MnM Minutes WGM 201309 Cambridge

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Sunday Sep 22 Q3

Attendees

Woody Beeler (chair), Abdul-Malik Shakir, David Hay, Rik Smithies, Lloyd McKenzie, Andy Stechishin, Grahame Grieve, Katherine Duteau, Jean-Henri Duteau

Agenda

Agenda Finalization

Hot Topic

• ActRelationshipType cleanup - will be discussed on Tue Q2 (GWB/JD)
• New Conformance Flag for Don't Ignore - has been developed in FHIR and will be classified as a Cold Topic
• Procedure or Act unknown not done - document that TermInfo is dealing with this topic
• Publishing a value set for a DEF or Criterion Act - leave it as hot topic but no action pursued until further information (who needs this?, what exactly is needed?)
• Value Sets Used in Datatypes - should be closed
• Role Class Ontological - Jean will check with Julie to see the status of this

Other Business

• Negative votes on Core Principles have been requested to be retracted
• Grahame raised the ballot comment about RIM Mappings that are missing in the current ballot
  • Woody pointed out that FHIR was going to be anchored on the RIM, so if we do not do it, are we failing on our promise?
  • Lloyd believes that it is achievable and desirable
  • Grahame wonders who would do the mapping and when would it be done?
    • Lloyd suggested that we ask the workgroups to make the mappings for their resources. If they are unable, then we will seek volunteers on the FHIR list to make the mappings.
  • This will be discussed on Tuesday Q1

FHIR Sessions

Tue Q1, Wed Q3, Thu Q1 - will all be ballot reconciliation and methodology

• Motion to accept agenda: Lloyd/Katherine - 7/0/0

Tuesday Sep 24 Q1

Attendees

Al Dahhasi, Wael (CCHI)

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Dijkstra, Willem (MGRID)

McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))

Smithies, Rik (NProgram Ltd)

Zimmerman, Jay (HL7 Canada)

FHIR - Reconciliation & Methodology

Primarily worked off of the FHIR Ballot Reconciliation spreadsheet and recorded actions therein

Tuesday Sep 24 Q2

Attendees

Al Dahhasi, Wael (CCHI)

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Dijkstra, Willem (MGRID)

Duteau, Jean (Duteau Design Inc)

Henderson, Mike (Eastern Informatics, Inc.)

McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))

Smithies, Rik (NProgram Ltd)

Zimmerman, Jay (HL7 Canada)

Gilbert, Pete (Covision.com)

Hot Topics - ActRelationship Type Proposal

• Hot Topics - ActRelationship Type Proposal
  • Had a review of the Harmonization Proposal that Kevin Coonan brought forward at the previous Harmonization meeting
  • Discussed the PERT concept and the details around changing it
    • Recommendation: Move children of PERT to ART
    • Two choices to discuss at Harmonization: leave PERT as a non-specific relationship with no children OR deprecate PERT and introduce RELEV as a non-specific relationship with no children
    • The proposal will have the discussion on the impact of both choices added and will urge reviewers to consider their intentions for PERT in recommending which choice.
  • Temporal Relationships
    • Some of the proposed codes had improper parents
    • Options are: 1) Take all of the proposed new codes with the parentage fixed, 2) Only accept the proposed codes that are not representable with inverses, 3) Add in all of the missing codes that are not represented, 4) Add in all of the missing codes that include inverses (basically implement Lloyd's spreadsheet).
    • Recommendation: do #4 - (implement the codes in Lloyd's spreadsheet)
  • Fixing up COMP
    • The current use of COMP is using a broader definition than what it actually is.
    • Recommendation: the proposal is to loosen the definition and create a new code STEP that will get the current definition of COMP. Add a new concept "Has Member (MBR)" that represents aggregation and have STEP be a child of MBR. Additionally, add "Has Part" (PART) that represents composition.
  • Interfered By
    • This was acceptable
  • Has Qualifier
    • It is more appropriate under SUBJ.
  • Intensional Value Sets will automatically change since they are not immutable.

