MnM Minutes WGM 201405 Phoenix

Return to MnM Minutes for 2014

Sunday May 4 Q3 - Finalize Agenda/Review Hot Topics

Attendees

Woody Beeler, Lloyd McKenzie (Chair), Grahame Grieve, Austin Kreisler, Paul Knapp, Jim Marks (AGFA), Marie Swall (VA), Jean Duteau (Scribe)

Minutes

• Determine agenda for the week
  • Tuesday Q1 will be a discussion of the UDI pattern
  • Monday Q1 and Tuesday Q2 will be cancelled as we have no topics to discuss
• Discussion of Core Principles and the need for a R3
  • Negation Indicator Guidance projects are progressing
  • ISO has caused some changes that may result in changes in Chapter 5
  • There was a consideration for a new Core Principles project but we decided to delay until the Negation Indicators project progresses.
• Discussion of the BlockedContextConduction Hot Topic
  • After discussion, Woody will attempt to write up a resolution. There is a belief that tooling is not the problem with this topic.
• Value Sets Used in Data Types are Incorrect
  • Should be closed as it has been fixed

Tuesday May 6 Q1

Attendees

Jean Duteau (chair/scribe), Woody Beeler, Paul Knapp, Grahame Grieve (initial part of the meeting)

Minutes

• Review of Decision Making Practices
  • Decided to change the quorum from Co-Chair and three members to Co-Chair and two members.
  • MOTION: Accept the new Decision Making Practices with the change to quorum rules. Woody/Grahame 3-0-0
• Review of Workgroup SWOT (on the Wiki)
  • MOTION: Accept the new SWOT as modified on the Wiki. Paul/Woody VOTE to be taken via e-vote process
• Review of Mission & Charter
  • MOTION: Accept the modified Mission & Charter. Woody/Paul VOTE to be taken via e-vote process
• UDI Proposal Discussion
  • Paul discussed the UDI proposal. We reviewed the patterns and the principles. We endorsed them and discussed the appropriate way to represent these in RIM-derived models. We will introduce the patterns and the proposed RIM changes at the Facilitator's Roundtable with a view to having formal harmonization of the pattern and changes in the next Harmonization cycle.

Tuesday May 6 Q3 - Joined Joint w/SD, ITS, V3 Pubs, Tooling

Attendees

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Nothing of significance to MnM

Wednesday May 7 Q1 - Hosting Vocabulary, FHIR

Attendees

Baptist, Joseph (NICTIZ Nat.ICT.Inst.Healthc.Netherlands)

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Bunker, Nathan (American Immunization Registry Association)

Couderc, Carmela (Siemens Healthcare)

de Moel, Ed (Hawaii Resource Group)

Fine, Steven (Cerner Corporation)

Hall, Freida (Quest Diagnostics, Incorporated)

Henket, Alexander (HL7 Netherlands)

Huang, Wendy (Canada Health Infoway Inc.)

Klein, William Ted (Klein Consulting, Inc.)

Lyle, Jay (Ockham Information Services LLC)

Macumber, Caroline (Apelon, Inc.)

McClure, Robert (MD Partners, Inc.)

McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))

McKinney, Frank (Frank McKinney Group LLC)

Millar, Jane (IHTSDO)

Narcisi, Jean (American Dental Association)

Parker, Craig (Intermountain Healthcare)

Reppen, Bertil (Apertura)

Shaver, Dave (Corepoint Health)

Trivedi, Prashant (NHS - UK)

Discussed how to get metadata in place that is identified as "best practice" in the value set definition syntax

Concern about FHIR locally-defined code systems and the slippery slope that creates

Discussed ISO Terminology constraint document. Will be offered as a new work item in ISO. Could potentially start ballot this year

Work in progress exposing v2 tables as "real" code systems & value sets

Working on process to expose HL7 value sets in VSAC

Wednesday May 7 Q2 - Hosting Vocabulary, FHIR

Attendees

Baptist, Joseph (NICTIZ Nat.ICT.Inst.Healthc.Netherlands)

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Bunker, Nathan (American Immunization Registry Association)

Couderc, Carmela (Siemens Healthcare)

Daniels, Reuben (National eHealth Transition Authority (NEHTA))

de Moel, Ed (Hawaii Resource Group)

Hamm, Russell

Henket, Alexander (HL7 Netherlands)

Huang, Wendy (Canada Health Infoway Inc.)

