20120513 arb face to face

ARB - Meeting HL7 Spring Working Group Meeting

Sheraton Wall Centre Vancouver, BC, Canada

May 12-18, 2012

Agenda

Sunday

1. Q1
   1. Call to order
   2. Roll Call
   3. Approval of Quarters Agenda
   4. Approval of WGM agenda
   5. Approval of Minutes
   6. Report from TSC (Charlie/Ron)
   7. Report to the TSC for Sunday Night TSC meeting
   8. Discuss Report to Co-Chair meeting Monday Night
   9. Review joint meetings to ensure coverage
   10. Adjournment
2. Q2
   1. Call to Order
   2. Approval of Quarters Agenda
   3. Substantivity???
   4. SAIF-CD??? aftershocks
   5. Adjournment
3. Q3
   1. Call to Order
   2. Approval of Quarters Agenda
   3. Strategic Initiatives
   4. DAM discussion from TSC
   5. Report from Architecture Project
   6. SAIF IG involvement.
   7. What is next for ArB
   8. Item 1
   9. Item2
   10. Adjournment

Thursday

1. Q3
   1. Call to Order
   2. Aproval of Quarters Agenda
   3. DAM - Kaiser Permanente Perspective - Peter Hendler
   4. Impact of Thomas Erl's presentation
   5. Substantivity???
   6. HL7 Business Architecture
2. Q4
   1. Maturity of HL7 and the Customer Base(Zoran/Andy)
   2. FHIR discussion
3. Other business and planning
   1. Conference calls will not resume until 2nd week after WGM- May 31, 2012. Will re-validate during WGM.
4. Adjournment

Meeting Information

HL7 ArB Work Group Meeting Minutes Location: Sheraton Wall, Vancouver, BC Canada		Date: 20120513 Time: 9:00am Pacific
Facilitator	Parker, Ron	Note taker(s)	Julian, Tony
Attendee	Name	Affiliation
X	Bond,Andy	NEHTA
X	Constable, Lorraine	Constable Consulting Inc.
X	Curry, Jane	Health Information Strategies
.	Dagnall, Bo	HP Enterprise Services
X	Grieve, Grahame	Health Intersections Pty Ltd
X	Hufnagel, Steve	U.S. Department of Defense, Military Health System
X	Julian, Tony	Mayo Clinic
X	Loyd, Patrick	ICode Solutions
.	Lynch, Cecil	Accenture
X	Mead, Charlie	National Cancer Institute
.	Milosevic, Zoran	NEHTA
.	Ocasio, Wendell	Agilex Technologies
X	Parker, Ron	CA Infoway
.	Quinn, John	Health Level Seven, Inc.
.	Guests
X	Luthra, Anil	Health Alberta
X	McKenzie, Lloyd	HL7 Canada
X	Stechishin,Andy	CANA Software & Services Ltd.
.	Legend
X	Present
.	Absent
Quorum Requirements Met: Yes

Minutes Q1

• Report from TSC:
  • Charlie: Unresolved points from TSC: Austin and John Quinn both committed to notion that SAIF architecture, Fast Healthcare Interoperability Resources (FHIR), and strategic initiatives connecte via SAIF. There is no SAIF-IG for HL7. The leading resource is Lloyd McKenzie, who is working on FHIR.
  • ArB proposed to take over SAIF-IG from MnM. There was angst, concluded when Austin declared that TSC owns the SAIF-IG.
  • LLoyd: there should be a SAIF-IG for V3, V2, FHIR.
  • Charlie: Will start with a single SAIF-IG, with branch points. There will be a discussion Sunday night of the notion of FHIR governance vs FHIR management vs FHIR architecture.
  • Ron and Charlie discussed the TSC meeting. Helen Stevens brought up the vertical/vs horizontal in the SAIF-IG.
  • Ron: The metrics are pointing out the lack of consideration of HL7 priorities in the current projects.
• Report to the TSC for Sunday Night TSC meeting
  • Grahame: FHIR SAIF-IG - I want the FHIR SAIF-IG to be the methodology guide, and I intend to write it. FHIR is only a partial methodology - not enventing anything new, just a different way to deploy existing methodology. The FHIR imformation model is borrowed from somewhere else.
  • FHIR proposes REST out of the box - which limits the dynamic model. FHIR puts together a flexible lightweight messaging model that matches those of version 2. If you cannot meet your needs by using REST or messaging, define a service yourself.
  • Jane: Documents?
  • Grahame: Yes, out of the box, but not necessarily CDA-R3.
  • Lloyd: you can have the charistics of a document that you can exchange using the same dynamic model as other content.
  • Jane: Same as V2 passing CDA?
  • Grahame: Actually better than MDM.
  • Lloyd:Documents in V2MDM are imbeded, FHIR documents are exposed.
  • Governance:
    • Grahame: FHIR is posted on HL7 servers, so is now HL7 IP. Until the first full normative version it will be freely available from the HL7 website at [| hl7.org/fhir].
    • Grahame: I propose that the TSC owns FHIR, and the FHIR governance board(FHIRGB) reports to the TSC. FHIRGB -Consists of persons who provide time commitements or money.
    • Ron: FHIR creates a defacto footprint, which wil allow other value propositions for the business of HL7.
    • Grahame: Derivative works are possible.

