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MnM Minutes WGM 201409 Chicago

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Return to MnM Minutes for 2014

Sunday Sep 14 Q3 - Finalize Agenda/Review Hot Topics


Woody Beeler, Chair
Grahame Grieve
Lloyd McKenzie
Austin Kreisler
Tony Abell
Abdul-Malik Shakir
Katherine Duteau
Jean Duteau, Scribe


  • Agenda Finalization
RIM harmonization will take place on Tuesday Q1.
Wed Q1 and Q2 will be swapped (Joint with FHIR and Vocabulary will be in Q1 and Joint with Vocabulary will be in Q2).
Friday Q1 will be released.
  • M&M Business
The list of Open Hot Topics has not changed in quite some time. We want to defer all of the existing topics to allow new topics to be seen more easily.
MOTION: Take existing Open Hot Topics and Defer them. Austin/Lloyd - 5/0/0 (ACTION: Woody will make this happen)
The Core Principles ballot reconciliation extended too long and thus has expired. It therefore needs a new ballot.
MOTION: Re-ballot Core Principles with no changes from the last time. Jean/Katherine - 6/0/0
There will be a morning meeting to discuss Vocabulary Harmonization issues.

Monday Sep 15 Q3

FMG Core session


Lloyd McKenzie (chair as MnM) Richard Kavenagh David Pyke Bill Majurski Craig Parker Chris Carr Martyn Harthoorn Ewout Kramer Tony Abell Dave Carlson Steve Fine Reuben Daniels Charlie McKay


Approved the following change requests (some with modification):

Deferred the following change requests (waiting for input):

Rejected the following change requests:

Raised the following change requests:

Tuesday Sep 16 Q1


Jean Duteau, Chair
Phil Heinrich
Woody Beeler


  • RIM Reconciliation
MOTION: Woody/Phil moved the resolutions of the comments (contained in the RIM Reconciliation Spreadsheet)
MOTION: That the RIM be submitted for publication after the changes needed for ballot reconciliation are completed. Woody/Phil - 2/0/0
  • Discussion about NIEM Information Exchange Model and potential relationship to RIM

Tuesday Sep 16 Q3 - Joined Joint w/SD, ITS, V3 Pubs, Tooling



Wednesday Sep 17 Q1 - Hosting Vocabulary, FHIR


Alexander, Annie (Cerner Corporation)
Baptist, Joseph (NICTIZ Nat.ICT.Inst.Healthc.Netherlands)
Beeler Jr, George (Woody) (Beeler Consulting LLC)
Case, James (NIH/CC)
Daniels, Reuben (National eHealth Transition Authority (NEHTA))
Farkas, Attila (HL7 Canada)
Grain, Heather (eHealth Education)
Grieve, Grahame (Health Intersections Pty Ltd)
Hamm, Russell (Lantana Consulting Group)
Hausam, Robert (Hausam Consulting LLC)
Klein, William Ted (Klein Consulting, Inc.)
McClure, Robert (MD Partners, Inc.)
Narcisi, Jean (American Dental Association)
Seabury, Tom (IHTSDO)
Yu, Seungjong (NOUSCO)


Most discussion was driven by the exception/issue list maintained for advancing the FHIR DSTU2 preparation. Following are notes related to those discussions. Decisions will be documented both here and on the FHIR tracker.

  • Grahame noted that a Terminology Service using FHIR will be mounted on a trial basis in the near future.
  • Suggestion that printName be part of the "ValueSet.compose.include".
    • Discussion ensued as to whether that inclusion should state expressly that this is added to "uniquely identify the code in its context of use". While there was agreement that there is merit in this context, it led to a further discussion in other contexts. Motion captured in tracker item 3258
  • Discussion of including the (or not) the base code as an "is-a" relational definition. Found that the current FHIR definition is not clear, as written. Resolution in tracker item 3192
  • item 3262 - Related to required nature of name and description in the VS resource, although it is only really required in Sharable Value Set where the extension defines that. Agreed to reduce to optional with added note to definition noting that the field will be required when it used as a Sharable Value Set
  • item New item 3535 - add optional version attribute even though it is way outside the 80%, because it is REQRUIED to deal with code systems that do not enforce concept permanence. The attribute will include a "do not use unless ...." warning
  • New issue - In Define (local code systems) is growing need for multiple languages in definition and display (designation) Agreed GG will draft this capability and bring back to Vocab for review
  • Agreed to add task to assure that Vazlue Set resource is aligned and compliant with the HL7 VSD specification.

