20130213 FGB concall

HL7 TSC FGB Meeting Minutes Location: call 770-657-9270 using code 985371# GoToMeeting ID: 489-406-709		Date: 2013-02-13 Time: 5:00 PM U.S. Eastern
Facilitator: Woody		Note taker(s): Lynn Laakso

Quorum = Chair plus 2				yes/no
Chair/CTO		Members		Members
regrets	Ron Parker	x	George (Woody) Beeler	x	Ewout Kramer
	John Quinn	x	Grahame Grieve
observers/guests				x	Lynn Laakso, scribe
					Austin Kreisler

Agenda

• Roll call -
• Agenda Review
• Approve minutes of 20130206 FGB concall
• Action Item review:
  • Ron to speak with PIC regarding “help wanted” wiki development.
  • Grahame will have patent position for next week's review.
  • Check on Grahame's description next week of the nature of relationship with IHE and what to accomplish needs a couple paragraphs from Grahame to go to Chuck Jaffe.
  • Ron and John to remind Chuck we intend to proceed with IHE plan and then draft for him some guidance for his endorsement
  • Ron to collaborate with Grahame on risk assertions for FHIR and draft precepts; check back next week.
• FMG update -
• Methodology update-
• Review precepts, associated governance points and risks
• HL7/IHE/DICOM coordination (John)
• Next steps: Define and Resource other Governance processes.
  1. Education
     • Need a work plan that is coordinated with HL7 Education Director
  2. Conformity Assessment
  3. Appeal Process / Escalation
     • What is the appeal process for resources not chosen for inclusion in the ballot?
     • What is the appeal / escalation process for Management decisions?
     • What is the appeal / escalation process for Governance decisions? Responsibilities for resources (education, conformity process, appeal process)

Minutes

• Roll call - convened at 5:10 PM
• Agenda Review
• Approve minutes of 20130206 FGB concall Grahame moves and Ewout seconds - unanimously approved
• Action Item review:
  • Ron to speak with PIC regarding “help wanted” wiki development. Ron is not available
  • Grahame will have patent position for next week's review.
  • Check on Grahame's description next week of the nature of relationship with IHE and what to accomplish needs a couple paragraphs from Grahame to go to Chuck Jaffe.
  • Ron and John to remind Chuck we intend to proceed with IHE plan and then draft for him some guidance for his endorsement; defer
  • Ron to collaborate with Grahame on risk assertions for FHIR and draft precepts; check back next week. Woody adds Grahame's list from last week and discussion ensued.
• Review precepts, associated governance points and risks
  • Ease of use -Ewout says you should be able to get a rough definition in a weekend.
  • Woody asks if we can assert the target implementation communities.
  • First four will be true for some group of people who step up to participate in FHIR. Risk is that we will not have ability to manage perceptions among them (multiple implementation groups) to find a collective sweet spot.
  • Ewout notes concern expressed that it may work for mobile and not anything else
  • Regarding HL7 process, where V3 academics accommodate the 99% instead of 80% useful for implementers. Risk is that academic issues dominate the discussion and prevent advancement. Mitigation is to have bright people come up with proposed reconciliations and vote on the block.
  • That brings up the scope creep issue to be lost in committee churn to the process "block" of comments. Risk is that FHIR will fail to deal expeditiously with details that can be clearly resolved by a consensus of participants but not unanimous agreement among participants. Ewout comments on how participants reopen discussions without control by chair. What is the mitigation? Need to manage discussion tightly and briskly. Some work groups are afraid of conflict and won't attempt to control the lone dissenter. Biggest mitigation is the governance and management groups, notes Grahame.
  • Too much - both the spectrum of technology as well as the spectrum of data. Grahame recounts approach suggested is to stick to REST and not try to do messages and documents as well, or concentrating on ADT and not the rest of it. Woody thinks the context of use would affect it. Not a binary choice but spectrum spread. Grahame recounts Raup's implementation and Matthew Graham's work at Mayo. Woody asks if it could be made more clear in the introductory material. Pharmacy will come up in the same space in comparing FHIR EHRs to a Google EMR as a technology issue. Woody recounts Korean national effort for IHE-type health record stored in repository based on CDA. How to determine if it is a 'step too far'. Ewout notes in data, if people want more they can have more, using extensions. The specification does not describe how one disassembles a composite document or addressing certain messages. Not describing how to make FHIR into full terminology server. Not making more serialization or packaging formats. Grahame notes they are considering SMS and RDF formats however. We don't try to create consensus about what belongs in FHIR, he notes. Ewout notes that PA has avoided trying to model things like 'employees' for resources. Constraint of end point platform with result set of a query is a consideration.
  • Scope regarding too much or too far should be managed by being well expressed in specification so that governance board and management can assist them in determining scope without thrashing issues preventing development and adoption of FHIR.

Adjourned 6:05 PM

Next Steps

Actions (Include Owner, Action Item, and due date)

Next Meeting/Preliminary Agenda Items 20130220 FGB concall

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