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RIMBAA 201209 Agenda

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These are the minutes of the RIMBAA meetings held at the September 2012 WGM in Baltimore, USA

Thursday Q1 (RIMBAA)

Attendees

  • Massimo Frossi PHI,
  • Chris Mellet NQF,
  • Elizabeth Carey NQF,
  • Gordon Raup Datuit,
  • Sean Muir,
  • Michael Lamoureux,
  • Lisa Nelson,
  • Gerald Beuchelt,
  • Michael Van Der Zel,
  • Ewout Kramer,
  • Galen Malrooney,
  • Peter Hendler
  • Andy Harris (virtual attendee via Webex),
  • Ching Bhatk, (virtual attendee via Webex),
  • David Russell, (virtual attendee via Webex),
  • R. Hamnes Niecher, (virtual attendee via Webex),
  • Randy Lyon (virtual attendee via Webex),
  • Sandra Raup, (virtual attendee via Webex),
  • Victor Chai (virtual attendee via Webex),

Minutes

  1. Peter calls to order at 09:00
  2. Developing a REST based FHIR-like product using JSON and CouchDb (Gordon Raup and Sean Muir, Datuit) (max. 30 minutes)
    • Our team at Datuit is building a NoSQL / JSON implementation of a V3 datastore. We are using NoSQL in general for its flexibility compared to RDBMS. We are using CouchDB in specific because of its rapid response times with very large Big Data aggregations. Our product is an application platform (SafeIX, for Safe Information eXchange) that serves up and stores V3 data from/to the CouchDB backend. It does not implement FHIR at this time, but is architectually similar, using the related concept of SMIRF which was discussed in RIMBAA prior to FHIR being developed. It is being architected with the intent to add FHIR support as soon as FHIR is ready for use in a production environment.
    • We are now able to demo our first app for the platform, the Datuit Care Plan Manager, which allows the patient and all of their providers to implement a virtual care team across organization boundaries. It is targeted at Medical Homes and Accountable Care Organizations. We will briefly show what we have and then peek under the hood to show how we are implementing it.
  3. Remaining administrative items
    • Agenda for Phoenix
      • Peter will request Monday Q3 and Thursday Q1.
      • Add to its agenda: LifeLines RIMBAA / DCM based (/ CIMI) (Michael van der Zel, UMCG, the Netherlands)
      • For possible presentations for Phoenix, Massimo Frossi stated that the PHI product is now using a simplified FHIR like persistance layer. He will be asking permission if he can come and present this.
        • Ewout, if he is able to come, may present on how to query for meaningful FHIR collections, such as all the resources needed to replicate the data in a clinical statement.
        • We did not ask, but Keith Boone while presenting his query mechanism Monday Q1 also mentioned that his persistence layer has about 7 separate schemas. For example, one for medications, one for problem lists, one for allergies etc.
    • RIMBAA three year plan
      • Needs update and formal approval.
      • MOTION to approve the updated three year plan. (Michael Van Der Zel/Massimo Frossi, 11-0-0)
      • Update of project 550 deliverables / due dates. PMO about project 550: Next Milestone Date Is: 2011 Sept WGM/Ballot Determine when the next deliverable will be (the tgt date can be a WGM or Ballot Cycle); send dates to pmo@HL7.org.
        • Suggestions were made for new white papers.
        • There are three approaches that have already been taken for persisting FHIR resources.
          1. Just each resource by itself with links
          2. Enough of a them linked together to be equivalent to a clinical statement or what we previously referred to as a SMIRF
          3. Entire CDA like documents that contain many clinical statements within them.
        • The experiences of persisting FHIR resources in any of the “clusters” above in the various “NoSQL” databases such as MongoDB (Ewout), CouchDB (Gordon), ?? (PHI), XML (Van Der Zel).
    • Move steering division
      • MOTION To request the FTSD and T3SD steering divisions to 'move' the RIMBAA WG from FTSD to T3SD. (Michael Van Der Zel/Massimo Frossi, 11-0-0)
    • Green CDA
      • Robert Worden (via e-mail prior to the meeting) It occurs to me that now that the [soon to be] renamed RIMBAA group is focusing on implementation issues - a hugely important task, in my view - it should take over any remit for Green CDA from SDWG, e.g. sharing experiences - as Green CDA is after all only an implementation technique. Perhaps the renamed RIMBAA group would like to discuss that at Baltimore.
      • This topic wasn't discussed, will be moved to the agemda for Phoenix

Saturday Q1-Q4 (RIMBAA)

Workgroup Date/Time Location Chair/Scribe
RIMBAA WG 2012-09-08,
08:00-17:00		 Baltimore, US Chair/Scribe: Peter Hendler/ Mike Henderson

