20140602 FGB concall

HL7 TSC FGB Meeting Minutes Location: call 770-657-9270 using code 985371# GoToMeeting ID: 136-494-157		Date: 2014-06-02 Time: 4:00 PM U.S. Eastern
Facilitator:		Note taker(s): Lynn Laakso

Quorum = Chair plus 2				yes/no
Co-Chair/CTO		Members
x	George (Woody) Beeler	regrets	Lorraine Constable	x	Grahame Grieve	regrets	David Hay
x	Dave Shaver		Ewout Kramer	x	Lloyd McKenzie (FMG)		Ron Parker
	John Quinn
observers/guests			Austin Kreisler
		x	Lynn Laakso, scribe

Agenda

• Roll call -
• Agenda Review
• Approve minutes of 20140526 FGB concall
• Action Item review:
  • Follow up with Provider candidate Catherine;
  • dave & woody review ‘principles of FHIR doc’ in next 2 days (woody "ok")
  • pass to FMG by week end for their review by tuesday am (before next FMG meeting
  • Lynn will draft summary position on conformance testing of FHIR for review and adoption of a formal response
    • FGB is reluctant to see FHIR DSTU prototypes be used to grant certificates rather than serving to define and guide development of full conformance testing in future.
    • FHIR's fundamental principle of scalability infers that conformance must be to a constrained scope in a wide range of interoperability spaces
      • environment (within a small clinic to across a country or around the world)
      • implementation environments (institutional, community, home health, etc.)
      • architectures (centralized/distributed, open/closed, tight/loose)
      • data loads (sms communication in the developing world to gigabyte/terrabyte EHR data dumps)
      • communication frequencies (daily/weekly updates to sub-second automated device data updates)
    • While conformance to the FHIR DSTU in terms of "shalls" and "shoulds" would be a useful exercise, any certification of conformance is not meaningful if the specification to which they have conformed is fully optional.
• Updates to Fundamental_Principles_of_FHIR (review and set plan to formally adopt)
• Issues passed down from TSC
  • Governance Issues in re FHIR Registry - particularly:
    • Distinction between registering an item onto an open list vs. Assigning identifiers and registering their assignment

    • Determine whether HL7, in instituting charges for the OID registry, means to include a fee for retrieving registrations from the registry, or only for adding items thereto. And, if the latter wjat is the intended distinction between: "internal" addition requests, "member" addition requests, and "outside" addition requests?

    • Built-in protections against BOT submissions

    • Expectations for "automated curation" surrounding elements that carry identifiers in HL7-managed namespaces, particularly uri: http://hl7.org/fhir ... and OIDs: 2.16.840.1.113883...

  • Governance issues in proposed projects related to

    FMG discussions on requiring WG FHIR projects to include work on CCDA profiles calls into question any WG FHIR projects.

    • See TSC Minutes item ! under Management
• Updates to FHIR_Governance_Precepts
• FMG update -
• Methodology update-
• Next steps: Define and Resource other Governance processes.
  1. Conformity Assessment

Minutes

Convened at 4:09 PM

• Agenda Review: discuss CCDA before registry as Furore has not issued their proposal yet. Discussion on WG conducting for comment only ballot separate from DSTU. discuss Skype channel
• Approve minutes of 20140526 FGB concall - note the open skype channel not happened yet for FGB; Lloyd/Dave moved unanimously approved
• Action Item review:
  • Follow up with Provider candidate Catherine; not done
  • dave & woody review ‘principles of FHIR doc’ in next 2 days (woody "ok")
  • pass to FMG by week end for their review by tuesday am (before next FMG meeting - has this happened? Needs FMG review. FMG agenda full for next couple weeks and they may not get to it. Discuss notes if there is time today.
  • Lynn will draft summary position on conformance testing of FHIR for review and adoption of a formal response - position statement included below:
    • FGB is reluctant to see FHIR DSTU prototypes be used to grant certificates rather than serving to define and guide development of full conformance testing in future.
    • FHIR's fundamental principle of scalability infers that conformance must be to a constrained scope in a wide range of interoperability spaces
      • environment (within a small clinic to across a country or around the world)
      • implementation environments (institutional, community, home health, etc.)
      • architectures (centralized/distributed, open/closed, tight/loose)
      • data loads (sms communication in the developing world to gigabyte/terrabyte EHR data dumps)
      • communication frequencies (daily/weekly updates to sub-second automated device data updates)
    • While conformance to the FHIR DSTU in terms of "shalls" and "shoulds" would be a useful exercise, any certification of conformance is not meaningful if the specification to which they have conformed is fully optional.

    Woody would like to see "FGB would like to see FHIR DSTU prototypes be used to define and guide development of full conformance testing in future rather than grant certificates."

