MnM Minutes WGM 201305 Atlanta

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Sunday May 5 Q3

Agenda

• Hot topic triage
• Agenda planning

Attendees

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Grieve, Grahame (Health Intersections Pty Ltd)

Hay, David (HL7 New Zealand)

Kramer, Ewout (Furore)

Loyd, Patrick (ICode Solutions)

McKenzie, Lloyd (HL7 Canada)

Shakir, AbdulMalik (City of Hope National Medical Center)

Stechishin, Andy (CANA Software & Services Ltd.)

Walker, D. Mead (Mead Walker Consulting)

Hot topics

1. RIM ballot reconciliation - Fixed values for collections of repeating attributes - What's the RIM default - How do we make it work in the schema generator

2. Lloyd will close the "social media" hot topic

3. Discussed "Model to Template Relationship", but no need to bring it up as a hot topic

4. Data types vocabulary schemas - what are we allowed to do within the framework of the ISO spec

5. FHIR RIM mappings - What will RIM mapping look like? - What do we do when the RIM can't do it? - What will it achieve?

Will tackle #1 and #4 in this meeting, #5 slotted for joint FHIR/MnM discussion For Wed Q3, will host FHIR (will release room 219)

Release rooms for Tue Q1, Tue Q4

Move SAIF Artifact Definition Project from Tuesday Q4 to Thursday Q2

Motion: approve agenda for WGM - Woody/Patrick

RIM ballot reconciliation

1. Dale's 2 comments - not persuasive 7-0-1 (Woody/Grahame) 2. blocked context conduction relationships:

• will create value sets containing conductable act relationship codes
• can create a new value set that constrains the base value sets as per the rules in Core principles
• can create a fixed value that is a "list of codes" that draws from the codes in the value set
• need to verify this will propagate properly through the tools to the schemas
• will document this in Core principles

Motion: Woody/Grahame 5-0-0

Woody takes action item to update Core Principles

Based on the above, Woody withdraws his negatives

Monday May 6 Q1

Agenda

Chair - Beeler & Grieve

• FHIR Methodology

Attendees

Abrahao, Marivan (HL7 Brazil)

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Cabrita, Rolim (Interfaceware)

Duteau, Jean (Duteau Design Inc)

Fine, Steven (Cerner Corporation)

Glinski, Steve (Surescripts)

Grieve, Grahame (Health Intersections Pty Ltd)

Henderson, Mike (Eastern Informatics, Inc.)

Jewell, Gabriele (Cerner Corporation)

Konishi, Yukinori (HL7 Japan)

Liu, Andrew (HL7 Canada)

Lynch, Cecil (Accenture)

Moehrke, John (GE Healthcare)

Parker, Ron (HL7 Canada)

Ryal, Tod (Cerner Corporation)

Shaver, Dave (Corepoint Health)

Smithies, Rik (HL7 UK)

Takasaka, Sadamu (HL7 Japan)

Walker, D. Mead (Mead Walker Consulting)

Wong, Nat (HL7 Australia)

Worden, Robert (Open Mapping Software)

Kavanagh, Richard (NHS England)

Walia, Randeep (Grafight Scratch, Inc.)

Murty, Kurella (Roche)

Topic: mustUnderstand

Discussion of mustUnderstand - Motion from G Grieve/Rik Smithies to "Rename mustUnderstand to isModifier, and add sentence saying that you must explain why it is that you think it is a modifier and/or what it modifies."

Approved 25-0-0

Topic: Various

Discussions around "messaging-like" paradigm with FHUR similar to V2, can be defined and has been tested.

Discussions on "Profile" resource and what is does. Is rather larger than desired. Was noted that although it is defined as a Resource, it is unlikely to be exchanged as instances.

Security and FHIR

There is a Wiki document in the "FHIR Publication" that is being built with the guidance of Security Work Group lists security-related issues when using FHIR, and how and where these might be addressed.