Attendees

  • Duane Bender
  • Keith Boone
  • Jean-Henri Duteau
  • Grahame Grieve
  • David Hay
  • Peter Hendler
  • Ewout Kramer
  • John Landers
  • Joginder Madra
  • Gordy Raup
  • Chris White
  • Mike Henderson (connectathon manager)
  • Chuck Jaffe (Observer)
  • Paul Knapp (Observer)
  • Thomas Lukasik (Observer)
  • John Moehrke (Observer)
  • Rene Spronk (Observer)
  • Stephen Chu (Observer)
  • Vin Sekar (Observer)

Minutes

  1. Given the informal nature of the meeting the management of the meeting is yielded to the connectathon manager (Mike Henderson). RIMBAA acts as the official HL7 sponsor for a test of FHIR implementations.
  2. Repository servers were provided by representatives of HealthFire, Health Intersections, Furore and Thrasys. FHIR clients were developed (some in advance of the event, others entirely during the Connectathon itself) and demonstrated by representatives of GE Healthcare, HealthFire, Health Intersections, Kaiser Permanente, Mohawk College and Orion Health.
    • Although rapidly developed, clients were able to interact with multiple servers, and to sync servers if they included that capability.
    • Small-footprint clients could potentially be used as testing tools.
    • Extensions could be provided to allow transmission of date/time recorded information and synchronization or update links to authorized clients.
    • Participants agreed that FHIR provides an easily accessible standard for a rapidly deployable framework. Secondary in importance is the RESTful framework within which FHIR operates.
    • There is a governance board that has final accountability for the integrity of the FHIR specification. Ewout Kramer is the developer community representative to that board.
    • The success of the Connectathon bodes well for the continuance of this event. It will be profitable to learn both from today's event and from the example of IHE connectathons.
    • Connectathon manager Mike Henderson will be asking for feedback from the participants that can be used to help plan connectathons around future HL7 meetings.
    • While it is desirable to hold the Connectathon immediately prior to the HL7 meeting, a day other than Saturday may need to be chosen to avoid conflict with the Saturday meeting of the Technical Steering Committee.
  3. (not part of the official minutes, added after the meeting took place) See also:
  4. The meeting adjourns around 17:00

Monday Q4 (Tooling / RIMBAA) - Convention Center Room 345

  1. Joint meeting with Tooling, hosted by Tooling.
  2. Tooling Strategy to include implementation oriented tooling.
    • Rene: As I pointed out earlier on the tooling and RIMBAA lists there is no reason to limit the scope of the tooling plan to standards creation tools - if there is a good business proposition for ANY kind of tool which would progress HL7s objectives and strategic initiatives, it should potentially be within scope.
    • As a background FYI - from the TSC minutes of Saturday Q4:
      • (qoute) Tooling Strategy/Plan Review
      • (qoute) John describes in a slide show. The spectrum is much larger than the scope of work from the Tooling WG. Advisory council recommends what we should be doing the most is the stuff we don't do at all - user tools. Free IP means less money for tooling funding. They need to be their own business, as otherwise they depend on whatever budget is left over by the Board. Recommendation by Grahame is a tooling coordinator per product line (or by WG?).
      • (qoute) Woody asks about the "user" tools, from EHR on FM Profile development and management tool, free to users and running on a real-time repository. He found that to be worth HL7's full budget for three years. John compares that to Trifolia (web application, SQL-server based) and CDA Templates. Free IP paradigm means we need to provide value to members, such as our tooling.
  3. Tools for RIM based software development
    • Michael: The question is how to get to appropriate categories. The proposed approach (during the last joint meeting) was to create a list of software and then come up with categories for those. So 5 people will do this and then we try to consolidate the categories. The result we will use as "the" categories on that page. Suggested categories: Tools for Standards Implementers (RIMBAA), “IHE”-like stuff, and Tools for Standards Creators.

Tuesday Q3 (RIMBAA)

Attendees

  • Peter Hendler, (chair/scribe)
  • Masimo Frossi,
  • Francesco Rossi,
  • Michael van der Zel,
  • Gunther Shadow,
  • Gordon Raup,
  • Michael Rossman,
  • Keith Boone (final 30 minutes)

