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Date: February 3, 2020

Quarters Q3-Q4

Agenda Topics

Opening Announcements and Call to Order

  • Welcome
  • Thank you

Introductions Round Table (Ron Parker)

  • Confirm proxies and quorum (20)
  • Round table introductions
  • Current Membership =39
  • Quorum for Decisions (40%=16), Directions (33%=13), Financial Decisions (51%=20) - Reached!!
  • Lapsed Affiliates - None with 'official' lapsed status

Secretary Report (Ron Parker)

  1. Review of use of Confluence & List Server - strongly encouraged 
  2. Review agenda 
  3. Reminder to put Affiliates presentation on Confluence
  4. ADDC has set up electronic vote for HL7 Belgium Affiliate Proposal

HL7 International Board Report & Welcome (Walter Suarez)

  • Incoming Chair of HL7 International
  • Thanked HL7 Australia for hosting this WGM
  • Strategic Plan - continuing to implement the 3 stated goals
  • Priority to enhance and improve relationship with, and support for, affiliates & expanding presence globally
  • New activity in Latin America - establishing a new organisation HL7 LAC (Latin America & Caribbean) to include help for non-affiliate countries
  • US Announcement ONC last week announced, at AGM (1,200 in DC), new organisation - Global Consortium for eHealth Interoperability (partnering with HIMSS & IHE International) to advance interop via core initiatives based on HL7 standards and IHE implementation artifacts, plus education - for more go to
  • welcomes any questions

CEO Report (Chuck Jaffe)

  • Preamble to lots of information to share over the coming week
  • NPRM: notice of proposed rule-making - from ONC & CMS. Not yet resolved; 'final' rules still under adjudication from Federal Treasury. Will have major impact to HL7 International.
  • HL7 FHIR Accelerator program - successful from marketing perspective; challenge to HL7 work groups from related demand. 5 programs in place (Argonaut, Da Vinci, CodeX, Carin & Gravity). Apple waiting for R4 of Argonaut to grow their related program. Emerging participants - Vulcan (research), CDC (public health) & AHRQ (evidence-based medicine).NB US public sector participation in FHIR
  • Collaborations: Payer community, Sequoia Project, CommonWell, National Council for prescription Drug Programs & HIMSS (new Statement of Understanding - Education & Training, HIMSS TV, marketing & communication, FHIR Solutions Showcase, International Awards progams.
  • Growing HL7 Affiliate Support - what is important, who gets to decide, how do these programs affect affiliates, which programs can be practically supported, what is the process for this to happen.

FHIR Update (Grahame Grieve)

  • Visiting a large number of countries - with and without affiliates
  • New FHIR IG - International Patient Access (IPA) - international version of the Argonaut/US Core IG - focuses on access not content (IPS for the later which it compliments). Will publish IPS and IPA together
  • FHIR Community Process - hasn't been advanced. Emphasis has been on Accelerator Program since last WGM - Board Approval being sought this week.
  • FHIR Trademarks - Grahame administers permissions process (5-10 queries per week), grants approval to use trademarks to non-HL7 uses of FHIR. Affiliates encouraged to train nationals in use of all HL7 trademarks.
  • Visited WHO, in late 2019, trying to digitize care guidelines. Stepped process leading up to use of FHIR resources to provide care plan guidelines to member countries. Asking for WHO General Assembly proposal for worldwide use of FHIR to implement this. WHO expressed concern with how HL7 engages with Affiliates - most countries don't have the resources to run Affiliates. Expressed the need for a type of Consultative Council to engage with less wealthy countries - WHO offered to provide help to HL7 to set this up. Grahame agrees that this is a very real concern.
  • FHIR versioning - still no push from ecosystem to publish R5. Major focus from implementers still on R4. The re-designed Subscription Resource is gathering the most interest- plus Care Plan (nb WHO interest in that resource).
  • FHIR Foundation - to be discussed at this week's Board Meeting

Proposed HL7 FHIR Community Process (Ron Parker)

  • Big interest in Canada - consistent implementation is much needed
  • Still hosted on Wiki - will move to Confluence once approved
  • Constraints if underlying conceptual framework differs from that already established in a given country (or state)
  • Grahame says it's not about adherence - more the transparency of rules, plans, etc to negate rushed, sub-optimal implementations

US Realm Presentation (Ed Hammond - see link to Monday Presentations below for full Slide Show)

  •  Noted that this meeting has the highest ever Affiliate representation
  • FHIR is becoming a 'celebrity' 
  • Policy, process and focus change - biggest shift to the patient is 'telemedicine' and news types of data (covering 90% of health & wellness data)
  • US National Initiatives - FHIR has a role to play in all of them, notably in the movement of data. Multiple uses of that data. Data science - AI totally dependent on quality & liquidity of data
  • Influencers of the future of FHIR - relationship between Standards developers, implementers and users (focus on applications and not the underlying technology)
  • New disruptive innovation requirements (The Innovators Dilemma - Clayton Christensen)
  • Where is the patient's data that I want
  • Mobile devices - replacement of brick & mortar institutions with virtual healthcare systems
  • Big Data and its impact
  • Assess each affiliate individual, rather than apply old world USA-created model
  • clearer articulation of problems and solutions for WGMs