Monday May 6 Q2

Ewout Kramer and Woody Beeler for FHIR and MnM

Agenda

• Host FHIR
• FHIR Methodology

Attendees

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Brancato, Chris

Cheung, James (Kaiser Permanente)

Fine, Steven (Cerner Corporation)

Greim MS RN-C, Patricia (U.S. Department of Veterans Affairs)

Jewell, Gabriele (Cerner Corporation)

Kavanagh, Richard (NHS England)

Kramer, Ewout (Furore)

Liu, Andrew (HL7 Canada)

Lynch, Cecil (Accenture)

Moehrke, John (GE Healthcare)

Ott, Russell

Parker, Craig (Intermountain Healthcare)

Pupo, Erik (Deloitte Consulting LLP)

Ryal, Tod (Cerner Corporation)

Shaver, Dave (Corepoint Health)

Smithies, Rik (HL7 UK)

Walia, Randeep (Grafight Scratch, Inc.)

Walker, D. Mead (Mead Walker Consulting)

Wong, Nat (HL7 Australia)

Distinction between "Type" and "Code" and Other field names

Rationale for discussion: "type" and "code" have been used as attribute names for what is likely to be an encoded result.

Discussion suggests that: "code" commonly adds NO understanding; should not repeat name of element in attribute; type works where it is the type of the element; code is not useful; if need further distinction and expand "type"

Similarly, "date" as an attribute name will beg the distinction of which kind of "date" (e.g. see V3 Act) is intended.

Usage of Terms like "Subject", "Author"

There were notes about inconsistencies of use of these terms. Discussion here suggests that:

1. Whatever definition for a term like "author" (for example) that FHIR selects should be consistent throughout FHIR
2. A Glossary would be very difficult (these tend to be more fine-grained than the usual glossary)
3. The RIM vocabulary (participation type codes, for example) provide fairly carefully thought out (and reviewed) set of definitions for things like "author", etc.

Suggest that FHIR consider adopting upper and lower camel case for names - lower for parameters and attributes, upper for resources and elements; etc.

Also the uniqueness criteria for names should be case agnostic. Thus "LastMan" and "lastMan" are not unique.

Discussed McKenzie Discussion of "Subject"

Appears focused on context conduction and the need to clearly state what if ANY assumptions can be made thereabout. What if a contained object has no subject??

Discussion recognized that FHIR's light-weight reference mechanism makes it reasonable to represent the subject in (for example) each member of a battery of tests.

Subsequent Summary by E. Kramer on this discussion and the topic above it

What the notes don't reflect is that there was no clear consensus about the use of subject/author etc. Most agreed that it was not necessarily a good idea to use them everywhere, because e.g. Order.subject is ambiguous.

There was concern that because of the v2/v3 background, users of the spec would assume they understood what "subject" and "author" means, though in FHIR the meaning of that word may change from resource to resource.

So, the consensus was that it should be used consistent across all resources if it is used on occasion, but that it is not necessarily a good idea to try to use these terms in all resources.

Discssion of mustUnderstand on optional Booleans

The line item 6 from McKenzie, is moot if all mustUnderstand have minimum cardinality of 1, which is currently on the "warning" track for becoming a rule.

Monday May 6 Q3 and Q4

Agenda

• Join Joint w/FHIR, ITS
• FHIR Infrastructure issues

Minutes by ITS

Tuesday May 7 Q2

Agenda

• "Ask MnM"

Tuesday May 7 Q3

Joint w/ Structure Documents (refer to their minutes)

Wednesday May 8 Q1

Agenda

• Host Vocab
•  ???

Representation of Human Language ConceptDomain

Problem is that the ConceptDomain HumanLanguage is bound in the RIM and data types. The Data Types binding causes a Universal binding to a ValueSet (from the ConceptDomain referenced in Abstract Data Types). There is a need presented to have the data type for RIM languageCode be CD (or CE) which would require a different binding.

Recognize that a different Concept Domain could be used for the RIM binding of languageCode in RIM, that then might be used for a different binding in a realm. Challenge is

Wednesday May 8 Q2

Agenda

• Host Vocab, FHIR
• FHIR Vocabulary

Wednesday May 8 Q3

Agenda

• Host FHIR
• FHIR Core

Thursday May 9 Q1

Agenda

• FHIR Methodology

Thursday May 9 Q2

Agenda

• SAIF Artifact Definition

Thursday May 9 Q5-Q6

Agenda

• MnM Roundtable

Thursday May 9 Q2

Agenda

• SAIF Artifact Definition

Friday May 10 Q2

Agenda

• Meeting planning