• • Ron: We need to discuss actioning. Charlie asserted that you cannot talk about governance unless you think of it from risk management.
  • Charlie: Do you have any sense as to how someone can claim conformance to the dynamic portion?
  • Steve: You can set the allowable states
  • Jane: Detail the roles - which are human, and which are automated at the conceptual level. If you dont, you have people guessing. Triggers in a more global sense, e.g. time conditions, something that triggers something to occur, with logical precedence (you cant cancel what you did not order).
  • Steve: You can define that a medication order has different behaviour from a lab order.
  • Ron: Patterns are emerging - elevating and layering. Properly dicomposing the services can be very powerful.
  • Jane: You can have a generic pattern that then forks with the complexity.
  • Ron: Told clinicians that a referal is an order fullfilment pattern - to which they objected.
  • Grahame: The clinicians argue about the requirements of the referal. It is appropriate to say that any specification that claims conformance to the DAM must explicitly express the conformace to the DAM.
  • Andy: This is emerging- in the end whatever you write down is a constrained pattern.
  • Ron: One of the measures of success will be external groups asserting their position on HL7.
• Report to co-chairs Meeting Monday Night
  • Ron: Morning slides will discuss our topics
  • Ron: ArB is doing stuff - why do I care?
    • Jane: Strategic Initiatives(SI) are marching orders from Board to TSC. We need to discuss alignment with the SI.
    • Ron: Semantic web and the impact to HL7 - IBM is adding RDF to rational.
    • Jane: there may be alignment opportunities
    • Lloyd: I educated Eric on HL7, his questions need to be discussed with Grahame.
• adjournment at 10:30am Pacific

--Tony Julian 17:34, 13 May 2012 (UTC)

Meeting Information - Q2

HL7 ArB Work Group Meeting Minutes Location: Sheraton Wall, Vancouver, BC Canada		Date: 20120513 Time: 11:00am Pacific
Facilitator	Parker, Ron	Note taker(s)	Julian, Tony
Attendee	Name	Affiliation
.	Bond,Andy	NEHTA
.	Constable, Lorraine	Constable Consulting Inc.
X	Curry, Jane	Health Information Strategies
.	Dagnall, Bo	HP Enterprise Services
.	Grieve, Grahame	Health Intersections Pty Ltd
.	Hufnagel, Steve	U.S. Department of Defense, Military Health System
X	Julian, Tony	Mayo Clinic
.	Loyd, Patrick	ICode Solutions
.	Lynch, Cecil	Accenture
.	Mead, Charlie	National Cancer Institute
.	Milosevic, Zoran	NEHTA
.	Ocasio, Wendell	Agilex Technologies
X	Parker, Ron	CA Infoway
.	Quinn, John	Health Level Seven, Inc.
.	Guests
X	Luthra, Anil	Health Alberta
.	Shakir, Abdul Malik	Shakir Consulting
X	Stechishin,Andy	CANA Software & Services Ltd.
.	Legend
X	Present
.	Absent
Quorum Requirements Met: Yes

Minutes Q2

1. Call to Order
2. Approval of Quarters Agenda
3. Substantivity???
4. SAIF-CD??? aftershocks
5. Adjournment

Meeting Information - Q3

HL7 ArB Work Group Meeting Minutes Location: Sheraton Wall, Vancouver, BC Canada		Date: 20120513 Time: 11:45pm Pacific
Facilitator	Parker, Ron	Note taker(s)	Julian, Tony
Attendee	Name	Affiliation
X	Bond,Andy	NEHTA
X	Constable, Lorraine	Constable Consulting Inc.
X	Curry, Jane	Health Information Strategies
X	Dagnall, Bo	HP Enterprise Services
.	Grieve, Grahame	Health Intersections Pty Ltd
X	Hufnagel, Steve	U.S. Department of Defense, Military Health System
X	Julian, Tony	Mayo Clinic
X	Loyd, Patrick	ICode Solutions
.	Lynch, Cecil	Accenture
X	Mead, Charlie	National Cancer Institute
.	Milosevic, Zoran	NEHTA
.	Ocasio, Wendell	Agilex Technologies
X	Parker, Ron	CA Infoway
.	Quinn, John	Health Level Seven, Inc.
.	Guests
X	Luthra, Anil	Health Alberta
X	Shakir, Abdul Malik	Shakir Consulting
.	Stechishin,Andy	CANA Software & Services Ltd.
.	Legend
X	Present
.	Absent
Quorum Requirements Met: Yes