MOTION: That we adopt the proposed changes as documented (Woody/Lloyd) - 7/0/0

Wednesday Sep 25 Q1

Attendees

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Canu, Nicolas (HL7 France, L'Atelier du Soft)

Case, James (National Library of Medicine)

Couderc, Carmela (Siemens Healthcare)

Duteau, Jean (Duteau Design Inc)

Grain, Heather (Standards Australia, eHealth Education)

Grieve, Grahame (Health Intersections Pty Ltd)

Hausam, Robert (Hausam Consulting)

Huang, Wendy (Canada Health Infoway Inc.)

Lyle, Jay (Ockham Information Services LLC)

McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))

Peytchev, Vassil (Epic)

Royce, Stephen (National E-Health Transition Authority)

Ryal, Tod (Cerner Corporation)

Sisto, Jennifer (Accenture)

Mallia, Tony (Veterans Administration)

Harmonization Process Clarification

Beeler noted that there are planned changes to the Vocabulary and RIM Harmonization Process on the Wiki (can be seen in Category:HowTo for review). These were developed by Co-chairs of MnM and Vocabulary and are intended for use in the November Harmonization meetings. They will be discussed during the Facilitators Roundtable on Thursday evening.

Discussion of the Ambiguities Surrounding "Value Set"

Diagram shows the concepts and their relationships that have commonly been labeled "value set."

Motion to adopt the following as a starting point and a direction for arriving at final set of definitions (Beeler/Case) 11-0-4:

"Value Set" is

"named set of concept representations"

Note 1: it is determined at a point in time and is an expansion based on a "value set definition"

From that point, we need to review Core Principles and make its use of the term align with this simplified definition, recognizing that a "context" qualification of multiple definitions (perhaps "computational") can result in a more stringent definition such as currently appears in Core Principles.

Similarly need consider "machinery"

Further issue is the term "machinery" in Core Principles

FHIR Ballot reconciliation

Lloyd worked through a series of Ballot reconciliations for FHIR and the results were documented in the consolidated spreadsheet for FHIR.

Wednesday Sep 25 Q2

Attendees

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Canu, Nicolas (HL7 France, L'Atelier du Soft)

Case, James (National Library of Medicine)

Couderc, Carmela (Siemens Healthcare)

De Moel, Ed

Grieve, Grahame (Health Intersections Pty Ltd)

Hamm, Russell

Hausam, Robert (Hausam Consulting)

Hendler, Peter (Kaiser Permanente)

Huang, Wendy (Canada Health Infoway Inc.)

Huff, Stanley (Intermountain Healthcare)

Kramer, Ewout (Furore)

Mallia, Tony (Veterans Administration)

Mandel, Joshua

McClure, Robert

McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))

Peytchev, Vassil (Epic)

Royce, Stephen (National E-Health Transition Authority)

Stuart, Sandra (Kaiser Permanente)

Shanbhag, Avinash (ONC)

Syed, Asif (AMA)

FHIR BAllot Reconciliation

McKenzie chaired a session in which FHIR ballot content particularly of interest to Vocabulary were presented and reconciled. Outcome and resolutions on these are recorded in the FIR Ballot Reconciliation spread sheet.

Wednesday Sep 25 Q3

Attendees

AbdulMalik Shakir | COH | AShakir@coh.org

Stephen Royce | NEHTA | stephen.royce@nehta.gov.com

Lloyd McKenzie | HL7 Canada | Lloyd

Mario Hyland | AEGIS | Mario.hyland@aegis.net

Norman Daoust | Daoust Associates | Norman@daoustassociates.com

Rik Smithies | HL7 UK | rik$nprogram.co.uk

Craig Parker | Intermountain Healthcare | craig.parker@imail.org

John Silva | Philips Medical | john.silva@philips.com

Tony Mallia | Edmond Scientific | amallia@edmondsci.com

Josh Mantel | Boston Children’s Hospital

Gaby Jewell | Cerner | gjewell@cerner.com

Vassil Paytchev | Epic | vassil@epic.com

FHIR - Mapping & Reconciliation

Ballot reconciliation details were captured in the FHIR consolidated Ballot Reconciliation spreadsheet.

