20181113 US Realm SC Call

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US Realm Steering Committee Call Agenda/Minutes Location: https://global.gotomeeting.com/join/929752237]		Date: 2018-11-13 Time: 1 PM Eastern
Co-Chairs	Ed/Brett	Note taker(s)	Anne

Attendee / Name
x	Calvin Beebe		Keith Boone		Hans Buitendijk
x	Lorraine Constable	x	Johnathan Coleman	Regrets	Ed Hammond
x	Tony Julian	x	Paul Knapp	x	Austin Kreisler
x	Brett Marquard		Ken McCaslin		Nancy Orvis
	Brian Pech	x	Wayne Kubick	x	Christol Green
x	Sandra Stuart	.	Pat Van Dyke	x	Craig Parker
	Danielle Friend	x	Eric Haas	Regrets	Jenni Syed
	Steve Posnak	.	David Susanto	.	John Roberts
Visitor/ Name
Quorum: Chair + 7

Agenda

Administrivia

• Agenda review
• Review notes from 20181023_US_Realm_SC_Call
• Review items
  • US Core R4 Block Vote
  • Approval to submit US Core R4 IG for January Ballot

Discussion:

• US Core - coordination with WGs

Minutes

• Agenda review
• Review notes from 20181023_US_Realm_SC_Call
  • Minutes approved via general consent

Discussion:

• US Core - coordination with WGs
  • Paul notes that TSC discussed yesterday around the US Core update work for R4. The position of the TSC was to reinforce that the management groups/US Realm should manage the work but not do the work. The problem with US Realm being the place that is doing ballot reconciliation or review/development of the FHIR R4 version of US Core is that the domain committees must be involved in the process. No committees were listed in the PSS. We would want to see at least one WG leading and the domain committees being involved in or signing off on the work. Don’t want to see work creeping into management groups. For this block vote, how are the domains represented here today? Wayne: We also need to resolve the PSS that wasn’t approved by TSC yesterday.
  • Brett: The idea of not doing ballot recon at US Realm is fine but where is the cross-organizational US Realm home for a product like this? There are profiles across six different WGs. In January we balloted it as a project underneath US Realm SC and we agreed to do reconciliation here. That is the home we used on the most recent case. We either a) come up with a new US Realm WG or b) decide which WG to park this under. Paul: We need to make sure that the WGs are reviewing and signing off on the material, so the question is where is that committee and what is the structure? There are no WGs under US Realm. What do we do with the work as we go forward and where does it reside? Where is the review and the expert knowledge to go through and review these items? Brett: I’m stuck because we’ve done this before on this committee. We’ve had a lot of domain input throughout the development of these profiles. The new stuff is very minimal. It’s a very awkward position to be in when we’re trying to go to ballot this cycle. Austin: The TSC hasn’t approved the project yet. Brett: What about the previous project which was approved by the TSC? Paul: If the changes are light, it shouldn’t be a burden for the WGs to review. Brett: If you’re saying to do the US Core product we have to go to each WG… Austin: Yes, that is the message from the TSC. Eric: That is unworkable. Austin: You are working outside of the Mission and Charter of this group and the TSC is reminding you of that; you need to identify a WG responsible for this work. Wayne: There’s a piece which is minor which is adapting US Core for R4. Resources are already approved. The major change is the new profile on Clinical Notes. Brett: Let’s say we go to ballot and get 500 comments. Those comments are split evenly across 6 different WGs. My thought is we’d have a central call and work through reconciliation that way. US Realm SC would be an active coordination group. I didn’t plan to have us present to each WG. Paul: There should be domain that owns it other than the US Realm Steering Committee. Not sure why each group would sit through the other couple hundred issues. Brett: What I’m hearing is this project needs a WG home. I propose we recommend Structured Documents. Calvin: TSC also wants other cosponsoring WGs. Paul: If we’re following FHIR methodology, it already has the requirement that the WGs must review and weigh in. TSC is at most supporting FHIR in its assertion of the methodology. Calvin: I don’t know that the TSC was advocating the level of involvement the WGs would have, they can choose the level they feel they need. Wayne: As I recall the entire discussion hinged on a complaint from one individual who was upset that their WG wasn’t being represented. Was our rationale accurate? The person is now involved and no longer have a complaint. Brett seems to be making every effort to involve the correct people. To have to go through every single WG could be unnecessarily burdensome. Paul: The TSC doesn’t require every WG being a cosponsor, they want to make sure every group has reviewed the material. Part of the reason that we created a richer structure was to ensure we didn’t get ourselves into issues where particular WGs generated domain content without the useful and complete engagement of the domain committees. That’s why we have some of these separations of concerns and work. Taking Pharmacy stuff back to Pharmacy to get their blessing is indeed more work, but there is value in it. When it comes to profiling in FHIR, you’re either subsetting or extending. You want to have the input of the domain people to make sure you’re subsetting is complete and your extensions are rational with respect to the business space. Wayne: They made every effort to do that. As long as they’re being open and transparent, I think Brett’s proposal makes perfect sense. Paul: If it’s been through the WGs they should be able to sign off on it without a problem. Brett: Does anyone object to Structured Docs being the primary sponsor?
    • MOTION that the US Realm Steering Committee take this work to Structured Documents as the primary sponsor: Wayne/Austin
    • VOTE: All in favor
    • ACTION: Brett will make that request to Structured Docs this week.
  • In terms of cosponsorship, the TSC is not requiring that. What’s key is that the domain committees are engaged in review and signoff. Austin: Content review is a requirement, and the broader the better. If you’re trying to sidestep that, this project won’t get through. Brett: We’re doing our best to be open. If we’re missing someone we want to fix that. Austin: We need to make the preview available to every WG who has a resource being profiled so they have the opportunity to review it. Wayne: In the future the affected WGs could appoint a liaison.
    • ACTION: Brett will send an email to all affected WGs with a link to the content
• Review items
  • US Core R4 Block Vote
    • Where would be the right place to vote on this now? Decision that it would be Structured Documents, with commenters advised. Austin suggests getting an announcement out that the block vote will be considered at Structured Docs on Thursday. Craig suggests that TSC should let people know that they are requesting this. Lorraine: We should ask that WGs highlight US Core material discussions in minutes. Structured Docs will have to update the PSS and send to Infrastructure SD, who will try to have a call to approve it before being reviewed by TSC next week.
  • Approval to submit US Core R4 IG for January Ballot

Meeting Outcomes

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Next Meeting/Preliminary Agenda Items 20181127 US Realm SC Call Tuesday at 1 PM ET

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