MnM Minutes WGM 201101 Sydney

Sunday Jan. 09 Q3

Attendees

Abdul-Malik Shakir, Andy Stechishin, Angus Millar, David Rowed, Geoff McDonnell, Grahame Grieve, Jacque Alsop, John Koisch, Lloyd McKenzie, Lorraine Constable, Mead Walker, Rene Spronk, Rik Smithies, Rob Savage, Russell Searle, Sam Heard, Sarah Gaunt, Woody Beeler,

Agenda

Establish Agenda for WGM from Hot Topics and Other Items

Steps:

• Reviewed the existing Hot Topics
  • Marked some as Resolved but not closed
  • Opted to defer some
  • Listed the rest for consideration in Sydney
• Added additional elements

Resulting list and resulting slot:

• Monday Q1
  • Core Principles Ballot Planning
  • RIM Ballot Planning
  • MIF Ballot Reconciliation
• Monday Q3
  • Patient Care and MnM re DCM modeling
• Tuesday Q3
  • Process for DAMS
• Wednesday Q2
  • Plan Action for Resolved Hot Topic Issues
• Thursday Q1
  • Data Types releases kerfluffle
• Thursday Q3
  • CMET Management
  • Static Model Quality Checklist
• Tuesday Q4
  • Role Identity

Monday Jan. 10 Q1

Attendees

Lloyd McKenzie - lloyd@lmckenzie.com Woody Beeler - woody@beelers.com Stephen Royce - stephen.royce@nehta.gov.au Bo Dagnall - bo.dagnall@hp.com

Agenda

MIF ballot reconciliation

Only one item - Keith Boon Not Persuasive - Woody/Stephen

Other ballots

Thur. Feb. 3 as first Core Principles reconciliation

Motion: Go forward with MAY ballot cycle for RIM release 4 and Core Principles Normative Ballot 3 under the existing project scope documents Woody/Bo - approved 3/0/0

RIM release 4 may be amended to include governance information (harmonization process) if the ARB gets far enough in defining how governance should be captured

Monday Jan. 10 Q3 - Joint with Patient Care in re DCM

Attendees

Bo Dagnall, Brett Esler, Carmela Couderc, Charlie Bishop, Corinne Gower, David Rowed, Grahame Grieve, Heather Leslie, Hugh Leslie, Jared Davison, Linda Bird, Lloyd McKenzie, Nweni Tun, Patrick Loyd, Rik Smithies, Sam Heard, Stephen Chu, Stephen Royce, Woody Beeler,

Intro

Opened with open forum on the "issues", steps that might be reasonable to undertake, given that the primary DCM proponents are not here, and that this meeting and the Orlando meeting precede the next ISO Meeting.

Discussion of the distinction of a need for a methodology as opposed to the definition of the role and function of DCMs, in generis.

What is purpose of DCMs?

Grieve: HL7 static models are fairly abstract in clinical content (e.g. observations), but these are too abstract to be useful in the context of creating sets of data, reports, and the like for use in a particular clinical setting. (A detailed setting). The DCM is intended to provide this function.

Question:

• Where do these fit in the "interoperability" space?
• How do we keep them aligned across settings?
• How does Clinical Statement relate - as a model against which the "templates" that derive from a DCM can be applied.

Proposal for consideration

• Patient Care to undertake as part of PC business between now and Orlando
  • Develop a set of requirements and "expectations" for the evaluation of DCM methodology
• Feasibility Demonstration Project (Team to be assembled, volunteers below)
  • Start with archetypes as the base
  • Establish adornments that map these to the V3 Ontology (Structured Vocabulary and RIM)
  • Create tools that then consume these to produce useful HL7-V3 artifacts (templates, or such)
• Present each of these in Orlando (May 2011)

Moved by Loyd/Bishop 15-0-1

Volunteers for feasibility demo project - Grahame Grieve(lead), Stephan Royce, Jared Davison, Hugh Leslie, Heather Leslie, Patrick Loyd, David Rowed

Monday Jan. 10 Q4 - Joint with Structured Documents

Attendees

Austin Kreisler, Calvin Beebe, Christof Gessner, Grahame Grieve, Jacque Alsop, Juha Mykkannen, Keith Boone, Larry McKnight, Linda Bird, Lloyd McKenzie, Nweni Tun, Ray Murakami, Rik Smithies, Rob Hausam, Sam Heard, Sarah Gaunt, Stephen Royce, Woody Beeler,

What makes Models ready for use in Documents?

Background: In CDA R3, the right hand side of the model (clinical statement side) will be the RIM directly. This will allow all existing models to be used in a CDA document. But it doesn't mean that all models are appropriate - how do we decide what models are appropriate?

• Some discussion about serialisation - but this is not important to MnM.
• Including large models presents some challenges for a document based paradigm
• Note: language and author do conduct directly, and the semantics are not unclear.
• Can only include a model if the interpretation of the model is not dependent on the context in which the model is used (including trigger event)
  • Agreement that this issue should be visible at the MnM level
  • inclusion of narrative within a computable model?