Minutes Q3

1. Call to Order
2. Approval of Quarters Agenda
3. Substantivity
   1. Jane:consider substantivity as a risk mitigation strategy to validate the measure/definition.
   2. Ron: The V2 definition does not apply to V2, and the definitions do not work between artifacts.
   3. Charlie: You want to cast various flavors of substantivity of risk?
   4. Jane: Risk they mitigate. Then we can have semi-objective criteria.
   5. Charlie: We have not had success with TSC because they do not have the time. FHIR is going on record that once a resource is ballot it will not be changed - it may be replaced.
   6. Jane: With V3, since XML is primary representation, if you change anything you have violated its structure.
   7. Charlie: FHIR is changing from design by constraint to design by extension.
   8. Ron: Motivator is around usage - 80/20 rule.
   9. Jane: CDA has not changed for five(5) years.
   10. Ron: This will hit us like a ton of bricks on Thursday.
4. Strategic Initiatives
   1. Subject to review after Austin sends out the latest revision.
5. DAM discussion from TSC
   1. Charlie discussed the heritage of the current Domain Analysis Model . This includes the addition of reference to conformance.
   2. AbdulMalik: The state of normative tells people that the content will not change.
   3. Jane: We need some way to document the use case to people who were not part of the discussion.
   4. Ron: For normative you need a degree of formedness that is well defined. People want degree of predictability. What is sufficient in a DAM to meet the burden?
   5. Charlie: We can define what we consider to be a correct DAM - a quantifiable objective. The other side is that people can have a lesser DAM that is useful, to be balloted informatively. We have to not define the subjective metric.
   6. AbdulMalik: I see this as a matrix.
   7. Jane: We need to have the dynamics.
   8. AbdulMalik: You would think it would have a scope.
   9. Jane: Scope is formed by the purpose.
   10. Bo: DAM is a conceptual model. By nature it is always informative at best - and forcing a publishing model does not add value.
   11. AbdulMalik: Informative allows you to pass without taking into account comments.
   12. BO: It goes to stability. The publishing mechanism does not fit the model.
   13. Charlie: I will take another crack at this.
   14. Ron: Sufficiency of a dam is its ability to support the downstream product.
   15. Jane: If we say you cannot introduce concepts that were not in your dam.
   16. AbdulMalik: Shalls/Shoulds Requirements/Best practice: All classes shall have a name,and a definition. All classes should have a unique name - how far do you go?
   17. Steve: Fully formed SAIF model.
   18. Charlie: TSC would like us to name the artifacts - not the representation.
   19. Jane: Helpful to have tools for consistency - but a word doc is ok.
   20. Ron: Could I negative ballot the downstream work product if the dam is faulty?
   21. Bo: It requires a waterfall.
   22. Ron: Is the dam sufficient to scope the product?
   23. Jane: Purpose is the important part.
   24. Ron: Maybe the completeness is tested through the ballot process for the downstream product. We should say this is what a dam is, this is how it is use, and this is the downstream result.
   25. AbdulMalik: Implies that all of our specification are proceeded by a DAM.
   26. Patrick: that is where we are going.
   27. AbdulMalik: There needs a way to express traceability to the DAM.
   28. Lorraine: We are getting into the IG space.
   29. Ron: Governance has a role in checking the quality.
   30. AbdulMalik: If we find a quality problem while developing the downstream product, do we have to reballot the DAM?
   31. Jane: That is why you go DSTU.
   32. Lorraine: that is why we have DSTU in the first place.
   33. AbdulMalik: We started with our model, and looked to the BRIDGE model, then went to create message specification (RMIM-DMIM). They had a different style in the British Model - no traceability. We discovered importance of multiplicity in the MIM's that we did not expose in the DAM. At implementation we had a lot of work to keep the DAM, IG, and final product in sync.
   34. Ron: Am i overloading the DAM?
   35. AbdulMalik: I am having problem seeing people go back to the DAM. It is too much work.
   36. Ron: The problem is repeatibility. I have seen it at HL7. Where interoperability requires coherence and repeatibility. The likelyhood that you will have to reopen the bag is small. I am prepared to back away from the position. HL7 needs to get the DAM right.
   37. Andy: If HL7 had the discipline of a single trajectory it would work well. It is incredibly difficult to say ultimately what it means if they are not on a single trajectory. How do you recognize the intersection between trajectories?
   38. Ron: Same problem I have faced on every team. The most successful was where the rigor was resolved.
   39. AbdulMalik: The immunization DAM will spawn many products with no cohesion.
   40. Jane: People want the DAM to be normative to feel it is sufficiently mature to rely on for the downstream products. If that is what we want to have, we have no choice.
   41. AbdulMalik: There are some implications.
   42. Jane: We changed the MIF's to map more directly.
   43. Andy: We have the ability to keep things out of the dam. I would rather have something with less, rather than nothing with more.
   44. AbdulMalki: I you dont restrict datatype you help the downstream.
   45. Andy: The less restrictive the better.
   46. Patrick: We chose to use conceptual data types.
   47. Andy: I dont care how you get there as long at you pass these three points to get there.
   48. Jane:I am on the fitness for purpose kick: The perceptual model defines the shared purpose.
   49. Steve: You have described the OMG model approach. You might want flexibility as you go down.
   50. Ron: Traceability controls what you put in you DAM . It has to provide a sense of context of the domain. As you drive down you may find you have missed something. For those who want to reuse the thing you made, redoing the DAM is good. Charlie see if you can define at what is sufficient at that level.
   51. Steve: Do we want to define the artifacts that go in the DAM?
   52. Charlie: That is part of the SAIF-IG.
   53. Steve: Do we need an HDF, and the groups use their SAIF-IG at different levels?
   54. Charlie: That is what Lloyd was talking about - and IG for FHIR, V3, V2.
   55. Steve: ArB needs to develop a higher level IG. Some groups want to do mind-maps, some want to do sequence diagrams.
   56. Bo: you need an independent IG.
   57. Steve: The IG got so deep into it they got burnt out. It was at such a detailed level, and was very restrictive.
   58. Patrick: I see something at the level of the HDF which applies to the IG.
   59. Steve: ArB should be doing a middle level document.
   60. Lorraine: I thought the IG was that product.
   61. Steve: Then everyone would do their own thing.
   62. Andy: The CD is the model. You have to choose V3/V2 - how do you describe dynamic process. There are different ways to cover the matrix. I am not sure introducing another level will help.
   63. Ron: Conformity with the CD will be needed. We may discover that we need to frame the CD differently, after we have tested the IG against the CD.
6. Adjournment at 3:00pm Pacific