Klein, William Ted (Klein Consulting, Inc.)

McClure, Robert (MD Partners, Inc.)

McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))

Millar, Jane (IHTSDO)

Parker, Craig (Intermountain Healthcare)

Shaver, Dave (Corepoint Health)

Swall, Marie (U.S. Department of Veterans Affairs)

Trivedi, Prashant (NHS - UK)

Planning for Value Sets In Harmonization

Ted and Woody noted that they will spend time before July Harmonization to attempt to capture required Value Set definition data (primarily around governance)for value set definitions being added or updated in that Harmonization cycle. Further, they will explore methods for improving the establishment of "release dates" for existing Value Sets.

FHIR QA Rules on Value Sets

Lloyd presented the current definitional principals for Value Sets that will applied to existing FHIR content while preparing for DSTU 2 (between now and September).

FHIR-defined code systems

Discussion on the use of FHIR-defined code systems, in the context of Encounter resource for "CODE" attributes, specifically Encounter Type and AdmitSource and the "requirement" for a "readable" code in such types. Lloyd suggested these be taken back to MnM and others for the enhancement of the QA definitions.

Role of the HTA

HTA seeks to be responsive in this area, and is interested in any QA changes that are defined in the terminology space. Agreed the HTA should undertake to present a Webinar on "How to Discover the Good Vocabulary that is Out There (LOINC, SNOMED, etc.)" in order to follow HTA good practices - and the sooner the better.

Discussion of "incomplete"=

In the QA the term "incomplete" as a Code System, as a result of the binding/conformance requirements of FHIR. (It means "extensible" or bound CNE to people who struggled to learn HL7 terminology in the past.)

Role of Vocabulary WG in Update of Resources in FHIR around Vocabulary

In past FHIR Core did these resources and tried to keep Vocabulary informed. Question is does Vocabulary want to take a stronger role. Response, Vocab seems unlikely to have the band width to do this.

Other

Help Desk Terminology responses

Lloyd noted that there are a number of Help Desk "responses" from FHIR in the Terminology space, and the Vocabulary Work Group might consider reviewing these, either formally or informally.

Items on the FHIR Issues Tracker on Gforge

Lloyd presented and the group discussed a few of these. The results were tabulated as responses on Gforge.

Motion to make these changes/responses was made by Lloyd, seconded by Ted and passed unanimously.

Thursday May 8 Q1 - Hosting FHIR

Attendees

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Daniel, David (4dd software)

de Beaubien, Bill (Systems Made Simple)

Graham, Matthew (Mayo Clinic)

Kramer, Mark (The MITRE Corporation)

McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))

McNeil, Tim (Surescripts)

Reppen, Bertil (Apertura)

Smithies, Rik (HL7 UK)

Swall, Marie (U.S. Department of Veterans Affairs)

Wang, Yunwei (Intelligent Medical Objects (IMO))

Trivedi, Prashant (NHS - UK)

Future directions for Methodology

Agreed to following plan for completing the FHIR Methodology

• Schedule Conference Calls through the summer to complete these
• Mark (on the Methodology page) those "questions" that are "asked but not answered" to help guide pieces required for completion.
• Subsequent to completion, review (and perhaps restructure) the Organization of the questions lists to assure that it is straight-forward and understandable as a documentation of Methodology.
• Write an "Introduction" that forms a readers guide to the Methodology
• Undertake a formal peer review for this specification. (A formal ballot should come later.)

