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MnM Minutes WGM 201205 Vancouver

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Return to MnM Minutes for 2012

Sunday Jan. 15 Q3


Woody Beeler, Jean Duteau, Austin Kreisler, Lloyd McKenzie, Rik Smithies, Andy Stechishin, Mead Walker, Grahame Grieve, Dale Nelson, Adel Ghemallah, Amnon Shabo, Lee Coller, Ann Wrightson, Adam Chee


Establish Agenda for WGM from Hot Topics and FHIR


  • Reviewed the existing Hot Topics
  • Reviewed when FHIR was going to be discussed in other committees
  • Updated the Agenda with the proper quarters noted.

Monday May 14 Q1


Woody Beeler, Abdul-Malik Shakir, Lloyd McKenzie, Ann Wrightson, Ewout Kramer


SAIF Artifact Definition & Implementation Guide

Started discussing the list of SAIF Artifacts to be defined from the SAIF Artifact List page. Re-categorized this based on current views of requirements, including the anticipated inclusion of FHIR in the forthcoming cycles. Lloyd McKenzie collected and edited a Word Document of the result of this discussion. It was agreed to by those present and will be attached to these minutes and used to update the SAIF Artifact List page by gwb.

Abdul-Malik Shakir agreed to take on Project Lead for this project and Woody Beeler agreed to be the facilitator for the project. We will schedule a call to re-invigorate this definition activity.

Monday May 14 Q2


McKenzie, Beeler - Failed to reach quorum


Ballot Reconciliation for Core Principles R2

Discussed the issues raised on documentation of "isDocumentCharacteristic". Agreed to a strategy to correct, and that would issue second ballot on this item only.

Ballot Reconciliation for RIM R5

Considered how to respond to votes. Most related to "isDocumentCharacteristic" (above). Will treat as non-significant change, and not re-ballot.

All these decisions will be revisited on a Reconciliation Conference Call.

Monday May 14 Q3


Woody Beeler, Lee Coller, David Hay, Linda Bird, Henry Wijaya, Ewout Kramer, Rik Smithies, Tanya Achilles, Dale Nelson, Paul Knapp, Mark Tucker, Piers Hollott, Ann Wrightson, Bo Dagnell, Lloyd McKenzie, Brian Pech, Grahame Grieve, Rajan Rai


FHIR Data Types and Extant Data Types R3 Requests

Questions :

  • Do we do an R3?
  • If so when? and
  • What is the content difference?


  • Will need to consider, with respect to FHIR, how to handle choices (selection of data type at instance time.)
  • Grieve: "Lack of a typed identifier is a serious omission in V3" (most noticeable in CDA)

FHIR Changes in re R2:

  • Structure of PQ with originalText
  • Relaxing constraints on: TEL, CD, II
  • Text content exists everywhere
  • Additional nullFlavors - "process error", and "as text"
  • Simpler version of GTS that might be of use in other settings

From R3 Page

The Data Types R3 Wiki page will be re-written to reflect these decisions. The following list is intended to summarize what is in scope for R3:

  • Update IETF RFC number under Language data type (BASIC) from RFC 3066 to RFC 5646 (or the latest RFC number) (Wendy Huang)
  • Address the issues raised by turn "II.scope into a mandatory attribute"
  • Add note to integrity Check about it's utility with digital signatures
  • Add ability to flag lists as unsorted.
  • PIVL is unable to express that an interval starts at a time relative to another event.
  • Make it explicitly obvious that relative URLs are allowed in CDA documents for URL types.
  • Add a property to the CD datatype as "valueSetDefinition" with a data type of ED intended to contain the CTS 2 (or possibly other) definition of the value set.

Whence DT R3?

Should follow the first cycle of FHIR deployment to gain experience before trying to tie down the R3 changes upon which FHIR is dependent.

Ergo: Initiate Data Type 3 project proposal discussion in January WGM 2013.