--Tony Julian 22:06, 13 May 2012 (UTC)

Thursday Meeting Information

HL7 ArB Work Group Meeting Minutes Location: Sheraton Wall, Vancouver, BC Canada		Date: 20120517 Time: 1:45pm Pacific
Facilitator	Charlie Mead/ Parker, Ron	Note taker(s)	Julian, Tony/????
Attendee	Name	Affiliation
.	Bond,Andy	NEHTA
.	Constable, Lorraine	Constable Consulting Inc.
.	Curry, Jane	Health Information Strategies
.	Dagnall, Bo	HP Enterprise Services
.	Grieve, Grahame	Health Intersections Pty Ltd
.	Hufnagel, Steve	U.S. Department of Defense, Military Health System
.	Julian, Tony	Mayo Clinic
.	Loyd, Patrick	ICode Solutions
.	Lynch, Cecil	Accenture
.	Mead, Charlie	National Cancer Institute
.	Milosevic, Zoran	NEHTA
.	Ocasio, Wendell	Agilex Technologies
.	Parker, Ron	CA Infoway
.	Quinn, John	Health Level Seven, Inc.
.	Guests
.
.	Legend
.	Present
.	Absent
Quorum Requirements Met: Yes

Minutes

1. Q3
   1. Call to Order
   2. Aproval of Quarters Agenda
   3. DAM - Kaiser Permanente Perspective - Peter Hendler
   4. Impact of Thomas Erl's presentation
   5. Substantivity???
   6. HL7 Business Architecture
2. Q4
   1. Maturity of HL7 and the Customer Base(Zoran/Andy)
   2. FHIR discussion
   3. Architecture of templating
3. Other business and planning
   1. Conference calls will not resume until 2nd week after WGM- May 31, 2012. Will re-validate during WGM.
4. Adjournment