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MnM Minutes WGM 201501 SanAntonio

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Sunday Jan 18 Q3 - Finalize Agenda/Review Hot Topics

Attendees

Jean Duteau, Chair/Scribe
Lloyd McKenzie
Austin Kreisler
Kevin Coonan
Katherine Duteau

Minutes

  • Agenda Finalization
Tuesday Q1/Q2 will be cancelled
Friday Q2 will be cancelled
  • M&M Business
Brief discussion of FHIR and its relationship to RIM (in context of Care Plan resources)
MOTION: Josh Mandel and Ewout Kramer are appointed acting co-chairs for M&M for purposes of handling M&M FHIR business (Austin/Kevin) 4-0-0-

Monday Jan 19 Q2 - FHIR Methodology Topics

Attendees

Lloyd McKenzie (chair), Gevity, lloyd@lmckenzie.com
Jevery Ting, Systems Made Simple, jeffry.ting@systemsmadesimple.com
Il Kon Kim, KNU, ikkim@knu.ac.kr
Pu Yun Lee, KNE, keveni@naver.com
Joon Hyun Song ZHIS, jhsong0135@naver.com
Mike Henderson, OSEHRA, hendersonm@osehra.org
Peter Antunn, Interfaceware, peter.antonn@interfaceware.com
Prashant Trivedi, NHS, Prashant.trivedi@nhs.net
Bill deBeaubier, Systems Made Simple, Bill.deBeaubier@systemsmadesimple.com
Isaac Vetter, epic, isaac@epic.com
Cecil Lynch, Accenture, cecil.o.lynch@accenture.com
Craig Parker, IHC, craig.parker@imail.org
Kevin Harbauer, Healthwise, kharbauer@healthwize.com
Cosmo Difazaro, Systems Made Simple, cosmo.difazaro@systemsmadesimple.com
Gaby Jewell, Cerner, gjewell@cerner.com
Brad Arndt, Cerner, brad.arndt@cerner.com
Puneet Nagpal, Web MD, pnagpal@webmd.net

Minutes

Reviewed the following tracker items:

Wednesday Jan 21 Q1 - M&M FHIR Vocabulary Joint Session

Attendees

Jos Baptist, Nictiz, baptist@nictiz.nl
Jim Case, NLM/NIH, james.case@mail.nih.gov
Heather Grain (scribe), eHealth Education, h.grain@ehe.edu.au
Peter Hendler, Kaiser Permanente, Peter.hendler@kp.org
Wendy Huang, CHI, whuang@infoway-inforoute.ca
Ted Klein, KCI, ted@tklein.com
Lloyd McKenzie (chair), gevity, lmckenzie@gevityinc.com
Rob McClure, NLM/ONC, rmcclure@mdpartners.com
Bill deBeaubier, Systems Made Simple, Bill.deBeaubier@systemsmadesimple.com
Frank McKinney, independent consultant, fm@frankmckinney.com
Bertil Reppen, HL7 Norway, bertil@apertern.ua
Paula Frazier, ONC, paula.frazier@hhs.gov
Michael Donnelly, Epic, Michael@Donnelly@epic.com

Minutes

How FHIR uses vocabulary – FHIR defined vs….externally-defined vs structural codes

Does HL7 want to have a single terminology name space across all of our content or not? The answer is yes, though we know that this might be challenging. FHIR can support this but needs to reach the normative stage. It won’t happen immediately. Vocabulary need to think about what it means to maintain a single namespace for code systems and value sets for all HL7 products.

The benefit of terminological naming across the organisation is there appearance of having our act together for those who don’t know better. Having the names the same with different value set content is often an issue. The ability to reduce the number of artifacts we maintain and increase consistency where this is viable. There is a need to be consistent and identify clearly where there are variations. What we are asking for is to have a closer alignment with FHIR, though the cat is already out of the bag.

FHIR have flexibility until they go normative. Lloyd didn’t think that it was essential that we use the same codes from the same code system and from a technology perjspetive it will be very difficulty to achieve that due to the differences in methodology between V2, V3 and FHIR. However we can come to a place of formal relationship between concepts between the products where there is a need to be different.

The multiple product space presents a lot of choices. FHIR is able to put some energy into this. IN DSTU2 nothting with change but we can use the time while in DSTU to consider tools and processes to manage the terminology harmonization more effectively.

When a code system or value set are needed by FHIR the following hierarchy of preference for code systems is used:

  1. external international code systems
    external code systems available internationally
    hl7 defined code systems, specified by example
    FHIR defined codes – take it up to the HTA – is there one of these within SNOMED CT, LOINC etc.


Profiles are provided and referenced from Resources tab, in the infrastructure the conformance area provides access to value set, naming system and concept maps. When Start at FHIRE and choose continuous integration build (hl7.org/implement/standards/FHIR – sends you to hl7.fhir.github.io from this point choose resources, scroll down to find value set, naming system and concept

For terminology services select resource and select terminology server from under the terminology heading.

Every resource page – propose a change (at the bottom of the page – you need a gforge tracker and you need to login.