Wednesday Sep 17 Q2 - Hosting Vocabulary


Baptist, Joseph (NICTIZ Nat.ICT.Inst.Healthc.Netherlands)
Beeler Jr, George (Woody) (Beeler Consulting LLC)
Gilbert, Peter (Covisint)
Hausam, Robert (Hausam Consulting LLC)
Huff, Stanley (Intermountain Healthcare)
Klein, William Ted (Klein Consulting, Inc.)
McClure, Robert (MD Partners, Inc.)
McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))
Naeymi-Rad, Frank (Intelligent Medical Objects (IMO))
Narcisi, Jean (American Dental Association)
Pyke, David
Seabury, Tom (IHTSDO)
Walker, D. Mead (Mead Walker Consulting)
Yu, Seungjong (NOUSCO)
Warzel, Denise (NIH)


Core Principles

Beeler noted that the September 2012 Ballot of Core Principles R2 had one stubborn Negative that he attempted (for too long) to get withdrawn without seeking recirculation ballot. In the end, the deadlines for this document expired. At this point the only choice is to re-ballot the content.

He and Klein (the two primary authors) seek to re-ballot with the content changes agreed to with all of the withdrawn Negatives, and a preface that details the rationale behind the "Not Persuasive" Negative that was not withdrawn. No other content changes will be made. Motion to adopt this strategy between MnM and Vocabulary (Beeler/Klein 15-0-0)

Value Set Versions

Beeler noted that effective in July and new or updated Value Sets are receiving a "proper" version with the Version Date set to a few days before the next WGM. This begs the question as to how to deal with the myriad value sets that are just receiving a "current" date. Given the source of truth, it would be possible to use generated MIF files for all value set changes since sometime in 2008, but not earlier.

After discussion the motion was made by McKenzie/Klein to: "Establish a version date from the end of the first trimester 2014 as the fixed version date for all value sets that existed at that time, allowing the updates from July and going forward to be unambiguously tracked." Motion passed 15-0-0

Proposal on ParticipationMode

Discussion on draft proposal to add a mode to allow participation via a survey.

Motion to modify per following and changes from Ted and accept such for Harmonization (Beeler/Walker) - 14-0-0

  1. Suggest that correct solution is to use: ONLINEWRIT (online written) Definition: "Participation by text or diagrams submitted by computer network (e.g. computer or online survey)." Parent: WRITTEN Child: EMAILWRIT.
  2. Second, although the mode ELECTRONIC is poorly defined, changing it in the fashion suggested can not be done because it clearly CHANGES the current definition. Need to either fix this (or at minimum add an OpenIssue to it.

Discussion on NullFlavor for "asked but response declined"

Agreed to ask Merrick to propose such a concept as child of ASKU (with a modification of the "eg" under the definition of ASKU

Thursday Sep 18 Q1 - Hosting FHIR


Arndt, Brad (Cerner Corporation)
Beeler Jr, George (Woody) (Beeler Consulting LLC)
Deerwester, Scott
Hirai, Masaaki (HL7 Japan Voter #2 - Nihon Kohden Corp, Eng. Oper.)
Kann, Vannak (U.S. Department of Veterans Affairs)
Lanphear, Daniel (McKesson Corporation)
McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))
McNeil, Tim (Surescripts)
Takasaka, Sadamu (HL7 Japan)
Kaney, Brian (Vermonster LLC with McKesson)


Worked through the FHIR Tracker List. Results are documented on the tracker. Items covered include: 3536, 3533, 3500, 3501, 3439, 3279 & 3263.

