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CS Meeting Minutes

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Back to Clinical Statement Work Group

Clinical Statement minutes are now linked from the main CS page here.

Older minutes are below.

Possible future work

  • FHIR
    • FHIR approach is to not have an overarching reference model (except that it is being mapped back to the RIM)
    • So no FHIR Clinical Statement is anticipated
    • But possible need for a "full FHIR" model, that can accept any FHIR data as a repository and be queried in a RIMBAA like fashion
    • Likely to be a collection of FHIR resources, rather than any V3 model
    • Could also map Clinical Statement to FHIR
    • Assess what would actually be useful
  • Validate that our schemas actually work (suspicion that element names may not match model and/or tabular view)
  • XML examples of Rx models expressed in clinical statement schema, to demonstrate (and check) alignment
  • Examples of Experimental Unit expressed in clinical statement schema (for FDA)


  • Workgroup documentation
    • SWOT updated at Atlanta WGM
    • Mission and Charter updated at Atlanta WGM
    • Updated new PSS at Steering division Monday at WGM
    • 3 year plan reviewed and reaffirmed at WGM
      • TODO need to submit M&C also find how to reaffirm PSS. SWOT sent to Hans.


  • Open issue with tooling, RMIM Attributes with no datatype. reported to tooling list 2013-03-29
    • This is a known issue, Tooling are aware
  • May 2013 ballot
    • Prepare ballot material (as above)
    • Submit ballot material
      • Done - Submit NIB for normative
      • Plan as suggested by TSC is to go for normative asap, with a well defined scope (which is to be as current CS, and with the completed alignment with Rx, that we are hoping to complete this cycle).
  • Tooling
    • Rik acting as tooling liaison. Expecting to contribute requirements to a project for a model to model derivation checker, probably based on Lloyd's OWL RIM
  • Change PSS to cover Austin's suggestion
    • Change from our current project type, as in our project scope statement, which is "V3 Messages - Clinical And V3 Documents – Clinical (e.g. CDA)" (we are technically neither) to a new type "V3 Foundation - Logical Model"
    • submitted to Lynn Laakso as requested, when NIB for normative went in

May 15, 2013

  • Rik Smithies, Isobel Frean
    • Apologies - Hans Buitendijk
    • discussed WGM activities and what we need to do to move forward.
      • Isobel to look into harmonization

February 15, 2013

  • Rik Smithies, Isobel Frean
    • discussed publication, NIB etc.
    • discussed that pending Pharmacy changes may affect one of the CRs we plan to do. Decided that not worth pulling ballot because of that, but may need to later, to accommodate that change in what is intended to be a release to cover all Pharmacy requirements.
    • Action: Rik to submit NIB for normative ballot. Done.
  • Subsequently updated PSS was submitted to Lynn, as required when balloting for normative.

February 01, 2013

updated todo list (above)

  • Completed actions
  • Ballot from Jan 2013
    • Reply to balloters where needed. Have replied to Mitra at FDA, awaiting response - done
    • Do submission of reconciled ballot - done
    • Other comments to be addressed:
      • Change CS text "HL7 Structured Documents Technical Committee" to "HL7 Structured Documents Work Group"
      • Add explanatory text to say where Experimental Unit is handled in CS (for FDA) - done
      • Update model for Woody's comments around RIM changes - done
  • Change requests and other changes
    • Several CRs approved and ready to be modelled - done
    • Others are out of scope of this normative ballot
    • Woody's ballot comments changes needed
      • What exactly are the changes that are needed? To research
        • Neg Mi - The core model has been "cleaned up" with regards to RIM-deprecated attributes, and context conduction, but the diagram with respect to clinical statement usage has not been so corrected. this too, should be modified to replace context conduction attributes in the Act Relationships with "blockedContext...." attributes.
          • Done - This was actually about the other diagrams in CS, not the model itself

January 17, 2013

  • Phoenix WGM - see (TODO add link to minutes as recorded by Hans)

November 16, 2012

  • Attendance: Rik Smithies, Hans Buitendijk
  • Discussed upcoming ballot, Rik to complete modelling of changes 107 to 114 and get to Isobel in time for ballot content deadline (done 2012-11-18)
  • Discussed upcoming ballot recon deadline - Rik to create consolidated sheet and upload (done 2012-11-18)
  • Hans contacted HQ to change co-chair info now that Patrick has resigned

