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HL7 CDAMG Minutes

Location: online!

Date:

Time: 1:00 PM Eastern

FacilitatorBrettNote Taker(s)Lisa

Attendance:

PresentName
  •  
Lisa R. Nelson
  •  

Brett Marquard

  •  

Jean Duteau

  •  

Rick Geimer

  •  

International Opening

  •  
Emma Jones
  •  
Linda Michaelsen
  •  
Andrew Statler
  •  

Yan Heras

  •  
Raychelle Fernandez

Quorum: Co-Chair +3

Guest(s): 

Calvin Beebe

Melva Peters

Natasha Kreisle

Didi Davis





Agenda (with Integrated Minutes)

STANDING BUSINESS

  • Attendance Review
  • Approve Minutes of 2020-07-15 CDAMG Meeting Minutes
    • Approve by Consensus
  • Approval Requests
    • Confirm for the minutes: eVote to approve Publication of the PACP Specification Passed. (Andrew/Linda) approved (7-0-0)
  • CDA R2.1 Education
    • Calvin will be coming on August 12 to provide an update
      • Share plan for the education that is coming
      • maybe one or two tutorials? (Calvin wants input on this choice.)
      • #1 Overview - Executive summary) 1.5 hours
        • Builds on CDA 2.0 (2005) and froze for 15 years with only IGs
        • CDA R2.1 (2019 RIM 2.35)
      • Calvin other idea (should we do this?)
        • With a standard conversion, you could build a transform to move any CDA R2.0 doc to a CDA R2.1
        • A reverse transform MIGHT be able to be transformed back from R2.1 to R2.0 (assuming the new stuff ins't used)
      • #2 Deeper Dive "delta walk through" presentation for just what extends CDA R2.0 to get to CDA R2.1 (standard tutorial timeframe - 1.5 hours)
      • Rick agrees this is just a delta focused course.
      • Calvin explains all the optional added features
        • Process of going into the standard an walking through it.
        • How to navigate the standard
        • How to read it
        • Highlight things that change.
        • More information on Templating in the base standard.
          • The templating material is general enough that it won't be outdated by the new SD templates from FHIR Tooling
        • More info on the Schemas and how to read them
          • How to make an extension
            • How it shows up in 2 and where it is in 2.1
          • Review of the changes spreadsheet (highlighted in yellow)
      • More material on how to create Templates.
        • Highlight World-wide usage and spread/adoption of CDA over 15 years of maturation.
        • ACTION - Forward info
      • Milestones and timing - no...still focused on scoping
      • Touch based during the WG meeting.
  • CDA Quality Planning (Update from Melva)
    • Discuss support / guidance available from HQ and how to support a communication plan
    • FHIR uses check-lists and QA tab on IG builds
    • QA.html had to be clean - and you need permission to have any warnings
    • Issue:  Publisher changes daily and brings new errors each day.
      • Rule about errors - only Grahame and Lloyd know how to read the errors.
      • Recommendation: Make sure IG developers know what the rules are for QA
        • Publish the rules ahead of time
      • FHIR's plan is not clear - many people don't know what it means, even experienced IG developers don't know what the rules mean.
      • Good:  There is an automated way to confirm that the Quality Criteria is met.  Bad:  having a list of criteria that needs to be checked manually
      • Some CDA IGs may be exceptions to the rule, for example, some kinds of IGs don't have full examples....that wasn't the objective for the IG
  • Update on C-CDA IAT
    • 51 people attended
    • Review Follow-up Actions - how to track to completion
    • Next IAT scheduled for October 21
    • Call for topic is out, Reply by Sept 15th
  • Work on Conversion of CDA Comments to JIRA (Andrew)
    • Review proposed letter to Work Group Co-Chairs
    • Review message to HL7
    • Update from Andrew on JIRA set-up for first phase of IGs
      • Has Phase I IGs working in the GitHub Tool - being loaded into the main repository. (Andrew will see if Josh can merge)
      • Don Lloyd is working on migrating comments from STU Comments to JIRA Dev (for V2)
      • When will the Cutover Happen? 
      • What are the steps to cut over?
        • Change links from product grid
        • Change permissions and migrate
      • Would like to do the cutover at same time as V2
      • Can we follow this pass:
        • Andrew finish setting up all (Aug) (Craig Newman did the V2 work.)
        • Don Lloyd import comments into Jira Dev (Early Sept)
        • Turn off STU Comments for CDA IGs (Sept 19th) on HL7.org
        • Communication before and during Working Group Meeting (aligned with HQ)
  • CDA Project and IG Registry Update
    • Review current progress in the context of supporting the JIRA Migration
    • New tracking procedures - what it means to the Quality Process
    • Let Dave Hamill know that CMG is doing this and how it is working in the context of the JIRA project and our Quality Plan
      • Present this to the PEST group - at WG meeting? 
  • Operational Improvements: CMG Confluence Site
    • Membership Update
      • Giorgio Cangioli has been nominated, waiting for confirmation from TSC
    • Co-Chair Responsibility
      • Brett Marquard has expressed interest in passing the baton on being co-chair, but will fill another term on CMG as a member starting in September
      • Linda Michaelsen has expressed interest in picking up the co-chair role starting in September
      • Motion to approve Linda Michaelsen as CMG co-chair:  (move: Lisa| second: Rick  vote: for: 6  abstain: 1 against: 0) 
  • Next Meeting: August 26th

