AID 201401 Agenda

These are the minutes of the AID HL7 User Group, which met during the WGM in San Antonio January 19-24, 2014.

Monday Q3, Minutes

Workgroup	Date/Time	Location	Chair/Scribe
AID HL7 User Group	2014-01-20, 13:45-15:00	San Antonio, USA	Chair/Scribe: Rene Spronk

Attendees

1. Rene Spronk, Ringholm (chair/scribe)
2. Peter Hendler, KP
3. Dave Shaver, Corepointhealth
4. Robert Worden, HL7 UK
5. Do Yan Lee, IHIS
6. Joon Hyan Song, IHIS
7. Michael van der Zel, UMCG
8. Andy Stechishin
9. Galen Mulrooney, VA
10. Ron Parker, HL7 Canada
11. Justin Fyfe, Mohawk College
12. Abtoni Shakid, HI3 Solutions
13. Taria Altaf, HI3 Solutions
14. Jeffrey Ting, Systems Made Simple Inc.
15. Rik Smithies, HL7 UK
16. Lloyd McKenzie, HL7 Canada
17. Claude Nanto, Cognitive Medical
18. Steve Fine, Cerner
19. Josh Mandel, Boston Childrens Hospital
20. Taf Fattani, HI3 Solutions
21. Tony Mallia, Edmond Sci

Minutes

1. Rene calls to order at 13:45
2. Administrative agenda items
   • Announcements
     • Rene: as per our DMP, I hereby announce my intent to record (video) some of the presentations; provided there are no objections.
     • Rene: there is election this week for an AID co-chair position. Please vote!
   • Approval of the agenda, as well as the agenda for the week
3. Implementing FHIR resource profiles (Tony Mallia, Edmond SCI, US, see http://www.hl7.org/documentcenter/public/wg/java/FHIRProfileSchemaPresentation20140120.pdf for his presentation, and https://vimeo.com/84673411 for a video recording of his presentation)
   • There is some work I would like to share on implementing FHIR resource profiles and detailed models as supplemental XML schemas. It sounds like this might be an opportunity to drill down on this area of specification and testing since there are many ways to construct FHIR resource payloads and for exchanges there needs to be a method of unification. The main focus of this technique is in the validation operation.
   • I will be sharing research and experimentation on using supplemental XML schemas to precisely define FHIR Resources using the example of Blood Pressure Observation. It is also possible that these schemas can be used as input to transformation tools to define precise sources or targets.
   • In lieu of textual minutes, a video recording of the presentation (with some questions/discussion edited out) can be found at https://vimeo.com/84673411.
   • Discussion/questions:
     • Michael: I worked on the FHIR toolkit to create UML from the FHIR definitions, not from the schema. Lloyd: should generate from the profiles, not from shema. Robert: I tranform profiles into eCore. Tony: that's fine, there are different ways of getting there.
     • Tony, showing a schema fragment (typedobservation.xsd), Extension has zero multiplicity. Lloyd: that's not valid, you have to have the ability to have extensions. Tony: will change that, next level of experimentation.
     • So upon receipt of a FHIR instance, one transforms the instance to a decorated variant that includes xsi:type definitions, those in turn are used to validate the instance.
     • Tony: aha, we could add an extension to the resource profile at the pint of slicing, to identify the xsi:type. Cool.
4. Supporting FHIR dcuments and REST using BizTalk 2013 (Vikas Bhardwaj/Howard Edidin, US)
   • Not presented, the speaker was not present.
5. Having sunday afternoon AID meetings
   • Rene (as a heads up) announces that AID has the intent to organize meetings on Sunday Q3/Q4 (directly after the connctathon) to exchange FHIR-specific implementation best practices. A formal motion related to this is likely to be accepted on Wednesday of this week.
   • Those in the room generally think this would be a good idea.
6. Meeting adjourned at 14:45

Tuesday Q6, Minutes

Workgroup	Date/Time	Location	Chair/Scribe
AID HL7 User Group	2014-01-21, 19:00-21:00	San Antonio, USA	Chair/Scribe: Andy Stechischin

Minutes

• Tooling presentations; Hosted by Tooling
• See the minutes of the tooling WG for details.