Recorded dispositions for the following ballot comments:

• Short description and full description
• 484: RIM Mappings (descriptive, non-computable)
• Mapping to CCDA
• 578 Sequence of elements
• 603 synchronization of data content for multiple resources

Thursday Sep 26 Q1

Attendees

Grieve, Grahame (Health Intersections Pty Ltd)

McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))

Parker, Craig (Intermountain Healthcare)

Smithies, Rik (NProgram Ltd)

Ting, Jeffrey (Systems Made Simple)

Walker, Mead (Mead Walker Consulting)

FHIR - Reconciliation

Continued FHIR Ballot reconciliation, with detailed documentation recorded in the FHIR Ballot Reconciliation spread sheet.

Thursday Sep 26 Q2

Attendees

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Kramer, Ewout (Furore)

McKenzie, Lloyd (Gordon Point Informatics (HL7 Canada))

Parker, Craig (Intermountain Healthcare)

Ryal, Tod (Cerner Corporation)

Ting, Jeffrey (Systems Made Simple)

De Moel, Ed

Walker, Mead (Mead Walker Consulting)

FHIR - Reconciliation

Continued FHIR Ballot reconciliation, with detailed documentation recorded in the FHIR Ballot Reconciliation spread sheet.

Thursday Sep 26 Evening

Attendees

Abdul-Malik Shakir (MnM/CIC), Woody Beeler (MnM/Tooling), Josh Mandel (FHIR), Ted Klein (Vocab), Rob Hausaum (Vocab), Lloyd McKenzie (MnM/FHIR), Alexander Henket (PA), Grahame Grieve (MnM/FHIR), Wendy Huang (PA), Jean Duteau (Pharmacy, PCare), Russ Hamm (Vocab), Andy Stechishin (ArB), Austin Kreisler (StructDocs), Ewout Kramer (FHIR), Rob Mulders, Paul Knapp (ITS)

Agenda

Harmonization Dates

With shift in Publishing schedule for January 2014 Ballot, the Harmonization dates have been moved back to:

November 19-22, 2013 Noon-4:00PM Eastern(Tuesday-Friday)

Initial proposals - Submissions due 10/20/2013, midnight Eastern

Final Proposals - Submissions due 11/10/2013, midnight Eastern

Harmonization Process Update

Discussion of changes listed in Vocabulary and RIM Harmonization Process - Planned Changes

Motion to approve: Beeler/Stechishin (11/0/3)

Renaming This Event

Premise: We should include FHIR Facilitators

New name:

1. Harmonization Facilitators Roundtable
2. FHIR, Modeling and Vocabulary Facilitators Roundtable
3. Vocabulary, Modeling and FHIR Facilitators Roundtable
4. Facilitators Roundtable

Motion: Rename this meeting to Facilitators Roundtable (Knapp/Beeler) (13/0/1)

We also need to communicate to the organization the purpose of this meeting and have it not appear in the brochure under MnM.

It will be made a Joint with FHIR, MnM, and Vocabulary.

Facilitator Reports

We agreed that the MnM and Vocabulary reports will provide an update on the entire week's activities.

• ITS (Knapp)

FHIR Reconciliation, Looking at Transports - Transport over HTTP may be balloting soon - V2 ER7/V2 XML/FHIR REST over the HTTP transport

Issue with Clinical Decision Support VMR specifications - looking at whether they have to create their own ITS for their content. They will have a Normative ITS that is based off the XSD schema file that they will be creating.

• Struct Docs (Kreisler)

Will CDA R3 continue? Deferred the question about the progress of the project to a subsequent conference call.

• Patient Care (Duteau)

Working on Drug&Food Preferences. There will potentially be some harmonization proposals as a result.