Adjourned:  

PROJECT REPORT OUTS: 


Scheduled Reviews:

DateProjectWhoResources for Review
8/26Use of Structure Definition

Rick

Jean

Lisa


NEXT STEPS:

Working to establish an overarching PSS for CDA IG Web Publishing (Lisa)

Pilot to demonstrate creation of C-CDA R2.1 IG using new process (Lantana dev/MaxMD QA)

OPEN ISSUES:


NOTES:

Invite Sean for the 8/26 meeting




C-CDA

Update Releases


Brett

Lisa

NEXT STEPS:


OPEN ISSUES:


NOTES:

Depends on new CDA IG Web Publishing capability



 C-CDA

Errata Releases

Brett

Lisa

NEXT STEPS:

Review the current Errata Release Checklist.

OPEN ISSUES:

Can official Errata Releases be prepared by SDWG in the mean time? - discuss at Sept WG meeting


NOTES:

Depends on new CDA IG Web Publishing capability



8/26Quality Plan

Lisa

Brett

NEXT STEPS:

OPEN ISSUES:

NOTES:

Backed up behind ballot for Quality Criteria.  Plan is coming along. (and Roadmap updates)


8/12

C-CDA Implementation-A-Thon

Lisa

Linda

Raychelle

NEXT STEPS:

  • Call for presenters for October 21, 2020 C-CDA IAT (closes September 15, 2020)

OPEN ISSUES:

  • Plan for 2020 needs to be solidified with Dave Hamill - Discuss at Sept WG meeting

NOTES:

GroupingItemResponsible personStatus 
Life and Death in C-CDA

Add rubric for to check that a patient's name is not changed (using any scheme) to indicate a patient is deceased

John D'AmoreBrett will working with John through Examples Task Force.
Life and Death in C-CDA

Create gold-standard example of problem list containing pregnancy information

John D'AmoreBrett will working with John through Examples Task Force.
Payer Section in C-CDA Documents

Determine where payer identifiers should go in the document and represent with gold-standard example

Linda MichaelsenLinda will continue to advance this need and potential solutions.
Payer Section in C-CDA DocumentsConvey support for the new identifier extensionLisa NelsonLisa Informed SDWG of the need to work on approving and executing this extension.
Extending CDA to add more useful identifiers

Update the Companion Guide to add guidance on using the new extension. 

Lisa NelsonLisa will complete following creation of the extension.
Extending CDA to add more useful identifiers

Determine real-world use cases and develop gold-standard examples - e.g. payer identifiers

Lisa Nelson

Jean Duteau

Should  Lisa do this in working with SDWG?

