may have some changes, but they should only affect publishing.

A change will be made to the generator to fix a known bug.

Publishing requests that work groups do not submit both Visio-created XML and Design Repository content for their static model designs (RMIMs and HMDs). Pick one or the other.

Woody agreed to post (and notify various lists) a set of instructions on how to load and install each tool. The posting will include instructions for using various Windows operating systems as well as the various "flavors" of Visio.

Clinical Genomics

Amnon Shaibo

Family Hx is now approved. The next version will have a more extensive dynamic model. Many presentations about clinical decision support.

Plan a CDA implementation guide for genomics.

Have new vocabulary and publishing facilitators.

Emergency Care SIG

Kevin Coonan

Working on an update to DEEDS.


Russ Hamm

For submission of vocabulary harmonization proposals, working groups are expected to submit both the MS Word template as well as the XML harmonization tool. If people have difficulties using the XML tool, they need to document these and send them to Russ, Woody, and Jane.

Woody will provide documentation for some of the idiosyncrasies of the XML tool.

Structured Documents

Bob Dolan

Tooling request: better ability to maintain internal consistency between the many different efforts and artifacts (e.g. TermInfo and templates).

Grahame pointed out that tooling support for incomplete models would be helpful in this area.

Mark Shafarman pointed out that the tooling used by the NHS may address some of these issues.


Hugh Glover

Struggling with lack of resources. Will skip another ballot cycle for the main Pharmacy ballot. Will go ahead with another ballot for Medication. Harmonizing with SPL.

May have some “odds & ends” for harmonization.

Need to be able to spread the workload across the group more, but HL7’s infrastructure (e.g. GForge & version control) does not facilitate this well enough.


Grahame Grieve

Templates ballot nearly passed, but will go out again as DSTU for one issue.


Grahame Grieve

Abstract data types: still moving ahead. Will be bringing forward a number of harmonization proposals related to abstract data types. The abstract data types ballot will likely go directly to Membership ballot.

Grahame raised the issue of when, after passing ballot, will the new data types be effective (mandatory?)?

Grahame raised the possibility of calling the combined release of new data types, wrappers, and such v3.1.

This will be discussed in a joint meeting at the next WGM Thursday Q3.

Progress was made with the dynamic model.

There was a some discussion about getting rid of interaction ids, but it was realized that for technical reasons, this could not be done.

Java SIG

Gunther Schadow

Has an issue with the vocabulary xml file. Woody believes this has been corrected.

Anatomic Pathology

Gunther Schadow

Almost ready to ballot a CDA implemenation guide.


Gunther Schadow

Still struggling. Need to work on a DAM.


Gunther Schadow

SPL goes to an R4 ballot.


Lloyd McKenzie

See presentation from Lloyd.

Other Topics


We identified the need to provide better training for modeling and vocabulary facilitators.


Concern was expressed at the amount of time it takes to get a GForge account.

Deadline dates

  • Cover sheets - October 7
  • Final proposals - October 12

Future harmonization meetings - 2008

Agreed that the current scheduling of Harmonization before the ballot opens was not a requirement and was overloading the facilitators by forcing harmonization preparation to occur at the same time committees were preparing ballot submissions.

Therefore we agreed to schedule the Harmonization meetings about four weeks prior to the next WGM, except for November, when it would be scheduled before Thanksgiving (being a term bound in the US realm). The resulting schedule for 2008 is:

  • April 1-4, Las Vegas
  • August 12-15, Boston,MA, Park City, UT, or Traverse City, MI
  • November 11-14, Washington, DC or Alexandria, VA

Friday Q1

Two Co-chairs met to prepare the meeting highlights, and draft schedule for the January 2008 WGM.

Friday Q2