Chair:  Jean Duteau 

Scribe: Floyd Eisenberg 

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This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."

Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)


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Minutes approved by consensus
Project Proposals and PSS ReviewPSS-2153 Enhancing FHIR to address Social Services and Social Determinants - updated - no new need for CGP to participate
Variance Requests

Follow up from US Realm Steering Committee regarding CGP endorsement of proposal (March 9) for the following change to the variance request process:
1) When new or changed profiles are only found in the CI build version of US Core
2) When an IG is publishing a Technical Correction with no profiles being changed

Update CGP Variance guidance: US Core Variance Request Process

The Physical Activity IG:





Late-breaking change on Transfusion and Vaccination AE Guide:

FHIR-40676 - Getting issue details... STATUS

Variance request from the Physical Activity IG:

FHIR-40398 - Motion to approve for up through US Core version 5.0.1 - Eric Haas/Jason Vogt: 20-0-0

FHIR-40399 - US Core Conditions, Problems, and Health Concerns - Motion to approve for version based on US Core 3.1.1 and 4..0.1 - Eric Haas/Floyd Eisenberg: 19-0-1

FHIR-40400 - ServiceRequest.reason - approve based on US Core through version 5.0.1 - Motion to approve: Eric Haas/Brett Marquard: 20-0-0

FHIR-40676 Profiles for Transfusion and Vaccination Adverse Event Detection and Reporting - will fixed the RelatedPerson to based on appropriate version of US Core RelatedPerson in the next version of the IG to be balloted in Fall 2023 - since the issue was only a technical correction, it cannot be changed. - Motion - Eric Haas/Brett Marquard: 20-0-1

Codex RT (Radiation Therapy)Status UpdateNo discussion
Military History

Status Update

No discussion
CCDA to FHIR Mapping 

Ballot content review on Monday project calls (10 AM ET) on CGP Zoom March 13 and March 20, with vote today (March 23) regarding ballot content readiness and submission.

Vote on readiness for ballot. Review period started Thursday, March 16 (email to WG from John D'Amore at 8:59 AM ET). Content at: with comments requested to be sent to John D'Amore (MoreInformatics), Natalee Agassi (Oracle Health AI), Jay Lyle (JP Systems), and Chun Li (Diameter Health) - Note that the CGP call for this project March 20 will discuss any questions or concerns as well.

A few points for context:

  • The original C-CDA-on-FHIR project did work from 2016-2020 but they did not publish granular mapping (focused more on Composition). Based on discussion between SDWG and FHIR Management Group (FMG), the decision was made in late 2022 that our project’s work should be included in the same implementation guide. The prior work is retained in the current publication but has not been updated (except in a few instances of QA errors and points about C-CDA<>FHIR mapping).
  • To access the “mapping” work, please use the “Mapping” dropdown along the top of the guide. Here is a link to the mapping project’s background:
  • Only maps for some clinical domains were ready to share at this time, specifically Problems, Allergies, Medications, Immunizations, Procedures and Patient (we refer to as PAMI+). Both C-CDA to FHIR and FHIR to C-CDA mappings and examples are included
  • For more information on the C-CDA to/from mapping project, you can go to our Confluence site:

Jay Lyle and John D'Amore joined the call to review content of the C-CDA on FHIR Guide with mappings. Reviewed 2 weeks ago and during Monday CGP specific calls March 13 and 20.  

Motion to approve content for ballot - Jay Lyle/Floyd Eisenberg: 20-0-1

FHIR IG & CDA Supplemental Guide for Medical Record Reviews

No discussion
International Patient Access IGStatus UpdateNo discussion

US Core - January Ballot Reconciliation Schedule

Ballot Reconciliation Schedule:

  • This week Feb 23: Clinical Notes DiagnosticReport
  • Mar 2: Conformance, Search
  • Mar 9: Assessments
  • Mar 16: Assessments -cancelled
  • Mar 23: open - currently planning to meet only during regular 2nd and 4th CGP calls unless alternate weeks become necessary
  • Mar 30: optional
  • April 13: open

Weekly Block Votes Schedule: <<BLOCK VOTING COMPLETED>>

Preview the groupings on Jira's US Core Dashboard. The tentative agenda for the weekly Block Votes (BV) Themes are:

  • BV-2 (February 2): Pregnancy , MedicationDispense/Request - done
  • BV-3 (Feb 9): Occupational Profiles (ODH), Coverage - done
  • BV-4 (Feb 9 -Feb 16): Specimen, Extensions - done
  • BV-5 (Feb 16 -Feb 23): Assessments
  • BV-6( Feb 23 - Mar 2): Assessments
  • BV-7 (Mar 2 - Mar 9): CarePlan, Clinical-Notes, DiagnosticReport
  • BV-8 (Mar 9 - Mar 16): Conformance, Search
  • BV-9 (Mar 16 - Mar 23): Leftovers

Goal: Finish trackers by end of March and Publish by May.

US Core Block Vote

No block vote today

US Core Individual Tracker Discussions:
  1. FHIR-40034: (pulled from BV6) Rename US Core Observation Category (Howard Strasberg) Persuasive
  2. based on above variance requests:
    1. reopen and redisposition FHIR-39940 
    2. new FHIR-40656
  3. FHIR-40103: Remove Must Support from and[x], (corey_spears) Persuasive with Modification
  4. FHIR-38808 and FHIR-40514 Add support for imaging identifiers/US core should have specific profiles for imaging and lab results (bvdh) ****

if time

4. FHIR-40583: Change Direct Address to be part of .telecom rather than .endpoint in PractitionerRole (Jessica Bright) ****

Other Tracker Discussion: 

FHIR-40034: (pulled from BV6) Rename US Core Observation Category (Howard Strasberg) Persuasive

  1. Hans Buitendijk joined to discuss resolution - creating a specific US Core assessment category value set as distinct from US Core simple observation profile
  2. Motion to approve - Eric Haas/Hans Buitendijk
  3. Eric pulled motion to review content of value set and determine if it is a specific US Core value set.
  4. To be discussed again at subsequent meeting.

Reopen and redisposition FHIR-39940 

Simple observation includes derivedFrom - it should be a simple observation and not require MS

Motion to reopen - Eric Haas/Juliet Rubini: 20-0-0

 FHIR-39940 - Change disposition to remove MS from derivedFrom the reference to US Core Observation Screening Assessment profile. And make it a USCDI requirement to support assessments and add user note Profile specific implementation guidance how to reference the source for assessments. 

Motion - Eric Haas, Yunwei Wang: 18-0-0

New FHIR-40656 - change MedicationRequest reasonReference and ServiceRequest reasonReference to use US Core profiles to only reference base FHIR profiles.  

Motion - Eric Haas, Gaye Dolin: 18-0-0

FHIR-40103: Remove Must Support from and[x], (corey_spears) Persuasive with Modification - to be discussed further


CGP continues to meet on the Second and Fourth Thursdays, additional calls for US Core ballot reconciliation only if needed

Adding another meeting next week (March 30) to address the other 4 trackers not discussed today as well as new trackers.

Adjourned at 2 PM ET.

Parking Lot Items



International Patient AccessConsideration of a variance process for future CGP review and approval.






Cambia Health


Phillips Healthcare
Brian MeshellMitre

Brian Swinkels

Wave One Associatesbrett@waveoneassociates.comyes

Elevance Health






yes  yes


Grace Mandel

Hans Buitendijk 

EMI Advisors



Duteau Design Incjean@duteaudesign.comyes

Altera Digital Health

Jessica Bright 





Keirscha Thompson 





Melisa Coker

NQF/CDC Contractor




Randall Severy











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