Implementation Considerations

When Generating C-CDA Encounter

Summary and Patient Summary Documents

Develop guidance for the Companion Guide around when summary documents are exchanged.

Joe LamyLisa will reach out to Joe to determine timeframes for guidance from Carequality/CommonWell.
Implementing Clinical Notes

Seek clarification from the ONC to update Companion Guide to include more concise guidance on use of Clinical Notes


Emma JonesEmma - can you write up a request of specific questions that need to be addressed/answered?
Implementing Clinical NotesWork with Regenstrief on LOINC Codes for Laboratory Reports and Pathology ReportsLisaLisa Initiated conversation with Regenstrief. Out of band meeting planned for later in August.
Implementing Clinical Notes

Develop gold-standard examples for each supported USCDI note type (e.g. Consultation Note, Discharge Summary Note, etc.)

Emma JonesEmma can you drive this in Examples Task Force?

Mapping Author Participation Information to 

FHIR US CDI Resources Derived from C-CDA Documents

Engage with SDWG and Patient Care to clarify how this work can move forward.

Perhaps initially focusing on smaller problems to solve

David RiddleLisa Initiated meetings with PCWG 8/6 following up on 8/13.
8/12CDA Base Standard

Lisa

Brett


NEXT STEPS:

  • Working with Calvin to draft an educational webinar that provides an overview of "what's new in CDA R2.1"
  • Waiting for HQ to publish on HL7.org using supplied Product Page request
  • Approved by ANSI in early 2020 - not sure of exact date.

OPEN ISSUES:


NOTES:





Maturity Model

Brett

Rick

Artifact created:

NEXT STEPS:

  • Implementing this after cutting over to use the FHIR IG publishing mechanisms.

OPEN ISSUES:

NOTES:

Agreed this should be utilized after going to Structured Definition.  SDWG would need to apply the Criteria. Could we get feedback at the IAT to apply the rating? Do we need a checklist to help the decision makers to assign the maturity model.

Would need to work with SDWG as the owner of C-CDA templates, to apply it to their templates.  


8/12

Jira Implementation

Andrew

Linda

Raychelle

NEXT STEPS:

OPEN ISSUES:

  • Revisit after February Meeting

NOTES:

Andrew is advancing this sending Wayne what he needs. HL7 supporting this conversion. This is a go via orders from Wayne.



8/12Templates IG RegistryLisa

NEXT STEPS:


OPEN ISSUES:


NOTES:

Working on a list and process to gather accurate information - real-time recording


Cross Workgroup Templates Pilot

Lisa

Linda

NEXT STEPS:

  • Lisa is comparing IPS to C-CDA for Problem Concern and Allergy Concern - update provided
    • Some progress comparing to IPS - reported to PC WG
  • Linda is working with FM and other on this actively.
  • Kai to help with Medication Templates. - No action

OPEN ISSUES:

NOTES




Value Set Process and UTG support

Lisa

Brett

NEXT STEPS:

  • This is being worked with Ted Klein and the Vocabulary WG

OPEN ISSUES:

Topic for Sept WG Meeting: Missing FunctionalStatus VS - Sept WG meeting

NOTES:

Need alignment of Vocabulary binding

Harmonization of Value Sets in aligned data models/USCDI v1.



ADDITIONAL TOPICS 

  • KEY GOALS BEFORE September WG
    • Update to PEST on IG and Project Tracking
    • JIRA Migration Plan communication of roll-out
    • Quality Plan communication of roll-out
  • CMG Membership and interest in participation - update CMG objectives and Home Page content
  • Annual items:
    • Term voting, Co-chair confirmations  - July
    • Current member term renewal pattern
      • Even Years: Brett, Jean, Raychelle, Yan, Emma 
      • Odd Years: Lisa, Linda, Rick, 

Meeting Outcomes

Summary of Votes/Key Decisions

Next Meeting/Preliminary Agenda Items

Action items