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FHIR Ballot Prep

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This page lists the tasks to be completed by work groups in preparation for the R4 release of the FHIR core specification. The timelines for implementation guide publication and balloting may differ. Implementation Guides may choose to either publish in sync with the core specification (and actively manage dependencies as underlying resources and profiles are updated) or may choose to ballot later, once the FHIR specification is finalized. (The disadvantage of the latter approach is that changes to the core specification identified as part of implementation guide revision won't be able to be applied until a subsequent release.)

Here is a link for Implementation Guide proposals


  • R4 is the first FHIR publication that will contain Normative content. For those who aren't familiar with HL7 processes, Normative means that, once the specification passes, we will no longer make breaking changes to the specification from that point forward - ever. The rules for change in FHIR for normative content are described [here].
  • R4 is also the first time we're expecting to have multiple "ballots" for FHIR core content. This means that there will be one FHIR specification hosted on the web. However, each page in the specification will identify both what level it's being balloted at (not balloted, draft, STU or normative) as well as which ballot it's part of. Multiple ballots are necessary to allow content to proceeed by different paths - balloting at different levels requires separate ballots and if there's a need to allow some content to be demoted to a lower level while other content remains on the normative path, that content needs to be packaged separately.

R4 Publication

These are the publication deadlines leading to the publication of the FHIR R4 core specification and any IGs that plan to *publish* on the same cycle.

  • 2018-09-29 - 10-05: October WGM (Baltimore).
  • 2018-10-06: Notification of Ballot opens for "final" targeted R4 normative ballots
  • 2018-10-12: Final reconciliation packages posted for Normative Sept. ballots
  • Working on R3/R4 conversions (see Progress on FHIR R3/R4 conversions)
    • Changes will be auto-deferred after this date
  • 2018-10-31: Final reconciliation package posted for STU ballot
  • 2018-11-01: Substantive content freeze for core R4 publication including all substantive QA changes. Decision based on vote results and withdrawals about which normative packages to drop to STU. Implementation guides publishing as part of R4 may continue to make substantive changes.
  • 2018-11-06: Targeted R4 normative ballot opens
  • 2018-11-11: Final content freeze for R4 publication and start of QA period. No changes permitted for FHIR Core without product director permissions. Implementation Guides may update based on their QA processes
  • 2018-11-25: QA period closes, QA change application begins
  • 2018-12-02: FHIR core and FHIR IGs are all locked. No further changes without product director permission
    • Finalization of FMM levels, final internal publication clean-up, publication process
  • 2018-12-06: Targeted FHIR core ballot closes
  • 2018-12-07: One-time meeting to reconcile any ballot comments - all out of scope comments will be found Not Related
  • 2018-12-08: Recirculation ballot opens?
  • 2018-12-10: Seek approval for publication from TSC (possibly pending recirculation)
  • 2018-12-22: Recirculation ballot closes?
  • before 2018-12-31: Publication of R4

The world rejoices, Grahame sleeps

Jan 2019 ballot cycle for FHIR IGs

NOTE: There will be no deadline extensions for this cycle. If you miss a deadline, your content will not appear in the January ballot and will have to wait for the May cycle.

  • 2018-10-17 - IG proposals due to the FHIR Management Group. (Earlier is better)
  • 2018-10-31 - Reconciliation packages posted to ballot desktop for previous ballots (if any)
  • 2018-10-28 - NIBs due, IG must be publishing on the CI build and "functionally complete"
    • FMG will be evaluating "need to ballot" - each ballot must be necessary
    • All artifact types, all key behaviors, etc. present. If there are bugs in the publication process, they must be identified by this point and must be resolved to the point that the build at least runs successfully and any tooling-related issues must be agreed to be resolvable
  • 2018-11-18 - Content deadline for QA. All content must be final from the workgroup perspective - no changes other than QA fixes from this point - no new artifacts or content
  • 2018-12-02 - Final freeze. If there are QA errors at this point, you don't publish. No slippage for any reason
  • 2018-12-07 - Ballot opens