MnM Minutes WGM 201601 Orlando

M&M Working Group Meeting - January 2016 - Orlando

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Mon Q2 - Open Business

Agenda

• Approve Minutes Prior Meeting on 12/01
• Approve Minutes Prior Meeting on 01/05

Attendees

• Woody Beeler, Beeler Consulting (chair)
• Elliot Silver, McKesson

MnM Functions

We lacked quorum, and therefor took no action on the minutes listed above and moved them to the next MnM quarter.

Elliot Silver, who is a Co-Chair of the Imaging Integration Work Group (IIWG) came to this session because he was interested in the modeling and desirous of determining how best the IIWG should interact with the modeling and terminology aspects of Vocabulary and FHIR.

Beeler provided a brief, but brilliant, overview of the history of MnM, RIM and V3 and its relationships to FHIR. In discussion we agreed he should contact McKenzie regarding the RIM-mapping of the ImagingObjectSelection resource in FHIR, might avail himself of pizza at the Facilitator's Roundtable, and should contact Vocabulary in regards to establishing a Vocabulary Facilitator role for the IIWG, if that is needed.

Tue Q3 - Hosting FHIR Infrastructure

Agenda

• TBD by FHIR

Attendees

• Lloyd McKenzie (chair/scribe)
• Bob Bishop
• Dennis Patterson
• Ewout Kramer
• Ron Shapiro
• Michael Donnelly
• Joshua Mandel
• Kevin Shekleton
• Artem Sopin
• Mead Walker

How do _include and _revinclude work?

Question from Artem. Brief discussion and explanation of how these can be used.

Artem agreed to submit a change request to include a 'complex' example showing how multiple layers of _include, _revinclude and various other search parameters could be combined

How much consistency can we expect from servers?

Question from Artem. Short answer: none. In the base spec, servers are permitted to have a wide range of capabilities. Consistency around server capabilities can only be expected if the server capabilities are standardized by agreed profiles. Clients who want to work with a wide range of servers will need to query the Conformance instance of the server and adapt to what the server can manage and handle the rest itself and/or limit its own exposed capabilities to reflect those of the server.

Grahame request

These 3 value sets: http://hl7.org/fhir/valueset-signature-type.html http://hl7.org/fhir/valueset-timing-abbreviation.html http://hl7.org/fhir/valueset-identifier-type.html

each include codes defined in a code system that is not bound to the schema. For this reason, the codes defined in these 3 value sets are supposed to moved through harmonization to elsewhere

timing=abbreviation - add to GTSAbbrevation

identifier-type -> add to v2 table

signature-type: policy question

• Created and approved 9239
• Created and assigned to Security: 9240

Change proposals

• 9182 - Not persuasive
• 9031 - Persuasive
• 8979 - Persuasive with mod
• 8777 - Not persuasive

See trackers for votes & details

Wed Q1 - Hosting Vocabulary and FHIR Infrastructure

Agenda

• Signature type VS
• FHIR Code systems
• Expansion profile resource

Attendees

• George Beeler (chair)
• Ted Klein
• Sheryl Taylor, NIST
• Sandy Stuart
• Grahame Grieve
• Carol Macumber
• Heather Grain
• Carmela Couderc
• Yunwei Wang
• Ron Shapiro
• Dave Carlson
• Peter Jordan
• Greg Gustafson
• Susan Barber
• Rob McClure
• Jay Lyle
• Oyrind Aassue
• Rob Hausam
• Masoud Hosseine
• Igor Gejdos
• Chris Grenz

Signature Type Value Set

Closed. Issues arise because of the use in this code system of OIDs for the primary code, and concern for IP issues with respect to ASTM. Grahame will communicate with Security work group to seek a path or alternative to the use of ASTM Code system ( see Urn iso-astm:E1762-95:2013)C

FHIR Code Systems

Should the FHIR "Terminology Service" be extended to provide access to Code Systems?

Good discussion and recognition that this is HARD to do, and we have not been able to find a partner that will take on support of HL7's terminology.

Solution: Create a CodeSystemInformation (or some such) resource in FHIR. This will provide the other information needed, but will not be a full-blown codes system maintenance environment.

For now, we need to address the immediate FHIR requirement and not try to extend to address all HL7 needs.