Thursday Sep 18 Q5 - Facilitators Roundtable - Joint with Vocab, FHIR


Abdul-Malik Shakir (M&M/CIC) chair, Jean-Henri Duteau (M&M/PC) scribe, Woody Beeler (M&M), Grahame Grieve (M&M/FHIR), Alexander Henket (PA), Hugh Glover (Pharmacy/RCRIM/BRIDG), David Hay (FHIR), Martijn Harthoon (guest), Lloyd McKenzie (M&M), Rob Hausam (Vocab/StructDoc), Julie James (Pharmacy/RCRIM/BRIDG), Gaye Dolin (Child Health), Dale Nelson (ITS), Paul Knapp (ITS), Lorraine Constable (O&O/ARB), Ewout Kramer (FHIR), Russ Hamm (Vocab), Ted Klein (Vocab), Katherine Duteau (PHER)


  • Harmonization Schedule Report
Currently set for November 20-21, 2014
October 19, 2014 for initial content; November 9, 2014 for final content
  • Committee Reports
    • Vocabulary (Ted/Russ/Rob)
      1. Value Set Definition project has passed and has started reconciling the comments.
      2. Tables Project is moving ahead and fully engaged with InM to make some changes to V2 vocabulary. FHIR will be creating a MIF file for inclusion. There is a concern with the CDA IGuide value sets.
      3. CTS2 has addressed all of the negatives but they missed the reconciliation deadline. They will be making a re-affirmation ballot.
      4. TermInfo is resolving its negatives and should be publishing by the end of the year.
      5. HTA is looking at all projects who are requesting controlled terminologies
    • ITS (Paul)
      1. Two ballots that have passed and are being reconciled - one of the items requires that some new mime-types be registered. Grahame pointed out that registering mime-types might be a more difficult procedure than it would seem.
      2. RDF community has expressed an interest in bringing RDF into HL7.
    • BRIDG (Hugh)
      1. BRIDG 3.2 has passed as an informative ballot. BRIDG v4 will be balloted as DSTU in January and Normative in September. An architecture review will occur resulting in BRIDG v5. Kathleen O'Connor mentioned that ONC had a new harmonization process bringing different models together.
      2. BRIDG will be seeking joint sessions with other groups that cover similar domain areas.
    • FHIR (Grahame/Lloyd)
      1. Grahame raised a point about how FHIR relates to Harmonization. FHIR will be trialling a social media-based process to harmonization. If it succeeds, then the intent is to migrate the current harmonization process towards this new process.
      2. Heather Grain has volunteered to help committees with their value sets to achieve higher quality in value sets.
      3. For creating FHIR Profiles, the tool to use is the Profile Spreadsheet.
    • CIC (AMS)
      1. Has a Trauma CDA IGuide that is moving forward. They have some outstanding LOINC code requests. Ted communicated that LOINC has requested some additional information. AMS will look into where the communication breakdown has occurred. CIC is also
    • Pharmacy (Jean)
      1. Pharmacy and Struct Docs has a concern on how to convey free-text SIGs in CDA R2. The recommendation was to have a COMPonent relationship to a child SubstanceAdministration where the free-text instructions are conveyed in the SBADM.text.
    • M&M (Lloyd)
      1. Provided an update on M&M activities during the week
        • Questions about the FHIR Terminology service specification arose

Friday Sep 19 Q1



Friday Sep 19 Q2 - Hosting: FHIR


Beeler Jr, George (Woody) (Beeler Consulting LLC)
Connor, Kathleen (Edmond Scientific Company)
Constable, Lorraine (HL7 Canada)
Gilbert, Peter (Covisint)
Glover, Hugh (Blue Wave Informatics)
Knapp, Paul (Knapp Consulting Inc.)
Kramer, Ewout (HL7 Netherlands)
McDaniel, Mary Kay (Cognosante, LLC)
Moehrke, John (GE Healthcare)


Item 3253 - "Need standard on whether Encounter is referenced everywhere"

Item 3528 - Hash algorithm