October 19, 2012

  • Attendance: Rik Smithies, Isobel Frean
  • Discussed upcoming ballot preparations. Rik to do modelling of changes 107 to 114. Isobel will submit

October 5, 2012

  • Attendance: Rik Smithies, Rob Hausam
  • General discussion including change requests to be implemented

July 27, 2012

  • No call

July 13, 2012

  • Attendance: Rik Smithies, Rob Hausam, John Hatem
  • Completed pass through differences sheet between CS and Rx DMIM
  • Next action is mostly to make change requests. Some items need more analysis in CS. John has a couple of actions to take back to Rx.
  • Sheet reposted to list July 27th

June 29, 2012

  • Attendance: Rik Smithies, Hugh Glover, Hans Buitendijk
  • Started pass through differences sheet between CS and Rx DMIM
  • Sheet reposted to list July 30th

March 23, 2012

  • Attendance: Rik Smithies, Isobel Frean (no quorum, should have 4 plus 1 co-chair)
  • Worked on the normative edition submission form
    • Content is from Jan 2012 ballot, which was issued in response to ballot resolution from September 2011 ballot
  • Discussed that there is no CMET section in menu of CS in draft ballot - Isobel to follow up with Don
  • Need to update A_SupportingClinicalStatement CMETs (both) to be same as the latest model, by ballot deadline of sunday - Rik

Feb 10, 2012

  • Attendance: Rik Smithies, Hans Buitendijk (no quorum, should have 4 plus 1 co-chair).
  • Discussion of new project for CS normative, and if we can use current project for continuation of DSTU
    • Also may need a different project for maintenance, post normative
  • Decided to carry on with current DSTU project (with new name not saying "Pattern") to get current change requests in, and perhaps PC and Pharmacy changes
  • NIB to go in to effect project name change

January 27, 2012

  • Attendance: Rik Smithies, Isobel Frean, Hans Buitendijk (no quorum, should have 4 plus 1 co-chair)
  • Time very short to get a new project statement in (this Sunday 29th), around changing scope to normative. Also no quorum today.
  • Also change reqs outstanding (genomics) and expected in-coming from Pharmacy and reactivated one from Patient Care perhaps.
  • Hence seems best to work on those under current DSTU for May 2011, and then do switch to normative in a new project created around May, for September 2012.
  • Rik to restart calls and reminders (done)
  • Also Reach out to pharma shortly and to Pat Care to see timescales for their change requests. Then can submit NIB etc (Rik - contacted PC and Pharmacy 10th Feb)

December 2, 2011

  • Present Rik Smithies (Notes), Hans Buitendijk, Charlie Bishop, Isobel Frean (No quorum)
  • Charlie not seen request to withdraw negative. Has said he is happy to do so. When email request comes through Charlie will respond then Hans will resubmit reconciliation sheet.
  • Now have a final DSTU. all votes addressed.
    • Need to have vote to publish DSTU, then can fill in a form and Don will publish (to next normative edition presumably)
  • Still need a discussion as to if CS needs to be something else, eg a template, which may need more changes or not.

Ideally want a "completed" status when DSTU is complete ie. not DSTU, "draft", since that implies not ready. Is the pattern to be normative? This doesn't seem to be likely. More likely to be an informative document in the Normative edition, hence gaining some authority from that. Not easy to enforce CS. But also not clear how other domains are "enforced". Who says that patient care-like models must adhere to patient care? ARB? Where is the statement about that? Suggest to ARB that they have a statement eg - when you model clinical data, do it like this (ie. using CS).