Wednesday Q4, Minutes

Workgroup	Date/Time	Location	Chair/Scribe
AID HL7 User Group	2014-01-22, 15:30-17:00	San Antonio, USA	Chair/Scribe: Rene Spronk

Attendance

• Peter Hendler
• Rene Spronk
• Robert Worden
• Brian Pech
• Justin Fyfe
• Andy Stechishin
• Rik Smithies
• Dmytro Rud

Minutes

1. Rene calls to order at 15:00
2. Administrative agenda items
   • Announcements
     • Rene: as per our DMP, I hereby announce my intent to record (video) some of the presentations; provided there are no objections.
   • Approval of the agenda
     • Approved by general consensus
   • Approval of the minutes of the Amsterdam out-of-cycle meeting
     • MOTION to approve the minutes of the November 2013 AID meeting held in Amsterdam. (Peter/Andy, 4-0-2)
   • Approval of the scheduled AID out-of-cycle meetings
     • MOTION to approve of the organization of the following three out of cycle meetings: one to be held on April 25 in Canada; another to be held in Amsterdam on June 3rd; and another one to be held in Amsterdam on November 27th. (Andy/Peter, 6-0-0)
     • ACTION for Andy to file the paperwork to get TSC approval for these 3 meetings.
   • Change e-mail listserv name
     • MOTION to request that HL7 HQ change the name of the listserv to aid@lists.hl7.org, with the changeover date to be agreed between the co-chairs and the HL7 webmaster. (Andy/Justin, 5-0-0)
       • Note that there are no redirects, so once the listserv name is changed that users using the old name will receive no redirection and no bounce-backs (spam rules don't allow HL7 to do bounce backs).
   • Discussion whether or not to organize one full days worth of 'users sharing implementation experiences' after each and every HL7 connectathon (currently: FHIR connectathons)
     • Rene: this could be either the monday of the WGM (also at plenary meetings), or sunday PM as long as FHIR connectathons are scheduled for the saturday-sunday of the WGM.
     • Discussion: have Sunday Q3/Q4 meetings; drop Thursday Q3 from our agenda (so we'll have 4 quarters in total), and have the joint meeting with tooling on Wednesday Q4.
     • ACTION Andy to make the room request for the next WGM
     • MOTION the AID HL7 User Group regards the participants of a HL7 connectathon to be part of its target audience and hence would like to facilitate the exchange of best practices between the connectathon participants by organizing an AID meeting in conjunction with the connecthon, i.e. Sunday Q3/Q4 for the forseeable future. (Andy/Peter, 6-0-0)
   • During its Sunday Q3 meeting, MnM added the following wording to its minutes: "Rik raised the issue of how to populate IVL_TS. M&M does not normally provide instance implementation guidance. That perhaps could be something that AID (formerly RIMBAA) does."
     • Guidance (Netherlands, Strucdoc): for 1-jan-2012 up to and inclusive of 3-jan-2012 use
     • <effectiveTime><low value="20120101000000"/> <high value="20120103235959"/></effectiveTime> instead of (the semantically correct)
     • <effectiveTime><low value="20120101"/><high value="20120104" inclusive="false"/></effectiveTime>
     • See Grahame's blogpost http://www.healthintersections.com.au/?p=707
     • Discussion: do we want to create a document that provides implemetation guidance for the v3 IVL_TS data type? Yes, we consider such guidance to be in scope of AID. We'll need to coordinate with ITS, given they have provided such type of guidance in the past as well. Andy: will have to look at the logistic aspects as well, quality review, publish. Justin: if AID actively announces that it's willing to publish such implementation guidances, this may invite additional suggestions for the publication of such guidance documents.
   • Review of AID Activities (time permitting)
     • Discussion: Andy: we should have more detail related to these 5 steps. Co-chairs to create a sterter version and to review this with the attendees of AID WGMs and AID out-of-cycle meetings.
   • Review of AID SWOT
     • The document was updated. MOTION To approve the new SWOT [http://wiki.hl7.org/index.php?title=AID_SWOT&oldid=82642 (this version) (Andy/Pater, 7-0-0)
3. FHIR-enabling existing applications (Robert Worden, Open Mapping Software, UK. See http://www.hl7.org/documentcenter/public/wg/java/20140122_Robert_Worden_AID_Talk.pptx for powerpoint slides, and https://vimeo.com/84860257 for a video recording)
   • Most existing FHIR servers are Greenfields implementations – with a new database, new code, etc. But as FHIR takes off, there will be a big demand to FHIR-enable existing applications. Probably most FHIR servers will be of this form?
   • There is now an Open Source Toolkit to do this – to build a FHIR server on any healthcare application which has a relational database. It is being used to FHIR-enable the PAS at a London NHS Hospital. The good news is – you don’t need to write new code to do it (at least for a read-only server). It is done by mapping the application database onto FHIR logical models for resources, and so can be very quick to do. (FHIR searches generate SQL retrievals; you don’t need to code them)
   • Open Mapping Software is an open source toolkit that can also be used to FHIR-enable existing applications. For two small demo servers built in this way, and for links to the tools, instructions, etc., see http://worden.globalgold.co.uk:8080/FHIR_a/hosted_demo.html.
   • Robert will cover the mapping approach between legacy databases and FHIR, and he'll discuss using a FHIR search on multiple servers at once.
   • Will CDA and FHIR be competing standards in the document space – or can they work together, to the benefit of both?
     • Meaningful use of CDA requires matching between data from the CDA and data from local EHRs. FHIR is the best simple data format for this matching
     • This requires a CDA-FHIR bridge, to extract information from a CDA as FHIR resources. This in turn will promote the adoption of both CDA and FHIR.
4. Meeting adjourned at 17:00