Lloyd's Notes Displayed during session

Model re-use across paradigms

• Model constraints imposed by Struc Docs on right-hand side
• Model granularity
• Information conducted from header/ControlAct wrapper
• Conduction across entries
• Context conduction of act.text
  • Human-readable = "some" header stuff, section titles, act.text
• Use of open classes in DIMs and SIMs

Decision

Create a project sponsored by MnM, OO, SOA, and SD with the scope "To define a methodology such that committees can construct domain committee models that can be leveraged in any and all of the document, message, and service paradigms, as well as the process by which such models are constrained to apply to a selected paradigm"

Calvin Beebe volunteered to draft the project proposal. To be distributed to both lists, and then for a joint call to approve

Tuesday, January 11, 2011 - Q3 - Joint with ArB in re: Implementation Guide Descriptors for Artifacts

Attendees

Andy Stechishin, Austin Kreisler, Cecil Lynch, Charlie Mead, Corinne Gower, Gavin Morris, Jane Curry, Jason Steenstra-Pickens, Jean Duteau, Joginder Madra, John Koisch, Lloyd McKenzie(Chair), Lorraine Constable, Marc Koehn, Mead Walker, Ray Murakami, Rene Spronk, Rik Smithies, Rob Savage, Ron Parker, Sarah Gaunt, Stephen Royce, Woody Beeler(Scribe), Zoran Milosevic

Discussion

Lloyd McKenzie opened the discussion stating that the session was intended to discuss the elements (descriptors) of artifacts that need to be defined in the HL7 Implementation Guide for SAIF. The discussion was based upon an early draft of the description/definition/rules for a "DAM" using a document that he had circulated previously by e-mail. The original document is on gForge.

Changes that resulted from this meeting will be incorporated in a forthcoming Wiki page for this from McKenzie.

Process going forward

Sources for rules for artifacts (like DAMs) may be - MDF, HDF, Core Principles, SAIF, etc.

ArB members are working on IGs for Information and Behavioral for NCI. Latter will be discussed in OO to inform a future Behavioral IG for HL7. The IG for information is targeted to guide NCI to HL7, and thus may be closer to what might be an HL7 IG for Information.

Joint ArB/MnM Concall for near future to plan and guide an HL7 effort to begin the HL7 IG for SAIF.

Tuesday, January 11, 2011 - Q4 - HotTopic: Role Identity

Attendees

Lloyd McKenzie, Marc Koehn, Rene Spronk, Rik Smithies, Sarah Gaunt, Stephen Royce, Woody Beeler

Discussion

The rules for determining when matching identifiers can lead to certainty about equivalence of the objects being compared are unclear. The following guidance was developed:

Role equivalence

Role identifiers can be considered to refer to identical role objects IFF:

• There are II values on each of the roles that are equivalent according to the II equivalence definition
• Both IIs declare the scope property
• Both scope properties are one of OBJ, VER or VIEW (they need not be the same on both instances)

In all other circumstances, object equivalence cannot be safely assumed without specific knowledge of the implementation environment, no matter how many other attributes are compared. (It may still be possible to achieve "high probability matches" with less information.)

Example: Clinic uses Social Security Number as their "public" patient identifiers plus an internal object identifier. Patient comes to clinic for several years, then leaves for several years and the role gets flagged as "terminated". They then come back to the clinic and a new role is created for the patient, still using the same SSN as the "public identifier, but with a new internal object identifier. Eventually they leave again and the status becomes terminated again. The SSN cannot be used to point to a single role object instance, even when paired with classCode, code, status, scoper, etc.

Playing Entities of Roles with equivalent Role identifiers can be considered to be equivalent.

Entity equivalence

The same rules for determining equivalency apply as for roles (equivalent IIs each with declared scopes other than BUSN).

In addition, in some cases an entity may be uniquely identified by the code. This may occur for entities with determinerCode of INSTANCE (e.g. countries) as well as those with determinerCode of KIND (e.g. drugs). This equivalence cannot be safely asserted without specific knowledge of the implementation environment.

For example, the ISO country codes might be used to "identify" both country codes (geographic region) and nation codes (political organization). However, the geographic entity object of type X is not equivalent to the nation entity object of type X.

Note: If an Entity II does not have a declared scope, in most circumstances it will be reasonable to presume it is of type "OBJ" and can be treated accordingly.

Act equivalence

The same rules for determining equivalency apply on Acts as for Roles (equivalent IIs each with declared scopes other than BUSN).

Note: If an Act II does not have a declared scope, in most circumstances it will be reasonable to presume it is of type "OBJ" and can be treated accordingly.

Participation and RoleLink equivalence

The scope property for IIs on Participations and RoleLinks must never be BUSN or VIEW. As such, the IIs can always be presumed to be comparable. The sole equivalence requirement is that the objects have equivalent IIs.