  • Action Rik - email ARB co-chairs to get a dialogue going, possibly meeting in San Antonio
  • Need San Antonio agenda
    • Draft:
      • Motion to publish to normative edition. Discuss what status do we want. Suggest Informative, but in normative edition.
      • ARB enforcement message? See above
      • Outstanding change requests:
        • Relatively new: CSCR-106 Include ReasonCode and ActivityTime in Encounter in CS (William Goosen)
        • Old: CSCR-025, CSCR-044, CSCR-062, CSCR-097
        • Passed but not actioned: CSCR-098 Incorporate Pedigree Family Structure
      • Project status page etc
      • Pharmacy - outreach before. Will there be material to review? Or plans we need be aware of.
      • MnM Patterns - MnM want patterns from us. What do we have?
      • Kai, Patient Care, Templates. Any progress there we need be aware of - outreach beforehand.
  • No more calls before San Antonio

November 18, 2011

  • Attendance: Charlie Bishop, Hans Buitendijk, Isobel Frean, Rob Hausam, Rik Smithies (chairing)
  • Some initial problems with the conference call line. Participation code of 157456 didn’t work, HQ provided 810878. Need to follow up for next time to see which is correct.
  • Quorum of 4 plus 1 co-chair reached.
  • Vote to remove "pattern" from out material - proposed Hans, seconded Charlie. Carried 5-0-0 (in favour, abstain, against)
    • Note that that there was no definite statement in the motion of what to replace "pattern" with. There was an assumption on the call from some parties that the word "model" would be used instead (which had been suggested as part of a proposed motion on the email list). During a discussion after the motion (and after Hans had left), this seemed acceptable to all on the call. It is expected that some wordsmithing will be needed and possibly a project name change.
  • Vote to approve project statements as circulated by Steering Division and copied to list 17-Nov-2011 (Cytogenics, ESMD). Proposed Hans, seconded Rob, Carried 4-1-0 (in favour, abstain, against)
  • No quorum for remainder of call.
  • Discussion of readiness for submission of our content. Model changes made. These will be circulated to the list but all appear to fall in category of technical changes (RIM updates, that should have been done earlier, and existing changes that had accidentally been removed, as noted by Charlie). Hence we do plan to submit and Rik and Isobel will work to get that done.
  • There are some change request outstanding including CSCR-98 that has been approved but not modelled. This was also the case at last ballot, so no real change in situation. Suggestion that we progress and mention these as to-do in the ballot text.
  • Discussion of the Pharmacy and CS review draft project plan. We are named as co-sponsors, which seems fine, although no official vote taken. Timescales have slipped so presumably Pharmacy will update those before appraisal by Steering Division. Plan is still draft and we haven't been formally asked about it yet, but no objections noted. Any work that needs doing after the review will be a different project, so little direct impact on our schedule, though we would be committed to work on the review (Rik can be involved).

Isobel said that they should be informed that the wiki is the place for change requests, but hopefully we will be involved in decisions about change requests before they are formally raised anyway.

  • No other business, meeting closed. Next call 2nd December.
  • Actions:
    • Isobel to reach out to Pharmacy, mention wiki as the place for CRs.
    • Rik and Isobel to get our material submitted including review current outstanding change requests and add wording to ballot to say what is in. (done, but as of 2nd December ballot preview site is not updated, continuing action to monitor)
    • Rik to send latest model to Isobel and put it on the wiki (done)
    • Rik to circulate model changes to the list
    • Rik to sort out the conf call number for next time (HQ have reissued - now have new passcode 1574561 (same as old with an extra "1" on the end)) (done)
  • Issue, not mentioned on call: did we yet submit the completed ballot sheet? Do we need a motion to resolve Charlie's comments? (which have been reviewed recently but not voted on).

No Quorum on calls 4 Nov, 21 Oct Notes can be added here

August 26, 2011

No quorum.

