Discussed conformance strategy, what is the future of the conformance WG? What should we be working on?
Welcomed Heather to the group, providing orientation. Discussed code sets. Discussed the use of patient identifiers, such as patient gender.
|Annual Review of Items||Nathan||Discussed, no change required for the moment.|
Going through Project Insight, updating projects and WGM agenda
|Preparation for discussion with InM||Frank|
|Preparation for discussion with FHIR||Frank|
Data Type Flavors Project
Craig introduces the Data Type Flavors project. It would be easier if there was a core set of data type flavors that could be reused.
Discussing hierarchies of Data Type Flavors for different countries. Address is an example of this problem. Talking about Vocabulary binding as well. Representation needs to be simple if you are only selecting a table and doing nothing else. For example having a line for each country to indicate which zip/postal code table to use. Talking about maintaining and presenting this information. These are two different questions. Frank is currently storing this in a relational database as a snapshot. It would be good by only storing the differences. Not sure if this is the best type of database. Talking about how three profiles might have the same changes and so improvements can be made by creating an intermediate profile that can be used by all three and thus reduce the amount of uniqueness in the lower nodes.
Explaining profile components that are used in IGAMT.
Plan is almost-certainly to re-ballot this. We didn't get much feedback on the conceptual model, only feedback on the details. Do we want to continue what we are doing now, just cataloging what is out there, or do we go to a more rich model. Needs more discussion. Put this on the Conformance Call agenda once NIST is back up and running. Frank wants to know how are we going to educate and tell people what to do?
Now discussing HL7v2/HL7v3/FHIR.
Things to talk to with FHIR:
Joint with InM
|HL7v2+ statement from InM||Tony (Frank)|
|Data Type Flavors Ballot|
|XPN table reference update|
|HL7 v2+ continued discussion|
Frank has already done the work to change how it is displayed, but now the change is to make how we define the standard. So concepts such as R, RE, O, X will be gone and will be replaced with cardinality and must support. Changes the expression of the standard, not what is on the wire. Hopefully we can stop having discussions with people about RE.
- X Nathan
- X Craig
- X Floyd
- - Stuart
- X Eric
- X Lori
- - Didi
- X Danny
- X Heather
- X Robert
- X Frank
The purpose of this meeting is to:
- Give updates on what you are working on in the immunization space
- Float ideas for new projects/efforts and get direction on where this would be best to move these items to
- Give a chance to meet face-to-face with those we normally work on by phone
|2.8.2 procedural question||Eric|
2.8.2 is now published, is there a page we can go and put comments?
Scope is currently locked by SISC. Are we free to put comments on it?
|NDC and CVX codes||Heather|
Recently received questions about NDC we never saw before
Robert, exploratory vaccines, test trials.
The current policy is that if there is no CVX created until it comes to market.
SISC didn't think they wanted to get experimental vaccines.
Would be willing to create a CVX code because an IIS is interested in having it.
Continuing to look for vendors/products to be recognized. No new updates to capabilities and test, because it is still early. AIRA and HIMSS are setting up a collaborative to enable discussion between EHR and IIS stakeholders. For example, what is the workflow when a fridge of vaccinations where found to be bad for an entire week? Some providers wait until patient comes back in to mark the old dose as bad.
At HIMSS they will have an interactive presentation. Mary Beth from AIRA will join and they will use mentimeter. Need Best Practices for both sides, which may feed into changes into the underlying standards too. Not creating standards but identifying best practices. There will be a selective executive committee but the membership will be open.
Discussion on idea for better queries
Also can discuss how FHIR could be leveraged as well
Continuation of a conversation from Baltimore and discussion with Alean about PIX/PDQ. Problem: in current guide Z44 profile, Z31 is not specified for that. The weighted matching process works 99% of the time, but not 1%. There is the ability to leverage the State Registry (SR) id. Using a two-step process the IIS can send back a possible match and then a second query with the SR id can be used to get the full record.
There is an PIXm and PDQm in the FHIR space. (M is for mobile.)
Ranking of the returned list would be helpful if ranked.
HIMSS are establishing a colloborative, there will be soft launch at HIMSS. These are kind of topics for a sub-group. Get some consensus. This issue might be good for them to put a group together to tackle?
Could contact CIC about Common Clinical Registry Framework (CCRF) http://www.hl7.org/implement/standards/product_brief.cfm?product_id=467
Will take this issue back to AIRA and EHRs and see if there is interest in picking this up as a potential project.
|Update on HL7 v2+||Craig|
HL7 v2.9 has been balloted in January, only a handful of comments, will be published later this year.
Project called HL7 v2+, rework on how it is presented. Feel a lot more similar to FHIR. Changes to how the standard evolves. Might change how it is published. Won't be out until later this year and into next year.
HL7 v2 management group now has management oversight over this. Not on content but on the higher level of the standard itself.
Notes from Monday Q1
- Frank submitted change requests, they will be rehashed for teleconference
- 19567, 19568, 19570, 19571, 19572
- Ioana is tracking the version discussion but she is not here, due to Government Shutdown
- Rob wants more explanation and understanding on Must Support and Cardinality, but he is not here either due to Government Shutdown
- Update from FHIR folks about conformance constructs, anything new that we should be aware of? Anything that we should be tracking from our end?
|Review of topics we want to discuss|
Must Support can be put in base profiles. So maybe in HL7 v2 then this could be done in the base.
Now discussing "Must Support", shouldn't a cardinality of 1..x simply "Must Support"?
How does the V2-to-FHIR handle RE and R mapping?
Might need to make a definition of Must Support for the HL7 v2 items.
Looking at section 18.104.22.168 here: https://www.hl7.org/fhir/conformance-rules.html An example it would be good to see this with two examples. Need to log a ticket on GForge. Need examples in both JSON and XML.
The phrase "This means that setting an element to a minimum cardinality of 1 does not ensure that valid data will be present; specific FHIRPath constraints are required to ensure that the required data will be present." has a problem because the word "valid" should be taken out.
What about content that is invalid like "ABCD" in a date field.
|Version of FHIR||Now that we have the means to say which version the resource. What about a MPI that links to patients from different versions? Not yet decided, waiting for problem to come up to really decided for sure.|
|Update from FHIR about Conformance Constructs|
Resource called Graph Definition, it has move from level 0. Would be interesting to take a look at this. Describes constraints you can have on a tree of data. You can use it to tell you what a tree look like.
Discussion about Conformance Statements. Frank wants to force people to use it, but FHIR says we are not the police. So there is a lot of exchanging going on without Conformance Statements being generated. Frank would like to raise "Conformance" to Level 1 from Level 2.
Could have demonstrations on FHIR tools at our next meeting.
IHE also has the concept of R2 instead of RE. Maybe this is a chance for them to clean that up?