Motion: That FHIR move code system from being in-line in value set and make it a resource. That the scope of this resource is the existing code system definition with additional code system information to be determined but not terminology maintenance.

Grieve Moved, Hausam Seconded Passed unanimous

ExpansionProfile resource

This has been implemented and is being implemented by Australia (Michael Lawley). Interesting discussion around whether an expansion should/could include codes that are not present int "current" version of a code system, but were present in the past. Discussion ended with no action, but principal discussants listened and learned from each other.

Wed Q2 - Hosting Vocabulary and FHIR Infrastructure

Agenda

• DSTU Vocabulary Items for FHIR
• V3 in re data types
• Archive Project 761 - Information Model Metadata Documentation
• Vocabulary Processes for
  • V2, CDA CIMI

Attendees

• Beeler (chair)
• Ted Klein
• Sandy Stuart
• Carol Macumber
• Heather Grain
• Carmela Couderc
• Susan Barber
• Rob McClure
• Rob Hausam
• Russ Hamm
• LLoyd McKenzie
• Laura Heritage
• Jim Case
• Craig Parker
• Elaine Ayres

Archive Project 761 - Information Model Metadata Documentation

McKenzie moves archive it. McClure Seconds Unanimous

TODO: MnM needs do this in Project Insight

V3 in re data types

Change proposal in regards to codes used in DT R2. Is actually a change to the Data Types R2 specification, but solely embodied in vocabulary tables. Lloyd suggests add codes to the code systems, but not to update the DT R2 release. Need to investigate relationship of V3 schemas and the code system content.

Action - GWB to investigate relationship to generated schemas. What objects are being changed. Where to ramify the changes - DT-R2 (no); V3 schemas?

Vocabulary Processes for V2, CDA & CIMI

V2

V2 table updates make this easier to accomplish, and Ted has created a V2 vocabulary change request form to affected parties. Discussion needs a little header meta-data to facilitate review in Harmonization. Lloyd had proposed some additional changes when he trialed the form. Agreed that we will use Harmonization to start for this.

CDA

Discussed the CDA need for a RIM/vocabulary that "formally" uses DT-R1. Ted and Woody in separate SD meetings outlined the issue to them. Henket and Kreisler are primary SD contacts.

CIMI

They are doing vocabulary but are not yet engaged in Vocabulary process, but they seem open to it.

Value Set Definition Project

Project is close to reconciliation and publication-ready. Spent three quarters on it at this WGM. Believe it will be published before the next WGM, but needs a motion in Vocabulary.

1. Document is available (via VSD wiki project page)
2. Need people to read this through (comments to McClure in next 14 days)
3. Can and may edit in DropBox, if you ask McClure for permission
4. Have been some significant changes to what was voted on, but this is permitted as a DSTU
5. May require updates to the existing HL7 VSDs

Value Set Binding Syntax Project

Have re-factored the syntax to simplify it. It is on the Wiki.

Have had strong participation from V2 and NIST. Seeking feedback from CDA, CIMI, MnM and FHIR.

Thu Q2 - Hosting FHIR Infrastructure

Agenda

• Approve Minutes Prior Meeting on 12/01
• Approve Minutes Prior Meeting on 01/05
• Quality criteria

Approve Minutes Prior Meeting on 12/01

Moved/Seconded Beeler, Grenz approved 8-0-0

Approve Minutes Prior Meeting on 01/05

Moved/Seconded Beeler, Grenz approved 8-0-0

Attendees

• LLoyd McKenzie (chair)
• Woody Beeler (scribe)
• Simon Knee
• Peter Jordan
• Andrew Torres
• Sungchul Bae
• Chris Grenz
• Mead Walker
• Michael Rutter
• Joon Hyun Song
• Joe Lamy

Quality Criteria

McKenzie reviewed a number of extant FHIR quality criteria to illustrate what are the good criteria to be applied. Looking now at criteria for elements other than resource content. See FHIR Conformance QA Criteria

The components of the Criteria on the wiki were updated (extended) during the meetings. To see which were altered, see the "History" for that Wiki page by lmckenzi dated Jan 14, 2016, 12:33 ans 13:27.

