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20160726 US Realm SC Call

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US Realm Steering Committee Call Agenda/Minutes

Location: 929-752-237

Date: 2016-07-26
Time: 1 PM Eastern
Co-Chairs Ed/Brett Note taker(s) Anne
Attendee / Name
x Calvin Beebe Keith Boone Hans Buitendijk
x Lorraine Constable Johnathan Coleman x Ed Hammond
x Tony Julian Paul Knapp Austin Kreisler
x Brett Marquard Ken McCaslin Nancy Orvis
Brian Pech Wayne Kubick Mark Roche
Sandra Stuart . Pat Van Dyke x Anne Wizauer
x Danielle Friend x Eric Haas . Jenni Syed
x Steve Posnak x David Susanto .
Visitor / Name
Avinash Shanbhag Chris Johnson
no quorum definition



  • Agenda review
  • Review notes from 20160628_US_Realm_SC_Call
  • Action Items
    • Ed to touch base with TSC, Grahame, etc to look at how we might tackle managing US extensions


  • Ongoing Role of US Realm Steering Committee


  • Called to order at 1:05 pm
  • Ed just back from Board retreat. First day is advisory council with a variety of representatives from the healthcare and government landscape.
  • HL7 FHIR Foundation has now been created as a 501C3 organization with a board; Ed is secretary of the FHIR Foundation board because of his HL7 board role. Still understanding how things will work and relate to HL7 proper. Discussions will be held regarding role of FHIR Foundation and FHIR products. Strong interest from Argonaut in participating with USRSC.
  • HSPC will also function much like Argonaut - they are creating some of their own resources and profiles and a repository.
  • Ed having conversations with CDC and FDA about some activities making use of FHIR that will create resources and profiles.
  • These projects are not well coordinated with one another and we may need to work to put them together at the USRSC.
  • USRSC: much of the work needs to be done in the WGs. Not appropriate that we become a technical body. Part of it is why bother to go to US Realm if you go through the WGs? What if the WGs aren't interested in dealing with maintenance of profiles and everything else coming back? How will we provide the coordination for these activities? May need a subgroup of USRSC. Need to answer who, how, when, and where.
  • Brett presents US Realm Next Steps document he created to begin addressing these concerns.
    • Recommendation is to pilot a 6-8 person task force to tackle the most pressing FHIR issues.
      • Lorraine: in May we started a PSS to coordinate governance processes and the repository. HL7 put that project out to RFP. How do you see those efforts relating to this? Brett: I see them as complimentary - doesn't seem like it would be duplicative. Ed: FHIR Foundation may hire someone to set up the registry; we would contribute to setting up rules, etc.
    • Brett: Do folks have concerns setting up an effort that deals purely with FHIR? Ed: Not initially, although we have responsibility for all HL7 activities. But at this particular moment it is appropriate to focus on FHIR as the most pressing issue. Calvin: I agree given where FHIR is at in its lifecycle. We can come back around at a later point and broaden the scope. Paul: This subgroup would be responsible for establishing relationship with external bodies? Ed: they may talk to those people and then bring it back to the larger body. Steve: Focusing on FHIR issues will illustrate other lessons learned that can apply to the bigger picture. There are a number of federal agencies that are interested in FHIR work; we have an interest in supporting infrastructure and other types of enabling elements for FHIR through HL7 that would be of benefit to US Realm and in general to everyone doing FHIR-related work. Interested in making the federal connection a central funneling point. Extension management is scary in terms of VA, DOD, ONC, FDA coming up with different extensions in an uncoordinated manner. This group is in a good position with the right focus to help adjudicate and keep everyone on the same track.
  • Brett: Is this a small enough bite to manage in the near future? Between now and Baltimore, should we first form this smaller group and then tackle reviewing the US extensions in the current FHIR build? Ed: Is this something that we are going to get HL7 to hire someone to do the technical part? We're tackling issues that are being discussed in TSC, executive committee, FHIR Foundation, etc. Concern that it's easier to do your own extension than to discover if one exists, so the registry becomes critical. Brett: I'm trying to focus in on a smaller piece of this; there are US realm extensions that we've put in the build, but there is no formal vetting of those extensions. If I want to create an extension on race, where do I go? Lorraine: If you're going to create a profile with or without extensions that is balloted within HL7, you have to create a proposal that is reviewed within the FMG. Brett: Who do I review my extensions with? FMG? Is FMG tracking the extensions I create within my project? Paul: We also have a design requirement that when resources are profiled, they should be reviewed by the committee that created the basal resource. Brett: Feedback I've gotten is that there is still not a central US group coming together to talk about those. Paul: We do need someone to tidy up what's been done.
  • Brett proposes that 5-6 people in August review the US realm ballot and the extensions that have been created, do a technical review, and then brainstorm about potential process for the future. Lorraine and Paul concur. Paul notes that we need to make sure there is not redundancy between US Realm and Universal extensions. Avinash: Would be useful if we could identify if the extensions in the core build have been reviewed by the US Realm Steering Committee. Paul: As FHIR grows we'll need growth on the HQ side rather than the volunteer side.
  • Brett will contact folks offline to discuss volunteers. Will update in Baltimore if not before on calls.
  • Danielle: If Epic wanted to create an extension, would that come to this group? Brett: That will be addressed as the second part of this effort, after the initial concrete review of what exists.
  • Adjourned at 1:48 pm Eastern

Meeting Outcomes

  • Brett to work on setting up smaller committee for US realm ballot and extensions review
Next Meeting/Preliminary Agenda Items

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