  • Agenda and todo list
    • Info - Orlando WGM minutes got updated
    • Info - Ballot update - ballot went in and after some glitches, is fine
      • ballot comments have come in.
      • I know of a couple of technical issues with the pattern that have been spotted in the UK.
    • No call before WGM, next meeting therefore Q3 and Q4 Thursday 15th September
      • Draft Agenda for WGM
        • Ballot comments
        • Pharmacy alignment (this is still on the pharmacy agenda)
        • Feedback from meetings earlier in the week re MnM and "Patterns" - Announce this to our list
          • Is this in fact the right place for our "topics"?
            • (If not, what do we want to do with these? The motion to remove them stalled.)
        • Where next after this ballot?
          • Possible CS changes from William Goossen (devices) and from Randy Levin FDA (last ballot comments)
          • What are we allowed to do if/when we pass ballot?
          • How to intercept CDA R3?
            • Need to be SAIF based? and what would that mean?
          • What does CS need from tooling?
            • How can tooling help people derive from/align to CS or validate a model for CS conformance
          • Impact of "fresh look taskforce" ideas from earlier in the week
          • Patient Care templates issue - mail thread with Kai 18-Jul-2011
          • How to remove the deprecated SuportingClinicalInfo CMET (Isobel to inquire)
          • Model tidies - the publication QA report has an unexplained error on statusCode (Isobel to inquire)
          • XML examples for CS and using the generated schema.
            • Likely to be some issues around element names - and see Mead post to CS list on source/target names

August 12, 2011

Attendees: Rik Smithies, Isobel Frean, Rob Hausam

  • Agenda
    • Ballot update
    • Next call due 26th Aug
    • Actions
      • How to remove the deprecated SuportingClinicalInfo CMET (Isobel to inquire)
      • Model tidies - the publication QA report has an unexplained error on statusCode (Isobel to inquire)

July 29, 2011

  • No meeting, lack of co-chairs

July 15, 2011

Attendees: Rik Smithies, Hans Buitendijk, Rob Hausam

  • e-Vote of 23rd June (re ballot resolutions and to go to DSTU) complete and affirmative
    • Rik to monitor and chase people to help get quorum nearer end of vote (20th July)
  • e-Votes now in flight on removing CS topics and having just the universal CMET, not minimal also
  • CMET part of ballot submission done
  • Rik to submit remaining ballot content for deadlines of July 17 and 24.
  • Rik to respond to MnM approach to meet at WGM re design patterns and CS
  • Rik to follow up on outreach to other groups re use of old CMET A_SupportingClincalInfo
  • Actions from last time
    • Rik to prep to CMET for July 10 - complete
    • Rik to prep spreadsheet to divide-and-conquer attribute level descriptions - not done and unlikely to be time for this before this weeks publication deadline
    • Rik to submit motion to remove topics from documentation - Isobel did this

July 1, 2011

Attendees: Rik Smithies, Hans Buitendijk, Rob Hausam

  • e-Votes in flight on ballot reconciliation and ballot submission
    • Affirmative: 3 (Rik Smithies, Hans Buitendijk, Rob Hausam). Need two more.
  • Isobel to submit preliminary content for July 5.
  • Rik to prep to CMET for July 10
  • Rik to prep spreadsheet to divide-and-conquer attribute level descriptions
  • Rik to submit motion to remove topics from documentation.

June 17, 2011

Attendees: Rik Smithies, Hans Buitendijk, Rob Hausam

  • Reviewed the ballot reconciliation
    • Rik to follow-up with Randy Levin on experimental units
    • Hans to generate 2 motions to address two votes
  • Propose to go back to ballot as DSTU
    • Hans to get motion in e-vote to accept
  • Follow-up with Isobel to prep for updates submissions.
    • We think we can have CMETs updated as well.
    • Concern remains the attribute level documentation
  • Need to have a motion to remove the Topics from the documentation
    • Rik or Isobel to submit.

May 6, 2011

Attendees: Rik Smithies, Hans Buitendijk, Rob Hausam

  • 14 ballot retunrs, 107 to go.
  • We set the WGM agenda.

March 25, 2011

Attendees: Rik Smithies, Hans Buitendijk, Isobel Frean

  • Update on ballot progress, all ready
  • Discussion on whether to remove "Topics" from ballot. Those on call in favor of removing, no longer seem relevant. Inquorate, and short of time before ballot, even for an email vote, so leaving for now.

March 11, 2011

Attendees: Rik Smithies, Hans Buitendijk

  • NIB done
  • Project Statement is up-to-date.
  • Rik waiting for CMET process update
  • Model updates in progress.

February 25, 2011

Attendees: Rik Smithies, Rob Hausam, Hans Buitendijk

  • NIB - Just CS Pattern, not CMETs
  • Rik waiting for CMET process update
  • Should be able to get updates to model in place for ballot submission.
  • Hans to complete the project statement review.