Formal view of profile content example is at: [1]

FHIR Terminology Service

FHIR is a terminology service is described at HL7-FHIR-github.io/terminology-service.html The terminology service includes concept map and value set information including instructions for value set expansions, Concept lookup and validation are also included. Instructions for subsumption testing is also included.

FHIR Core WG relationship – artifacts (resources, data types), value sets

MnM provides guidance to WGs on modelling best practice including FHIR. The FHIR Core Work Group could be designed similarly to the way MnM functions within HL7. The difference is that MnM doesn’t own any components of V3. From a governance perspectives you don’t want a group defining the rules for what an artifact looks like being responsible for defining an artifact. FHIR Core Work Group defines methodology group, management group which is responsible for coordination of work activities and content, and ballot timing and resource creation management and responsibilities. Governance group sets objectives and high level precepts upon which everything else is based. None of the governance level structures do the work. The purpose of the core work group is to produce artifacts, particularly core infrastructure artifacts such as definition of what is a resource, value sets, conformance, what is a bundle etc. This group functions under FHIR Management Group, MnM etc in the same way as other content development groups. This is similar to Vocabulary, where the methodology is defined, rules and policies and practices are defined by Vocabulary. Vocabulary also has stewardship of common components and publishing considerations to manage.

In V3 you have all artefacts, RMIM’s etc and the MIF is in another corner. In V2 you have published pdf pages with tables and codes. The method of sharing data in V2 is not the format in which it is distributed. In FHIR the publishing, distribution, value set resource etc are balloted in the same manner as all other artifacts.

Minutes

Wednesday Jan 21 Q2 - M&M FHIR Vocabulary Joint Session

Attendees

Lloyd McKenzie, Chair

Minutes

Thursday Jan 22 Q1 - FHIR Methodology

Attendees

Rik Smithies, HL7 UK, rik@nprogram.co.uk
Paul Knapp, Knap Consulting Inc, pknapp@pknapp.com
Peter Bernhardt, Relay Health
Ilkon Kim, KNU, ikkim@knu.ac.kh
Gaby Jewell, Cerner, gjewell@cerner.com
Jason Mathews, Mitre, mathews@mitre.org
Daniel Loewenstein, Epic, dlowens@epic.com
Joon Hyun Song ZHIS, jhsong0135@naver.com
Isaac Vetter, epic, isaac@epic.com
Dave Shaver, Corepoint, dave.shaver@corepointhealth.com
Lloyd McKenzie (Chair), Gevity, lloyd@lmckenzie.com

Minutes

Reviewed the following change proposals:

Thursday Sep 18 Q5 - Facilitators Roundtable - Joint with Vocab, FHIR

Attendees

Jean Duteau, M&M, Chair/Scribe
Mead Walker, RCRIM/CIC/BRIDG
Kevin Coonan, EC
Ted Klein, Vocab
Sandy Stuart, INM
Paul Knapp, ITS
Brian Postlewhaite, PA
Alexander Henket, PA
Pat Van Dyke, EHR
Mark Roche, StructDocs
Andy Stechishin, Publishing
Ewout Kramer, FGB
Kathleen Connor. Security/CBCC/FM
Hugh Glover, Pharmacy
Lloyd McKenzie, M&M/FMG
Joginder Madra, PHER
Wendy Huang, PA
Rob Hausam, O&O
Calvin Beebe, StructDocs
Katherine Duteau, PHER

Minutes

  • Harmonization Schedule Report
Initial Harmonization Deadline - February 1, 2015
Technical Review will be Feb 2-5, 2015
Final Proposal Deadline - February 22, 2015
Harmonization Meetings - March 3-5, 2015
Motion: Accept the harmonization dates as written above. Andy/Kevin 18/0/0
  • Committee Reports
BRIDG - Balloting v4 of the model in May 2015. They are also reshaping and determining what features/mappings it needs to relate to the rest of HL7, eg. RIM, FHIR
PC - With a DAM being completed, determining what next. In the past, a DMIM and RMIMs would be created, but unsure in the new environment how to move forward. Further discussion was deferred to the M&M List. Patient Care was told that they "cultivate" a resource and need to know what that means. A new term will be chosen and the FMG will clarify the difference between owning and "cultivating".
Vocab - CTS2 and TermInfo passed ballot and will be published. ValueSet Definition project passed ballot and are reconciling. Dealt with issues with external vocabularies (eg. SNOMED) and the IP issues. A lot f work on a common set of vocabulary across all artifacts.
Security - Proposals: One set of codes for Trust vocabulary. One for ParticipationFunction (out of CBCC).
O&O - Two harmonization proposals: cleanup on interpretation code system, NullFlavour codes.
StructDocs - One discussion proposal for Harmonization - use one version of the RIM and a different version of the RIM vocabulary. Will bring the item to M&M and Vocabulary before the Harmonization meetings.
FMG - Lots of reconciliation was done by the committees! There were issues with GForge and FMG will reach out to EST about these issues. Workgroups have indicated that they are comfortable with the stated deadlines. O&O had some concerns and FMG will be working with O&O on priority and assistance.
  • M&M Wrap up - Did FHIR reconciliation of methodology and datatype issues. With the recent trend of M&M meetings at WGM and the apparent lack of v3 modelling, M&M will be refocusing on its methodology work.
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