Moved: Grieve/Beeler Unanimous

Tuesday May 15 Q1


Woody Beeler, David Hay, Tanya Achilles, Dale Nelson, Mark Tucker, Ann Wrightson, Lloyd McKenzie, Brian Pech, Grahame Grieve, Andy Stechishin, Charlie McCay, Steve Fine, Jay Lyle, Rik Smithies, Grahame Greive, Ewout Kramer, Abdul-Malik Shakir, Charlie Mead, Peter Hendler, Paul Knapp, Linda Bird, Even Osfer, Ndri Nguyen, Peirs Hollot, Bo Dagnall


FHIR Methodology - Profiles and Extensions

Q: Are profiles necessary for the definition/use of extensions? A: Yes extensions are defined by profiles. Some Profiles will only be 'grab bags' of extensions

Q: Are profiles part of the core specification? A: Profiles are expected to be balloted separately from the core specification (much like implementation guides), the specification of profiles and extension is part of the core specification.

Q: Are profiles cascading? Do profiles apply to profiles? A: Yes

Q: What are drvinign design principles behind FHIR's extension mechanism A: Static wire format. 'Z' segment problem - I have received blob of data or collisions of content/naming. Leveraged experience of OBX segment.

Full principle: in order to deliver a specification for all user you need to deliver a specification that meets all users needs - must have an extension mechanism

Ann: this is really an open system but may need to explore implementation with different trade-offs Grahame: not essentially an open system but rather a system for governance.

Grahame; If you design an extension and do not vet it with HL7 there is a risk the extension will be orphaned by the community. HL7 may decide it needs to be part of the resource and update the resources. However, If HL7 blesses an extension it will never become part of the resource (this is proposed governance policy, not formalized)

Grahame describing the 'unrolling' or 'unpicking' mechanism for the definition of profiles. Note Grahame illustrated the profile in a spreadsheet but this is simply a way to define the profile (user data collection tool) the normative form is the resource/profile definition (XML)

Sidenote: FHIR is not tied to tools, there is no prescribed tooling stack. The specification should be easily produced with readily available, software that is expected to be installed on the majority of resource definer's systems.

There was a side discussion on the display format of the resource definition.

AMS asked about the mapping columns on the definition spreadsheets. Lloyd described the mapping for the Lab resources. Lloyd stated that the there is a desire to express the mapping in RDF.Ann raised the question of whether GELLO could be used for the mapping language. Lloyd detailed some of the challenges that occurred in the RIM mapping. AMS requested that we use something existing rather than inventing a new language. Grahame has a preference for using RDF. There was agreement in the room that we have need for two columns, one for the committee at large (textual) one for the Modelling facilitator.

Grahame presented a sample extension. There was discussion on the possible 'noise' injected into the instance from the inclusion of extension definition reference, but it was ultimately agreed that the mechanism was a reasonable trade-off between additional data and explicit-ness

Tuesday May 15 Q2


Woody Beeler (Chair), Lloyd McKenzie, Jean Duteau (Scribe), David Hay, Austin Kreisler, Hendry Wiljaya, Chris White, Brian Pech, Celine Williams, Piers Hollott, Bo Dagnell, Dale Nelson, Grahame Grieve, Gerald Beuchelt


FHIR - Governance and Ballot Plans

  • Lloyd has created a draft resource request spec:
    • Proposed Resource Name criteria
    • Scope of Coverage needs to be defined
    • Bo presented some parts of his Interoperability document
      • There will be committees that produce resources and there will be committees that produce profiles/aggregations of resources; we need governance for both
      • We will put Bo's diagram about layers of resources will be put on the FHIR Wiki
    • RIM Mapping for the base resource is required - at the end of the day, the full RIM space will have been fulfilled by our resources
    • There are a number of criteria that will be used to ensure the appropriateness of the resource
    • Sources (V3, V2, CDA, OpenEHR, etc.) need to be considered to determine data elements for a resource
  • Lloyd has also created a draft Project Scope Statement Template for committees to use

Tuesday May 15 Q4


Lloyd McKenzie (chair), Jean Duteau (scribe), John Ritter, Rob Savage, Rik Smithies,


Concern/Condition from March Harmonization

There was a large discussion of the CONC, COND, CASE, and OUTB Act class codes. Working with the PHER representatives, we walked through their use cases and definitions for Public Heath Case and Outbreaks. We have come up with a model to represent those and have the following items:

  • Move CONC up from OBS
  • Deprecate COND
  • Deprecate existing CASE and create a new code that represents a Public Health Case but is under CONC.
  • Deprecate existing OUTB and create a new code that represents a Outbreak but is under CONC.

