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MnM Minutes WGM 201701 San Antonio

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MnM 2017 January San Antonio WGM Minutes

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Wed Q3


  • Lloyd McKenzie (chair)
  • Ron Shapiro (minutes)
  • Vassil Peytchev


  • Revised Ballot Process PSS
    • use a new tool to handle ballot comments and move away from spreadsheets
    • include support for mixed (Draft/STU/Normative) ballots (balloting of one artifact with a mixture of different ballot status artifacts)
    • pilot a "fake" ballot through the next ballot cycle
    • Movement for approval: Vassil Peytchev/Ron Shapiro: 2-0-0
  • Unified Terminology Governance Process PSS
    • develop a detailed process for unified vocabulary governance in HL7 across V2, V3, CDA and FHIR
    • use a new tool to handle requests, voting on requests and workflow around requests
    • Movement for approval: Ron Shapiro/Vassil Peytchev: 2-0-0

Review exceptions for warnings in FHIR STU3:

  • "WARNING:CarePlan.addresses Element names should be singular" and "WARNING:Goal.addresses Element names should be singular"
    • could enhance validation tool to check for Address data type, but meanwhile we will approve exceptions individually
    • Movement to approve exceptions: Ron Shapiro/Vassil Peytchev: 2-0-0

Tracker Items:

  • 12460 - Invariant on Timing - Day of Week and Time of Day - Persuasive with Mod
  • 12637 - change usage text for Timing element to allow for event usage - Persuasive

Thu Q2


  • Lloyd McKenzie (chair)
  • Ron Shapiro (minutes)
  • Elliot Silver
  • John Moehrke
  • Brad Genereaux

Review Media resource usage:

  • need to review the Media resource and identify how it is being used
  • stated purposes are now out of date and incorrect
  • discussion about Attachment data type and the inline data included
  • the inline data could be moved to a Binary resource
    • this could lend itself to allowing Security to be applied around the content of the Attachment
  • discussion about changing description on Media to better clarify intended uses
  • discussion about reference to/from Media resource and Observation/ImagingStudy/etc (Elliot will add CP)
  • discussion about using workflow patterns in the Media resource
  • added CP 12653 - DocumentReference.indexed
  • added and moved CP 12654 - DocumentReference, DocumentManifest and Media should be part of the Event pattern on the workflow page - Persuasive
  • added CP 12655 - DocumentManifest.content.pAttachment should be removed
  • added CP 12656 - Add relationship of Observation to Media
  • added and moved CP 12657 - Modify Media to align with Event pattern - Persuasive
  • discussion about changing the DICOM/ImagingStudy text in Boundaries and Relationship section on the Media resource (Elliot will add CP)
  • discussion about adding the Event pattern elements to DocumentReference and DocumentManifest (Elliot will add CP)
  • discussion about adding Media as a Reference option everywhere that Observation is currently used (Elliot will add CPs for each committee involved)

Thu Q5 - Facilitator's Roundtable


  • Abdul-Malik Shakir (Chair), Jean-Henri Duteau (Minutes)
  • Ted Klein (Vocabulary), Rik Smithies (Clinical Statement), Mead Walker (BR&R), Ewout Kramer (FHIR), Mary Kay McDaniel (PLA), Austin Kreisler (SD), Alexander Henket (PA), Paul Knapp (ITS), Diana Proud-Madruga (SOA), Joginder Madra (PHER), Mark Shafarman (Templates), Lloyd McKenzie (MnM/FHIR), Virginia Lorenzi (Education), Jane Daus (V2 Publishing), Rob Hausam (Vocabulary), Susan Barber (PHER), Lynn Laakso (Staff), Wayne Kubick (CTO)
  • Brian Postlethwaite (Observer)


  • Harmonization Sizing - Group
    • PHER Harmonization - Susan Barber
    • V2 Publishing Harmonization - Jane Daus
    • SD Harmonization - Austin Kreisler
    • FHIR Harmonization - Lloyd McKenzie
    • OO Harmonization - Rob Hausam
    • Vocabulary Report - Ted Klein
  • Harmonization Date Review - Ted Klein
  • Update on 'Future of V3' meeting - Jean Duteau
  • Introduction to CDA 2.1 - Austin Kreisler
  • CDA Product Family - Austin Kreisler
  • AOB

Minutes: Harmonization Sizing

  • PHER - Rewriting Table 357 (ERR codes); may be ready for this harmonization cycle but definitely this or next.
  • V2.9 was balloted but there is substantive changes so there will be re-ballot; there may be some V2 codes out of the re-balloting
    • Any changes to V2.C need to come through Harmonization
  • SD - Handful of harmonization proposals for CDA 2.1
    • Projects were told to submit proposals for changes to any of the CDA value sets - could be a large volume of proposals
  • FHIR - no specific harmonization proposals at this time, but there may be some proposals out of the FHIR QA that all workgroups are doing
    • Publishing on STU3 is proceeding on schedule; proposals for new draft resources will be accepted until mid-February by the FMG
    • Project is being started to revamp ballot processes for everything; looking at tooling and processes
    • FHIR Release 4 will have mixed content; some as draft, some as STU, and some as Normative; published in October 2018.
  • OO - Will be at least one harmonization proposal; may be some more from ODH
  • Vocabulary - there is work on a Unified Vocabulary Maintenance Process project

Harmonization Date Review

  • Harmonization is currently scheduled for March 1-2
  • Initial proposals are due by Midnight Eastern February 3rd for Tech Review
  • Final proposals are due by Midnight Eastern February 24th for meeting preparation
  • Late submissions can not be accepted

Update on 'Future of V3' Meeting

  • Three streams of activity:
    • Review of existing V3 material and a call-out to Workgroups to
    • Review of the existing V3 creation and publishing process to look for how we can make it simpler and easier to create and publish
    • Work on the communication both internally and externally on what the Future of V3 actually is
  • There is a new mailing list group - v3-mnm - under M&M and there will be meetings in Madrid to continue the discussions
  • Communication will be made to the original invitees and the co-chairs list inviting them to the mailing list and the discussions

Introduction to CDA 2.1

  • Calvin has created a mock version of the CDA 2.1 specification
  • Based on a version of the RIM that is based on Datatypes R1 and will remain backwards compatible to CDA R2
  • Draft for Comment ballot in the May ballot cycle; Normative ballot is planned in January 2018

CDA Product Family

  • TSC has authorized the Product Line Architecture task force to stand up a CDA Product Family
    • This will include the standing-up of a number of management groups.