Manage Tracker Entries for FHIR Change Request

The group reviewed, prepared responses and approved those for a good number of the entries in the FHIR Change Request tracker on Gforge.

Thursday May 8 Q5 - Facilitators Roundtable - Joint with Vocab, FHIR

Attendees

Abdul Malik Shakir (M&M/Chair), Woody Beeler (M&M/Harmonization), Mead Walker (RCRIM), Grahame Grieve (FHIR), Paul Knapp (ITS, FM), Pat Van Dyke (EHR), Austin Kriesler (Struct Docs), Hans Buitendijk (O&O), Riki Merrick (PHER), Eric Haas (PHER) , Alexander Henket (PA), Lloyd McKenzie (M&M), Kevin Coonan (Emerg Care), Rob McClure (CBCC, Terminology Authority), Russ Hamm (Vocab), Wendy Huang (PA), Ted Klein (Vocabulary), Joginder Madra (PHER), Jean Duteau (Pharmacy, M&M/scribe), Christian Hay (GS1), Leslie Tomkins (FDA), Brett Marquard (Struct Docs)

Minutes

• Harmonization
  • UDI Design Pattern
    • Paul Knapp presented a document on the Unique Device Identifier pattern. It listed the elements that were contained in the UDI. It also gave advice on how to represent the UDI in FHIR, in V3 models, and in V2 messages. If the pattern is accepted, then there will be some FHIR changes and V2 proposals. There will be no V3 RIM changes required. V3 CDA appears to be possible using existing structures. The pattern and any V3 proposals will be brought forward in the upcoming Harmonization in July.
  • Patient Administration Proposal - Adding three concepts to represent foster parents (including foster mother and foster father). Wendy/Jean 12-0-0
  • HL7 Canada Proposal - Add a number of vocabulary objects to the ControlActReason domain. Wendy/Hans 11-0-1
    • There was an issue with the CLINMOD code due to a perceived disagreement between the Code and the given description. The description was subsequently changed before the motion was made.

• Harmonization Schedule Review
  • The original schedule is for July 21-25, 2014
  • Motion: Change the dates to the July 16-18, 2014. This would make the submission deadline be June 15th and July 5th. Woody/Paul 15-0-1

• Facilitator Reports
  • BRIDG (Mead) - BRIDG is back with a new workgroup and will be balloting the BRIDG model for comment in September and then a new version will then be balloted on the Normative track in January.
  • Struct Docs (Austin) - The CDA project to update it to the latest RIM has been closed. CDA "Next Generation" which will be of a more limited scope is still being worked on. A project for CDA in FHIR is being proposed.
  • FHIR (Lloyd) - FHIR visited every group and gave them deadlines and tasks.
  • Vocabulary (Russ/Ted) - CTS2 had trouble to publish in time and have received an extension. V2 tables will be cleaned up and brought forward at the September WGM. V2.9 will include some V3 vocabulary model binding information. Value Set Definition project will bring a normative standard for the Value Set object - this may result in new requirements for value set creation requests.
  • PHER (Joginder) - Public Health CMETs are about to expire and the workgroup is considering not re-balloting them. PA and PHER are working together to determine the extent of the Patient Public Health CMETs. There is a project that is creating a V2 message and a CDA Implementation Guide and would like to use to same value set in both places. This is posing a problem and PHER and Vocabulary will be working this out.
  • HL7 TermAuth (Rob) - A new body has been stood up with appointed members and will be provide governance and advice on vocabulary issues. There is a move to expose HL7 value sets outside of HL7 and the HTA is taken that on.
  • M&M (Lloyd) - Updated the group on the various M&M activities.

Friday May 9 Q2 - Hosting: FHIR

Attendees

Rik Smithies, Woody Beeler, Katherine Duteau, Lloyd McKenzie

FHIR change request review

Reviewed and approved a number of FHIR "core team" change requests