2018-02-02 SGB WGM Agenda

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HL7 SGB Minutes Location: TBD		Date: 2018-02-02 Time: 9:00 AM Central
Facilitator	Paul/Calvin	Note taker(s)	Anne

Attendee	Name
x	Calvin Beebe
x	Lorraine Constable
	Russ Hamm
x	Tony Julian
x	Paul Knapp
	Austin Kreisler
x	Wayne Kubick
x	Thom Kuhn
	Ken McCaslin
x	Rik Smithies
	Sandy Stuart
x	Ewout Kramer
Quorum: Chair + 4

Agenda

• Agenda review
• Q1
  • Short/long term work plan for SGB
  • Drafting Shared Product Management Responsibilities
  • Technical Alignments Between Product Families
  • How groups are to interact with publishing, EST, Vocabulary, etc.
• Q2
  • RDAM/projects referencing SOLOR re: licensing issues (with HTA)
  • Precept for adding new tools (include that WGs with a specific mandate must be involved, such as EST, Publishing, Vocabulary, etc.)
  • Precept on bringing in large projects
  • Vocabulary - review HTA material for precepts

Minutes

• Agenda review
  • Made adjustments
• Issues from the week:
  • Calvin mentions HAI project that wants to ballot and produce two artifacts from a single ballot (FHIR and CDA) and they want them to be consistent in content. They are going to Lynn to discuss whether or not it can be done. We do allow multiple artifacts from the same PSS but these are different product families. Is this governance or tooling? Issues of tooling and issues of governance.
  • Lorraine notes that an issue from the week is that we’ve created building blocks and now we’re trying to put them together; need to have more cross conversations.
  • Calvin: Also, Structured Documents is beginning to get a pinch that they need to change value sets on a regular basis. Struggling with what frequency do you produce value set artifacts such that they’re current to and legally respect the contracts we’re operating under? Consolidated CDA took a vote that the bindings of value sets in C-CDA should consider all the bindings as dynamic. All the value sets there come from CDA, that is based and biased by the RIM which are statically defined. This vote has no applicability to that standard. What is specified in the base standard is fixed. We have no governance over the vocabulary. Our standards need to be the structures that are statically defined, but the content bindings that you need for SNOMED and LOINC have to be dynamic, and we’re backing ourselves right back into concept domains. All the product families have to come to grips with this. We’ve got a whole way of thinking about our standards and their value set bindings that we’re not dealing with. If we create the notion of the generalized and the instance of the specific, you can claim conformance to the general. C-CDA is US centric, and the new International Patient Summary project is the international representation. Lorraine notes that C-CDA has implications beyond US Realm.
  • Calvin notes that Structured Documents used sections over again in multiple document types, and he is suggesting that it may be too hard for vendors to implement. Structure has been over specified by reusing it. Now looking at methodology and saying the document types should be created with less structure. This is a learning experience and likely not a governance issue; CDAMG might look at it. Paul asks if it could happen in V2, V3, or FHIR? FHIR has a lot of implementer feedback embedded in the development process. Lorraine: Could happen in QI Core/US Core. Paul: Lack of structure can lead to variability in where the information is recorded. The epiphany for report writer is that over specifying structure when adoption is optional has proven to be unadoptable. They are simply handling it with big text boxes. One of the fundamental issues; is not directly a governance issue. Decreases the likelihood of interoperability.
• Q1
  • RDAM/projects referencing SOLOR re: licensing issues (with HTA)
    • The issue is that SOLOR is tooling and supporting code coming out of VA/HSPC for terminology support. Supposed to link RXNorm/SNOMED and provide crosswalks. Is a common structure but they don’t map term to term. CIMI says they use SOLOR for terminology, but that’s not exactly what they’re doing. RXNorm is US-based and they’re using it in an International standard. SOLOR is just a tooling. The issue isn’t so much SOLOR as it is RXNorm. If our things become dependent on an external thing, we’re impacted. CIMI has said they’re using SOLOR to produce terminology, so it’s part of the tool kit separate from licensing. The issue for HTA is really how do we make sure that SNOMED and LOINC are available to the rest of the world. SOLOR is just a table of references that is helpful to standards developers. Would be easy for us to require that when they’re putting their standards together they reference the original value, not the SOLOR values. This issue may have resolved itself in terms of what we need to discuss with HTA. Probably more informational than issue.
    • Discussion over projects coming in with new tooling that isn’t being reviewed.
  • Short/long term work plan for SGB
    • Short term:
      • HTA set of precepts. Do we have a vocabulary precept that our value sets have to change in our standards based on the rules of licensing? We have a SNOMED contractual obligation to keep the sets current. Need communication from HTA on these issues.
        • ACTION: Create PRECEPTS that require that it be articulated in the standards how the value sets specified within the standards respond to changes in regulation, licensing, time, etc.
        • ACTION: Look at creating the precepts in April/before Cologne.
        • ACTION: Post documents regarding HTA/vocabulary precepts and send out
      • Need to look at how we address tooling with precepts. Need to inform the organization that the process is an investment in two resource bodies: the CTO and the TSC.
        • PRECEPT: In order to ensure sustainable tooling, the organization needs a reasonable and rational vetting process on any new tool that becomes a dependency of the efficient and effective generation of standards.
          • MOTION to accept this precept: Lorraine/Calvin
          • VOTE: Ewout abstains. Remaining in favor
• Election of co-chair to replace Austin
  • Paul asks for nominees. Lorraine puts her name forward. All members vote to put forth Lorraine’s name as candidate.
    • MOTION to appoint Lorraine as cochair: Calvin/Thom
    • VOTE: All in favor
• ACTION: Carry forward:
  • Drafting Shared Product Management Responsibilities
  • Technical Alignments Between Product Families
  • How groups are to interact with publishing, EST, Vocabulary, etc.
  • Elections
• Q2
  • Session with HTA
    • Raised a number of issues that we need to think about. You have to update your specifications if they contain SNOMED codes with the current version at the time of ballot, and if you otherwise would’ve been doing a reaffirmation, you actually have to reballot unless you ask HTA for an authorization to continue with the same code. Discussion over how you tell what version is being used. Need to specify the time context of what was current then.
  • Meeting time for Cologne with HTA
    • Last third of Sunday Q2 and last half of Thursday Q4 we’ll meet with HTA
  • Precept for adding new tools (include that WGs with a specific mandate must be involved, such as EST, Publishing, Vocabulary, etc.)
• ACTION: Carry forward:
  • Precept on bringing in large projects
  • Vocabulary - review HTA material for precepts
• Adjourned at 12:25 pm Eastern

Meeting Outcomes

Actions

Next Meeting/Preliminary Agenda Items TBD

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