Resolution

Motion: Rene/Lloyd 6/0/0: "Incorporate the above language into Core Principles at the earliest possible opportunity"

Thursday, January 13, 2011 - Q1 - Joint with ITS re Data Types and Infrastructure Versioning

Attendees

Austin Kreisler, Dale Nelson, Heath Frankel, Lloyd McKenzie, Mead Walker, Paul Knapp, Rene Spronk, Russell Searle, Woody Beeler

1. Static models MUST reference Abstract Datatypes 1.0 or Abstract Datatypes 2.0

2. Static models whose functioning is dependent on any capabilities not present in Abstract Datatypes 1.0 must use Abstract Datatypes 2.0

3. Abstract Datatypes 2.0 models MUST be generated using Structures 2.0 ITS, referencing Datatypes R2

3. Abstract Datatypes 1.0 models are generated using a structures schema that is unchanged for Structures 1.0 and Structures 1.1 ITS.

4. Implementers *may* substitute the 1.1 datatypes schemas for models generated using the 1.0 schemas. This substitution *WILL NOT* be done in HL7 International specifications which must reference the normative specifications and cannot assume site-specific negotiation. Normative and DSTU specifications MUST NOT reference informative-track specifications.

5. Reference models, such as Common Product *MUST* use the current HL7 infrastructure (RIM, datatypes, etc.) so as to ensure committees are able to take advantage of the current infrastructure and are consistent with all other committees.

6. Specifications submitted for joint adoption with other standards bodies should meet, at minimum, the requirements that would be in place if those standards were to be approved by HL7 alone.

Motion: The above statements reflect the joint position of the ITS and MnM committees with respect to the use of Datatypes ITS 1.1 in HL7 International specifications: Woody/Dale - 5/0/3

Thursday, January 13, 2011 - Q5 - Facilitator's Roundtable

Attendees

Woody Beeler (Chair), Lloyd McKenzie (MnM), Grahame Grieve (PC), John Koisch (ArB), Bob Dolin (StructDoc), Rob Savage (PHER), Austin Kreisler (StructDoc), Rob Hausam (Vocab), Rene Spronk (RIMBAA), Patrick Loyd (O&O/ClinicalStatement/InM), Lorraine Constable (ES), Joginder Madra (Immunization), Mead Walker (PS), Christof Gessner (HealthcareDevices), Wendy Huang (PA), Andy Stechishin (Tooling/Publishing), Hugh Glover (Medication), Jean Duteau (Pharmacy/MnM), Paul Knapp (ITS), Dale Nelson (ITS)

Publishing Calendar

• NIB Deadline - February 27
• Harmonization - March 15-18
• Ballot opens - April 3

Harmonization Deadlines

• Proposal Deadline - Feb 13
• Technical Review - Feb 22
• Final Update - March 6
• Harmonization - March 15-18 from Noon-4pm Eastern

Roundtable Reports

• Patient Care
  • had a joint meeting with MnM to discuss Methodology. Clinical concepts will be modelled via archetypes and then the archetypes will be marked up. Demonstrate a proposal in Orlando.
• ArB
  • There was a discussion about where the hData ballot fits. ITS will be take a new look at the project scope statement.
• StructDocs
  • Will be testing the publishing CDA IGuide tooling. Trying to publish using MIF and the regular V3 publishing capabilities.
  • Question about derivationExpr and the use - it will be deprecated imminently. The use of PQ.expr was discussed.
• Vocabulary
  • Made some further progress with Core Principles Reconciliation
• O&O
  • Dietary Project is started with a DAM and HL7 models.
  • Behavioural Framework is moving forward - Patrick and Austin have some action items
  • Microbiology Result template off of the Lab order - may result in vocab harmonization needs
• Patient Safety
  • Working on a specification to report risks associated with products
• CIC
  • Producing a document that describes conventions for Information models and Behavioural models within CIC
    • There was a discussion about this project and how CIC should collaborate with MnM, ArB and others on DAM requirements.
• Pharmacy
  • 6 ballots - 1 passed, 1 substantive issue in the remaining five
  • It appears that CPM has universal CMETs but Publishing appears to have a technical problem with them
  • One remaining topic to ballot and then Pharmacy will be mostly "done"
  • Had a discussion with new users of HL7 standards and have decided to create a introductory implementation guide.
    • Lloyd suggested that a formal project statement be created as well as referencing it from the balloted material.
• ITS
  • Spent a lot of time on hData - went out as two informative ballots which passed but the negative comments are being dealt with.
  • There may be some harmonization proposals as the hData record format is re-architected.

MnM Report

• Reconciled MIF and it only had 1 negative
• RIM and Core Principles will be balloted again in May
• Project with SD,SOA,OO to define a methodology for creating models that are usable in multiple paradigms
• Reviewed a draft artifact definition document
• Discussed Role Identity/Equivalence - guidance will go in the Core Principles
• Accepted process for non-English vocabulary harmonizations
• Grahame will be presenting a way of identifying meta-data about a model, i.e. how to answer the question "please do this in this way"
• Hot Topics were resolved
• Agreed to a project to formally define all artifact types in SAIF-based methodology
• Resolve that Datatypes 1.1 can not be officially referenced in any HL7 International Normative or DSTU specification