Lloyd will present this to PHER on an upcoming conference call and Rik will write up the Harmonization Proposal.

Wednesday May 16 Q1



FHIR Vocabulary

Wednesday May 16 Q3


Lloyd McKenzie (chair), Jean Duteau (scribe), Kevin Coonan


ActRelationshipType Clean Up

  • Kevin walked through a MindMap he created of the ActRelationshipType vocabulary hierarchy.
  • We worked on it and made it reflect a consensus of the participants.
  • Extensive work was done on COMP, PERT
  • Action: Kevin will take the result of the discussion and write up the Harmonization Proposal.
  • Action: Kevin will discuss the IMM codes with PHER.
  • Action: Kevin will define logical properties for the codes, i.e. transitive, reflexive, etc.

Thursday May 17 Evening


Woody Beeler MnM, Bo Dagnall ARB, Andy Stechishin Tooling, Austin Kreisler SD/OO, Abdul Malik-Shakir CIC/MnM, Russ Hamm Vocab, Ted Klein Vocab, Wendy Huang Conformance, Charlie Mead ARB, Lorraine Constable OO, Steve Hufnagle EHR, Kevin Coonan PC, Grahame Grieve MnM, Paul Knapp ITS, Dale Nelson ITS, Mead Walker PS/RCRIM


FHIR Resource Scope Discussion

Bo Dagnall presented some slides representing a breakdown of Healthcare levels. This might form a basis for the 80-20 rule of Resources.

Facilitators' Reports

  • StructDocs
    • Balloting CDA R3 For Comment in the summer
  • CIC
    • MAX Tooling Initative - to allow you to export things out of an UML model and then re-import them. They are looking for volunteers to help with the initiative.
      • Woody raised that PIC is putting out a "I am a Volunteer/I need a Volunteer" Wiki page
  • Vocab
    • Apelon mapped the Vocabulary MIF to the IHTSDO Workbench format and created a document that is a mapping
    • IHTSDO Officers were present for some joint meetings
    • Vocabulary is moving forward with their plans to move V2 Vocabulary into the V3 model
    • FHIR Discussion was held to determine how to handle Vocabulary and bindings in FHIR
  • PA
    • Concept domain definition proposal will be coming forward where we will add a definition to the “IncidentalServiceDeliveryLocationRoleType” concept domain.
    • We may submit another harmonization proposal about the link between two encounters pending comment submitter withdrawal or not.
  • O&O
    • Discussed 2.x issues
    • Met with the Anatomic Pathology group to include their requirements into the Specimen DAM
    • Had a number of Project approvals go forward
    • Nutrition DAM completed and we will be going forward with HL7 Models
    • Common Product Model reconciliation
  • EHR
    • Developing some EA tooling for producing EHR FM profiles
  • PC
    • New proposed DSTU project for Core Structural Models and Methodology for developing DCMs
    • Harmonization Proposal for cleaning up the ActRelationshipType concept domain
  • ITS
    • Approved XML for V2 for publication
    • Recirculation ballot on ISO datatypes passed
    • Working on a StructuredDocument for StudyDesign and there will be some Vocab harmonization proposals
    • Discussion about a mapping to BRIDG and how DAMs relate to HL7 models
    • Reballoting the Medication Order and Dispense Normative R2
    • Working on a project for Medication Profile although there is still some discussion on what constitutes a profile
  • PHER
    • Recirculation Ballot for POIZ
    • Concern/Condition Harmonization Proposal will be coming from PHER

Schedule 2012 Harmonization

  • June 10, 2012 - Initial Harmonization Proposal Deadline
  • July 1, 2012 - Final Harmonization Proposal Deadline
  • July 10-13, 2012 - Harmonization on Tue/Wed, Parking lot on Fri, Design Proposal on Thu

Friday May 18 Q1



MnM Business and Planning Mtg

We developed a schedule for September and posted the spreadsheet on Gforge.