    Need to rewrite bullet 2: need constrained scope to make meaningful conformance testing. Lloyd suggests: "FHIR is implementation-agnostic platform where most elements are optional and therefore conformance cannot be meaningfully asserted aside from simple wire format validity" for which the value is questionable.

    further discussion ensued

    • FGB would like to see FHIR DSTU prototypes be used to define and guide development of full conformance testing in future, rather than grant certificates.
    • FHIR is implementation-agnostic platform where most elements are optional and therefore conformance cannot be meaningfully asserted aside from simple wire format validity. Simple testing of validity of instances against resource definitions and profiles, and support of servers for claimed services is fully automatable and freely available. Therefore, to drive significant revenue, conformance testing from HL7 would probably need to add a layer of human review for content not testable in an automated fashion.***Therefore, while conformance to the FHIR API is possible now using existing tools available at no cost, meaningful conformance testing will require the availability of implementable FHIR profiles.
      • Lloyd moves and Dave seconds adoption of this position statement and send to HQ and the members of the current conformance testing activity. Unanimously approved.
• Listserv sharing; FMG feels we should maintain separate and distinct FMG and FGB skype chats, even if each desires a public and private chat.
  • Woody notes that today's chat had several messages about attending the call. There are partial conversations on the skype chat that do not reflect continuing conversation and resolution via voice. There is the possibility that the discussions may confuse.
    • Support for transparency stated by Grahame. Dave is neutral on the bot.
    • Motion: Lloyd moves and Grahame seconds this approach. Vote: Unanimously approved.
• Issues passed down from TSC
  • Governance issues in proposed projects related to

    FMG discussions on requiring WG to work on FHIR projects to include work on CCDA profiles calls into question any WG FHIR projects.

    • See TSC Minutes item 1 under Management

    How do we deal with content from an overall FHIR perspective that does not fit in a WG's bandwidth and remain sensitive to HL7 culture as well as long-term interests of FHIR. What is the best way to deal with PSSes? The governance question is that under what circumstances to decide that a particular set of content is important enough to FHIR to request it be undertaken by a WG or if the WG does not have bandwidth to seek other volunteers to do the work and allow the primary WG to review? This has been done in the past.

    • Woody asks if having an available appeal mechanism would help? That might be a fallback but Lloyd suggests we set up the process such that people are comfortable with it. The appeal process has already been exercised with discussion to the FMG and escalation to FGB and then TSC. Austin described directly to TSC his concern with WGs taking on CCDA development without SDWG as primary sponsor. Patient Care PSS was returned for CCDA scope inclusion as well as OO. What criteria should FMG be using to determine what work is sufficiently important to punt back PSSes or find other volunteers to do the work and allow WGs to review.
    • If FMG is prime focal point for these decisions Woody is not comfortable asserting rules for the decision making. Lloyd suggests that it is in the mandate of FMG to manage the FHIR work even if the primary WG cannot undertake it. Woody asks about a list of those key resources for which this option is being exercised including the FGB and TSC chair be provided.
    • Lloyd notes the PSSes for the work on CCDA can be driven by FMG rather than individual work groups if needed. It is less comfortable to consider allowing SDWG to oversee the work instead of the primary WGs taking responsibility. PA has agreed to do it, PC is comfortable with reviewing. Grahame notes lack of clarity to the task for requirements and need to discuss more in future. FMG will take up again on Wednesday.
    • Lloyd reports sensing that WGs feel that FHIR is moving faster than WGs can cope with should be addressed. Need a process for declaring these things important and deal with the PSS aspects.

Being over time, defer remaining items to next call. Adjourned 5:09 PM

• Updates to Fundamental_Principles_of_FHIR (review and set plan to formally adopt)
• Concern by FMG to allow WG conducting for comment only ballot separate from DSTU - open to all WGs?
• Issues passed down from TSC - continued
  • Governance Issues in re FHIR Registry - particularly:
    • Distinction between registering an item onto an open list vs. Assigning identifiers and registering their assignment

    • Determine whether HL7, in instituting charges for the OID registry, means to include a fee for retrieving registrations from the registry, or only for adding items thereto. And, if the latter what is the intended distinction between: "internal" addition requests, "member" addition requests, and "outside" addition requests?

    • Built-in protections against BOT submissions

    • Expectations for "automated curation" surrounding elements that carry identifiers in HL7-managed namespaces, particularly uri: http://hl7.org/fhir ... and OIDs: 2.16.840.1.113883...

• Updates to FHIR_Governance_Precepts
• FMG update -
• Methodology update-
• Next steps: Define and Resource other Governance processes.
  1. Conformity Assessment

Next Steps

Actions (Include Owner, Action Item, and due date)

Next Meeting/Preliminary Agenda Items 20140609 FGB concall

Back to FHIR_Governance_Board

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