February 11, 2011

Attendees: Rik Smithies, Rob Hausam, Hans Buitendijk

  • Isabel happy to be facilitator again
  • Hans to check on project statement
  • Rik checked with Jean on CMET IDs, but no feedback yet.
  • Rik to complete WGM Thursday Q4 minutes into wiki
  • Waiting for pattern update feedback. If we get it, great, if not, we'll still move forward with ballot.
  • A couple of updates still to apply.

January 28, 2011

Attendees: Rik Smithies, Hans Buitendijk

  • Updated Project Statement with minor edits and requested Dave Hamill / Lynn Laakso to get Project Insight up-to-date.
  • Submitted CBC for the pattern, while the CMET is idle.
  • Rik to complete WGM Thursday Q4 minutes into wiki
  • Updated pattern was sent around for comments.
    • Waiting for Rx updates/feedback and other feedback
    • Pending context conduction updates
    • Focusing on everything but attribute level descriptions first
  • Need to get CMET IDs for the new "integration" CMETs on the pattern. Rik to check who issues them.

December 17, 2010

Attendees: Rik Smithies, Hans Buitendijk, Rob Hausam

  • Doodle polls for motions are in progress. We met quorum, so if current votes stand both motions stand.
  • Model on ballot site is out-of-date. Rik is following up with Don to fix.
  • Struc Doc had us booked for Thursday Q4, while we had asked for Q3 to join with OO. Calvin never responded, so we're stuck. Hans and Bob have to attend another meeting Q4, so won't be there. We'll go with current flow as it's too late to get rooms adjusted. Disappointing, but so be it.

December 3, 2010

Attendees: Rik Smithies, Hans Buitendijk, Rob Hausam

  • January WGM Agenda
    • We updated the CS January 2011 WGM agenda.
    • Key question remaining is which quarter we will be joint with Structured Documents as they did not yet respond to our suggestion for the third quarter while we're meeting joint with OO third quarter.
  • CS and Pharmacy
    • Rik will further discuss in person during Sydney meeting.
  • Model Updates
    • We agreed it is easier to review updates applied, rather than attempting to apply updates during the meeting. Rik will sync with Patrick to ensure Rik can make updates.

November 12, 2010

Attendees: Rik Smithies, Hans Buitendijk

  • Decision Making Document
    • We finalized proposed updates to the Decision Making Document template to fit Clinical Statement.
    • The updated version is attached - File:CSWG Decisionmaking practices v2.0.doc
    • With these updates and the Mission/Vision update, Hans will send out these documents for e-vote.
  • CS and Pharmacy alignment - Rik
    • Not discussed
  • Work on the pattern
    • Not discussed
    • Required steps:
      • update to new RIM
          • start refactoring the model according to the plan
      • creation of CMETs - need to be able to publish these
  • Ballot plans
    • Not discussed
    • Required steps:
      • publishing - do we need to be using a new method yet (MIF based?)
      • attribute level descriptions

November 5, 2010

  • Admin
    • Co-chair elections are happening January for me and Hans, but I don't think action is needed, HQ deals with it all.
      • Hans to check who to submit the nomination to.
    • Workgroup health items
      • Hans to check that all minutes are posted.
      • Mission/charter up to date (and with review date)
        • Current: Continued evolution of a clinical statement model that enables different workgroups to consistently incorporate clinical statement patterns in their domain.
        • New: Continued evolution of a clinical statement model that enables different workgroups to consistently incorporate clinical statement patterns in their domain as templates, CMETs, or other valid methods.
        • Out for doodle poll. Then to SSD + Dave Hamill/Lynn Laakso.
      • Review decision making practices new version - Template, Draft:File:CSWG Decisionmaking practices v2.0.doc
        • We want to link from website to wiki page. How do we do that? Hans to check.
    • Need to get clarity on Project Health measure on con call minutes. Not meeting or no quorum does not mean not healthy.
  • Work on the pattern
    • update to new RIM
    • start refactoring the model according to the plan
    • creation of CMETs - need to be able to publish these
  • Ballot plans
    • publishing - do we need to be using a new method yet (MIF based?)
    • attribute level descriptions