Allergy/Intolerance Models passed DSTU

• FHIR (Grieve)

823 ballot comments which boiled down to a lot of details and several controversial issues

Many committees have to do reconciliation but they are at the beginning of understanding FHIR. StructDocs and CGIT are two exemplary workgroups.

Family History has two different views - Clinical vs Clinical Genomics - which proved to be controversial.

Methodology questions around how FHIR does vocabulary and harmonization. There will be "resource-bound" vocabulary that are tightly bound to the resource and managed via the balloting of the resource. (These would be the equivalent of v3 CS attributes)

Will be determining on Friday (09/27) whether they will be balloting one more time. Plan to publish in January.

• Patient Administration (Henket)

Struggling since May 2011 due to reaffirmation of ballots, DSTU updates, etc. Believe that they are ready to move forward

Encounter DSTU R2, Scheduling Normative, Personnel Management R1, PA CMETs alignment

PHER wants to hand over their patient-related CMETs and make PA be the stewards

• Tooling (Beeler)

Vocabulary Maintenance Widgets was recently releases on gForge and is available for facilitators. It includes VML schema update, transforms, ANT-script widget to transform, ANT-script to post VML to database

Intend to migrate RIM maintenance from Rational Software Architect to Enterprise Architect

• CIC (Shakir)

Ballot Reconciliation on Trauma Registry, EMS

Update on the progress of the MAX Project

They have become an entry point for producing DAMs. Clinical Associations will come forward to CIC. The question is what is the required harmonization of DAMs? TSC has asked CIC to help provide a gating

• Financial Management (Knapp)

Use case for the use of two calendars that can not be converted between. This might be solved within the datatype or it might require a change in the RIM to add the ability for a second date (eg. birthdate)

• Vocab (Klein)

Joint with MnM on Harm process

Largest time around issues of binding and stability of content - V3, V2 etc. related to conformance testing

TermInfo - will reballot DSTU in January

CTS2 - continue reconciliation

V2 Publishing and cleanup of V2 Tables

IHTSDO Workbench demonstration

Joint with CGIT on NIST Conformance testing

VSAC (Value Set Authority Center)(US)

Worked on Nutrition terminology and its representations

Because of VSAC, etc. came to requirement to create a standard data structure for value sets that will be proposed as joint MnM & Vocab specification project.

• MnM (McKenzie) (summary of Lloyd's summary report)

January 2014 - FHIR Profiling tools tutorial

Act Relationship Type proposal will be re-drafted and offered for November Harmonization

Joint with vocabulary seeking a generic definition for "Value Set" and a way to avoid improper use of the term

Other Business

• V3 Issue (Grahame)

UDI data requirement for a unique identifier for every medical device

Will cause issues in V3, appears solution will involve multiple HL7 Work Groups

Friday May 18 Q2

Attendees

Beeler Jr, George (Woody) (Beeler Consulting LLC)

Constable, Lorraine (HL7 Canada)

De Moel, Ed

Hobbs, Allen (Kaiser Permanente)

Kramer, Ewout (Furore)

Mallia, Tony (Veterans Administration)

Moehrke, John (GE Healthcare)

Mulders, Rob (Furore B.V. and Stichting HL7 Netherlands)

Omata, Robin (Kaiser Permanente)

Sisto, Jennifer (Accenture)

Smithies, Rik (NProgram Ltd)

FHIR Reconciliation

Kramer led a discussion of a few MnM-rlated FHIR Ballot items. Resolutions were captured in the FHIR consolidated spreadsheet

FHIR-RIM Mappings

Discussed and demonstrated the RIM Mapping exercise that was undertaken after the Facilitators Roundtable last evening. Used it to pick up another candidate mapper.

Agreed we need:

1. Some formalization of the syntax to use, but probably falling short of BNF.
   • Goal is consistency and assistance to readers
2. Need to assure that Work Groups editing their resource definitions remove the mappings on lines that undergo substantial change.