• Action Item for Lloyd:

  Raise the question in Vocabulary and FHIR lists of the need/desire for a "computable" Name (as opposed to the current unconstrained string) for FHIR ValueSet and ConceptMap.

• Action Item for Lloyd:

  Solicit thoughts on TestScript naming from the FHIR list.

Thu Q5 - Facilitators Roundtable

Agenda

• Introductions
• Scheduling of the 2016 Harmonization deadlines and Meetings
• Seek comments from each represented Work Group of their intended Harmonization proposals
• Discussion of V2 Vocabulary Harmonization

Attendees & Introductions

• Abdul-Malik Shakir (M&M)
• Jean Duteau (M&M)
• Brian Pech (v2 Publishing)
• Ted Klein (Vocabulary)
• Calvin Beebe (StructDocs)
• Tony Julian (InM)
• Austin Kreisler (StructDocs)
• Ewout Kramer (FHIR)
• Eric Haas (PHER)
• Michel Rutten (Observer)
• Anoop Sheth (Observer)
• Lloyd McKenzie (MnM/FHIR)
• Paul Knapp (ITS/FM)
• Lorraine Constable (O&O)
• Andy Stechishin (v3 Publishing)
• Rob McClure (Vocab)
• Woody Beeler (M&M)
• Joginder Madra (PHER)
• Elliot Silver (Imaging)
• Dale Nelson (ITS)
• Amnon Shabo (Clinical Genomics)
• Diana Proud-Madruga (SOA)
• Russ Hamm (Vocabulary)
• Mary Kay McDaniel (FM)
• Mark Shafarman (Templates)
• Brian Postlewhite (PA)
• Alexander Henket (PA)
• Rob Hausam (Vocab)
• Sandy Stuart (InM)
• Melva Peters (Pharmacy)
• Grahame Grieve (M&M/FHIR)
• Rik Smithies (Clinical Statement)

Scheduling of 2016 Harmonization

The following schedule works backwards from the planned "ballot open" dates as posted on the HL7 Website. In the following, the notation T1, T2 and T3 represent the first, second and third trimesters of the HL7 year.

T1 Harmonization March 8-10 2016

• Initial Proposal Deadline February 7, 2016
• Final Proposal Deadline February 28, 2016

T2 Harmonization July 12-14 2016

• Initial Proposal Deadline June !2, 2016
• Final Proposal Deadline July 3, 2016

T3 Harmonization November 8-10 2016

• Initial Proposal Deadline October 9, 2016
• Final Proposal Deadline October 30, 2016

Roundtable Reports

SD

• formal adoption of concept domains in the CDA model will result in many domain proposals
• relax universal binding on HumanLangauge
• roadblocks on LOINC codes for IGuides

M&M

• one v2 proposal to trial the new process

O&O

• UDI proposal
• may have a v2 table proposal

Security

• audit lifecycle proposal
• consent proposals

Vocabulary

• Value Set Definition is almost ready for publication
• CIMI is a WG which results in five sources of vocabulary (V2, V3, CDA, FHIR, CIMI)
• Getting closer to a signed agreement about SNOMED CT IP
• Still determining the best approach for supporting Structured Documents in moving vocabulary backwards into an older version of the RIM
• Work is moving forward on a unified vocabulary process initiative
• Continuing work on Terminology Binding - look at the Bindings Project for information

TermInfo

• published a new "Use of SNOMED in CDA R2"

M&M/FHIR

• there will be v3 methodology on the V3 and FHIR Methodology calls
• quality criteria for FHIR implementation guides and profiles
• FMG/FGB will not be balloting in May but will be balloting all resources in September
• FMG will be looking at rules for Connect-a-Thons and the rules around ballot comments for Resource maturity

V2 Vocabulary Harmonization Discussion

• V2.9 is planned to be balloted in the May ballot cycle
• M&M/Vocabulary voted that changes for V2 vocabulary would be brought forward to Harmonization
  • Since we have clean vocabulary, we would like V2 vocabulary to go through the Harmonization oversight process
  • For joint vocabulary, they should come to Harmonization at the same time. They could be in one proposal but if is done as two proposals, then you should indicate that the proposals are linked (the Harmonization Proposal ID should be used to ensure that they are kept together)
• Harmonization output will be a MIF for V3 and an export of the V2 tables