2017-05-31 SGB Conference Call

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HL7 SGB Minutes Location: https://global.gotomeeting.com/join/538465637		Date: 2017-05-31 Time: 10:00 AM Eastern
Facilitator	Paul/Calvin	Note taker(s)	Anne

Attendee	Name
x	Calvin Beebe
regrets	Lorraine Constable
x	Russ Hamm
x	Tony Julian
x	Paul Knapp
x	Austin Kreisler
x	Wayne Kubick
	Mary Kay McDaniel
	Ken McCaslin
x	Rik Smithies
x	Sandy Stuart
x	Lisa Nelson
Quorum: Chair + 4

Agenda

• Agenda review
• Approve Minutes of 2017-05-07_SGB_WGM_Agenda
• Approve Minutes of 2017-05-12_SGB_WGM_Agenda
• Action Items
  • Wayne will forward info from Grahame on variance from normal balloting/publishing process
  • Anne to send provider role nomination solitication to cochairs list copying Paul and Austin
    • Complete
  • Revisit our current precepts and add who our precepts apply to and how they are to be implemented
  • Paul to write precept on mixed ballot content
    • Related: Find principles document
  • Austin to update mission and charter boilerplate
  • Anne to gather all principles and precepts and publish on Wiki by mid-June
  • Tony to find vitality assessment slide deck
  • Anne to complete meeting room request – Q3 on Sunday and Q1 and Q2 on Friday
    • Complete
  • Followup on Issues around Privacy Assessment Cookbook
    • Kathleen Connor to take back questions. The term Standards Under Review (SUR) is not used by HL7.
  • SGB to join ARB on 2017-06-06
• Discussion Topics
  • State machine alignment between CDA and FHIR - Lisa Nelson
  • Review PIC document on balloting best practices
• Parking Lot
  • Review Publishing M&C updates regarding dual roles
  • Write/post precept on vitality assessment
  • Next steps on Substantivity (from ARB)
  • How do we deal with making sure that WGs involve those whose content domain they’re touching? (CIMI and Pharmacy and Lab models)
  • Review Mission and Charter
  • PSS approval process: managing unresponsive parties - propose new precept to TSC
  • Handling situations where two documents come out of one project
  • FHIR Product Director Position Description: we should 1) review further and draft feedback, then 2) map back the description to the role of FGB
  • Drafting Shared Product Management Responsibilities
  • Vocabulary precepts
  • General precepts
    • Precept around training WGs in CDA methodology and management principles
  • Levels of standards
  • Separation of concerns
  • Ownership of content
  • ISM
  • Ask methodology groups to define how the definition of substantive change applies to their product family; management groups must then operationalize