Minutes

  1. Administrative
    • Announcements
      • Peter, on behalf of Rene: the 'informal notes' of the RIMBAA meeting in Gothenburg (March 2012) don't need formal approval. there was no co-chair present and as such it wasn't an official RIMBAA meeting, but just an informal gathering of RIMBAA members.
      • Peter: there was an election in July 2012 for the FTSD (the steering division to which RIMBAA belongs) representive to the TSC. There was one candidate (up for reelection): Tony Julian. At the end of July, after a brief discussion between the co-chairs, RIMBAA did vote for Tony without asking the RIMBAA members for their vote, which is a requirement per our DMP.
        • MOTION Whilst in conflict with the RIMBAA DMP, the working group, given the deadlines for the vote for FTSD representative to the TSC, and the unlikelyhood of there being a majority of RIMBAA members who would vote for another candidate than the incumbent, approves of Tony being the representative to the TSC for FTSD, and calls upon the co-chairs to organize a proper election next time. (Rossman/van der Zel, 6-0-0)
      • Peter: please vote, before Wednesday 17:00, in the election for the open RIMBAA co-chair position.
    • Agenda Review/Additions/Changes
    • Approval of the minutes of the meeting in Vancouver
    • Changing the scope of RIMBAA
      • Discussion: Need to decide on scope, mission and charter revisions. Included may be an update to the group’s name. The essential focus of the group has been implementation for some time, but it has been suggested that the scope may be extended to provide a forum for v2 implementation issues. However, it was pointed out that v2 implementation is thoroughly covered in other groups, principally focused on extensions and refinements of existing work.
      • A question was raised as to whether the WG needs to expand our notion of what “RIM based” or “RIM derived” does and should mean. It was suggested that we are at “an inflection point.”
      • MOTION To change the mission and scope of RIMBAA to this versioned text (Rossman/van der Zel, 6-0-0)
        • The mission scope was discussed and accepted except the idea that we would also cover V2 was not accepted. Gordon particularly was against that and said there are many other forums for that. Discussion on a new name for the WG was deferred until the next WGM.
    • Re-approval of the content of the Software Implementation of CDA whitepaper.
      • There were no objections raised to re-approving this one.
      • MOTION to approve the Software Implementation of CDA whitepaper as a reflection of current best practice. The document will be up for re-approval during the September 2014 WGM. (Rossman/van der Zel, 6-0-0)
  2. Tools for RIM based software development
    • Discussion, based on change in RIMBAA's scope and the outcome of the joint meeting with Tooling yesterday
      • Report: Joint meeting with tooling – the tooling group was seeking feedback on desirable tool projects for HL7 to sponsor and fund. Problem categories: static models, dynamic models, policy-based implementations, mapping support, analytics, conformance testing, tutorials and learning aids, reference implementations, publishing, generating examples.
      • Priorities among the above: static models are pre-requisites.
  3. Discussion: how could standards developers make life easier for implementers?
    • From the e-mail list:
      • MOTION RIMBAA, as representatives of the HL7 software implementers community, are of the opinion that it would greatly ease the implementation of HL7's static model artefacts if there were to be at least 2 solid examples for each and every artefact included in any normative specification. We therefore ask and recommend that the TSC, as part of the publishing rules, require that such examples SHALL be created by the authors of a standard prior to the publication of a normative standard.
      • (motion, continued) Whilst acknowledging that this puts a burden on the standards developers, we believe the ROI to be significant, not just from an implementation perspective but also from a QA perspective. There are example-generator tools which could be used to lessen the burden on the standards developers. During the publication process one could automatically check for the existence of an x-number of examples; subsequently the balloters could determine if the examples have sufficient/reasonable content. (Rossman/van der Zel, 6-0-0)
    • Organize connectathons? Conformance impact (CGIT), testbench impact (RIMBAA)
      • There will be additional FHIR connectathons, the HL7 CEO would also like to see connectathons related to other HL7 standards. How does RIMBAA/Implementers WG relate to the organization of connectathons?
      • MOTION RIMBAA, as representatives of the HL7 software implementers community, are of the opinion that connectathons are a useful tool for HL7 implementers, and it would like to be involved in the organization thereof. (Rossman/van der Zel, 6-0-0)
    • Fall out-of-cycle meeting
      • MOTION To approve an out-of-cycle RIMBAA meeting to be held in North America before the January 2013 WGM. The likely location will be in Canada. (Rossman/van der Zel, 6-0-0)
  4. Querying clinical data (Keith Boone, GE)
    • Keith has authored a series of blogposts about the implementation of 'querying clinical data', the lack of a query language which is of concern to RIMBAA (Query_Expression_and_Execution_Technology); we need to have a query language irrespective of whether one has a CDA-store, a RIM based store or a FHIR store: Keith will present his opinions/experiences related to querying data.
      1. Query By Example (QBE) as used by HQMF/Query Health.
      2. How to compute with parts of the graph (this is not addressed by HQMF/Query health).
    • KB has spent considerable time looking at and doing querying of clinical data, for example, in connection with IHE. His interests relate particularly to queries that respond with sets of entities satisfying some qualifying conditions. Example: IHE’s QED. (Patient Care Coordination specification.) This query returns a care record (“a message equivalent to CDA” – e.g. a structured, machine readable representation as a sequence of “care statements” which apply the clinical statement pattern). The Care Record Profile Query specifies the qualifying conditions, which include a variety of data elements (such as patient birth time and name).
    • KB provided suggested resources to GG for FHIR resource specifications based on his experience and work with IHE QED.
    • The following links from KB
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