Thursday Q3, Minutes

Workgroup	Date/Time	Location	Chair/Scribe
AID HL7 User Group	2014-01-23, 13:45-15:00	San Antonio, USA	Chair: Peter Hendler/Scribe: Andy Stechishin

Attendance

• Peter Hendler
• Brian Pech
• Justin Fyfe
• Andy Stechishin
• Hetty Khan
• Michelle Williamson
• Dymtro Rud
• Serafina Versaggi
• Peter Haug

Minutes

1. Administrative agenda items
   • Agenda was approved with no additions
2. Tooling aspects (max 30 minutes)
   1. Evaluation/promotion of implementation oriented tools (see Tools for RIM based software development, our scope has widened however)
      • Peter and Andy will work with Rene off-line to improve/edit the Tools for RIM based software development. After the edits have been completed by the smaller group, the updated wiki page will be presented to the wider AID community for ratification at an upcoming meeting
   2. Creating 'implementation packages' of HL7 standard publications, software processable expressions thereof that can be used for source code generation, as well as other related implementation tools and toolkits.
      • AID has passed a motion that states we think the publication (by HL7) of such packages would be a good idea. Whom do we need to convince within the organization, what would it mean in practical terms, to create such packages for e.g. HL7v2, CDA, etc.?
        • Update: Andy has proposed this concept to the steering division and TSC. Both groups agreed that the idea was worth pursuing. Andy is tasked with creating a PSS for the work, gaining appropriate approval
3. Implementing Natural Language Processing (NLP) (Peter Haug, Intermountain Healthcare, US)
   • Peter Haug presented how InterMountain Healthcare is using natural language processing (NLP)
   • Peter described the basis and fundamentals of NLP in the clinical setting
   • He described the process building the system that enabled the use NLP in a specific application for an indication of Community Aquired Pnuemonia
   • Peter's full presentation: [Peter's presentation]
4. NLP implentation issues (Heather Grain, AU)
   • Heather was unable to attend due to other work group commitments
5. General Discussion
   • Following the NLP presentation a general discussion on the uses and application of NLP to some specific projects occurred.
   • The discussion of bundles earlier in the meeting, prompted Serafina Versaggi to comment on work being done in the Attachments Work Group to define a document listing the standards and/or materials needed to execute a successful implementation. And and Serafina agreed to work together to have AID and Attachments co-sponsor the PSS work on bundles. The approach would perhaps use the Attachments work as a pilot to develop a 'bundle recipe' for use in other areas