Minutes

• Agenda review
• Approve Minutes of 2017-05-07_SGB_WGM_Agenda
  • MOTION to approve: Russ/Austin
  • VOTE: All in favor
• Approve Minutes of 2017-05-12_SGB_WGM_Agenda
  • ACTION: Anne to add approved ballot comment disposition to TSC agenda for review
  • MOTION to approve: Rik/Austin
  • VOTE: All in favor
• Action Items
  • Wayne will forward info from Grahame on variance from normal balloting/publishing process
    • Nothing yet
  • Anne to send provider role nomination solicitation to cochairs list copying Paul and Austin
    • Complete
    • Several responses have been received.
  • Revisit our current precepts and add who our precepts apply to and how they are to be implemented
    • ACTION: Add to next week's agenda under discussion
  • Paul to write precept on mixed ballot content
    • Related: Find principles document
      • Add to next week
  • Austin to update mission and charter boilerplate
    • Add to next week
  • Anne to gather all principles and precepts and publish on Wiki by mid-June
    • Add to next week
  • Tony to find vitality assessment slide deck
    • Add to next week
  • Anne to complete meeting room request – Q3 on Sunday and Q1 and Q2 on Friday
    • Complete
  • Followup on Issues around Privacy Assessment Cookbook
    • Kathleen Connor to take back questions. The term Standards Under Review (SUR) is not used by HL7.
  • SGB to join ARB on 2017-06-06
• Discussion Topics
  • State machine alignment between CDA and FHIR - Lisa Nelson
    • Lisa here to discuss. Topic has wide ranging ramifications, including to patient safety. Implementers moving data back and forth between CDA and FHIR using a state model. There are many places where there are entries that include a state model that can be active, suspended, aborted, or completed that can be captured. The problem arises because the FHIR resources that have been profiled to correspond to the information have different state models - active, recurrence, relapse, well-controlled, poorly-controlled, inactive, remission, resolved. The state models don't line up and cause chaos. We need to be proactive about resolving this by setting forth some principals. Right now, we don't have all of the CDA entry templates lined up with FHIR resources; the responsible way is to establish a proper profile on the appropriate resource and complete accurate mapping.
      • Paul: It's surprising the degree of difference. Is that an artifact of blank sheeting it? Lisa: Yes, and it's different people involved. Paul: Are the states in CDA coming from the RIM? Lisa: Yes, that's correct. Paul: Is it an older RIM? Austin: They've been static for a long time. Rik: Some of the CDA states probably can't be realistically represented. Discussion over if the same issue exists in V2. Austin: Some of these may need to map to the role state machine. Lisa: Additionally, the state model that goes with concern is a whole different issue than the clinical status of a problem. The value set that the clinicians use for clinical status was put in the spot that maps to the state model of the information in CDA. Austin: FHIR resources are more interested in the business states. The RIM distinguishes between clinical and business rather than mingling the two. Discussion over work currently going on in workflow.
      • Paul: Certain methodology should apply across the organization, and by creating separate methodology, we risk siloing. Austin: The theory is that we have a single methodology group doing V3 and FHIR. Paul: I think we need to move this issue back to the methodology group to address this problem, with the recommendation that we think the state machines of information should be separate, and that we should provide a manageable progression to the marketplace. We need to also think about where else this behavior might be occurring. Discussion over mood code alignment, as there is no true mood code in FHIR. We also need to understand the things we've decided not to do anymore and the reasons for not doing them. To what degree is this MnM and to what degree is it Structure Docs?
      • ACTION: Paul to draft a precept on state machine alignment
      • ACTION: Anne to invite MnM/InM//Structured Docs cochairs to 2017-06-14 call to discuss

• • SPIA email followup
    • Reviewed email from David Pyke. Decision had already been made that it would not be mandated. Remaining questions from SGB were over terms appearing in the document.
      • ACTION: Anne to respond (copying Austin/Paul) that SGB had previously been asked to consider mandating and declined to do so as we believe that the use of the Cookbook as guidance is more appropriate. During the committee's review of the document, we had identified a term (SUR) which appeared not to have a definition within the document; we had asked those terms to be defined prior to publication.
  • Review PIC document on balloting best practices
• Parking Lot
  • Review Publishing M&C updates regarding dual roles
  • Write/post precept on vitality assessment
  • Next steps on Substantivity (from ARB)
  • How do we deal with making sure that WGs involve those whose content domain they’re touching? (CIMI and Pharmacy and Lab models)
  • Review Mission and Charter
  • PSS approval process: managing unresponsive parties - propose new precept to TSC
  • Handling situations where two documents come out of one project
  • FHIR Product Director Position Description: we should 1) review further and draft feedback, then 2) map back the description to the role of FGB
  • Drafting Shared Product Management Responsibilities
  • Vocabulary precepts
  • General precepts
    • Precept around training WGs in CDA methodology and management principles
  • Levels of standards
  • Separation of concerns
  • Ownership of content
  • ISM
  • Ask methodology groups to define how the definition of substantive change applies to their product family; management groups must then operationalize

Meeting Outcomes

Actions

Next Meeting/Preliminary Agenda Items 2017-06-07 SGB Conference Call

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