Co-Sponsor - Guidance for the Crafting of International Standards (Ron Parker)

  • Taking it to M&M WG for each individual product

Regional Reports  (see link to Monday Presentations below for full Slide Shows)

HL7 Europe (Catherine Chronaki)

  • 10 celebration of HL7 International Foundation Europe
  • EU Policy initiatives - cooperation with CDN and WHO, both interested in IPS
  • Various European funded projects & initiatives - Fair health and Smart Living homes
  • European mHealth Knowledge and Innovation Hub
  • IPS Global Community of Practice
  • Recent and upcoming events - plus an extensive work plan for 2020

HL7 Latin America (Diego Kaminker)

  • FHIR implementation progressing in Argentina
  • New affiliate in Chile
  • Uruguay no longer an affiliate but using FHIR
  • FHIR projects in Peru and Bolivia
  • Brazil retaining Affiliate status - possibly about to be re-energized (Grahame going after US Dev Days)

HL7 Around the World (to be continued on Friday)

  • HL7 Argentina - expanding member base due to FHIR implementation. Have created national FHIR profiles. 4,000 participants in education events!!
  • HL7 Germany - new Board - new Patient Data Protection Act - will join SNOMED International in Jan 2021 - first national FHIR IGs and development of core data set

Friday Agenda Topics (Ron Parker / Peter Jordan)

  • IHIC 2020 and beyond?
  • HL7 Asia Pacific meeting (Michio)
  • Supporting Implementers (Wayne)
  • African Project (20 min) (AMS)
  • Affiliate Health
  • DMP & IC Budget Review
  • May 2020 WGM Planning
  • 2022 International Meeting
  • Affiliate use of Confluence & Jira
  • Report from the Joint Initiative Council

Date: February 7, 2020

Quarters Q2-Q4

Quorum Q2

21 members present - Quorum for all levels achieved.

Review and Approval of Sept 2019 minutes

  • Motion to approve: Ed Hammond, seconded Catherine Chronaki
  • Vote: 19, 0, 0 (In favour, against, abstain)

IC Budget

Requests for May recorded in spreadsheet. 

HL7 Australia proposes a motion that if, by end of September, any budget not allocated is utilized

Peter: we need discussion and decision on whether we use these funds for "normal" meeting travel 

  • Catherine - proposes that in January meeting  - seek a way to expedite decisions should a situation call for it.
  • Jason: clarification - only that unallocated funds are addressed - 
  • Robert: crucial to differentiate WGMs organized by an affiliate (such as Australia) in terms of receiving any unused
  • Peter: we can  

Motion: that all unallocated funds not disbursed by November to go HL7 Australia to help offset their costs for hosting Feb 2020 meeting.  Moved by Jason, seconded by Robert:  vote: 20, 1, 0

Report from JIC by Catherine:  (link to presentation)

  • Motion: to reaffirm Catherine Chronaki as HL7 International non-voting member to the JIC  Moved by Jason, seconded by Georgio VOTE: 21, 0,  


Quorum 20 affiliates represented in person or proxy

Africa Outreach Project - Abdul Malik Shakir

  • Tom deJong travels to Africa fequently and wants to be engaged.
  • AMS asks for access to the IC Confluence page... to post updates, minutes (Peter asked him to send an email to be sure we don't lose that) - see Slide 8 from AMS presentation
  • AMS also asks to be able to use FreeConferenceCall for meetings
  • Ed Hammond:  add to next steps... identify a list of names of key people to make aware of this initiative.  Extremely important to have a network of influencers.

IHIC - Peter Jordan

  • request to those who 
  • Robert requested we speak to the Joachim Dudek award:  this is sponsored by HL7 International.  What does HL7 want to do with this?  There was no award last year as there were no submissions.  the proposal is to open up to already reviewed scientific paper 
  • Robert is unaware there is anything planned this year.  He feels it has outlived it's usefulness.  Initially a venue for joint academic forum.  
  • Ed Hammond feels strongly that it should continue.  
  • HL7 Germany:  the Poland meeting was a success, however it needs to be changed from a scientific conference.  However there are other venues such as connectathons or Dev-Days.  Slyvie proposes that it retain some scientific representation, but without formal peer review. 
  • HL7 Austria:  objective of IHIC Poland was intended to show the value of HL7 to the local community, rather than to showcase the regional affiliates.
  • HL7 Italy:  what is the target?  Reaching the scientific community, reaching the developer?  Better to not attempt to mix them
  • Peter:  if it is to continue, someone needs to take ownership 
  • Jason: he went to Poland event to market the HL7 Australia meeting in Feb 2020.  
  • Peter:  attaching it to MedInfo had some appeal to some people.

Motion: Propose that we discuss the Joachim Dudeck award and change in Terms of Reference in San Antonio. Moved: Ron Parker, seconded: ??  Vote: 20, 0, 0

HL7 International 2022

  • Mark MacDougall - the Netherlands proposal is the only viable proposal so far.  He recommends the IC endorse this selection.
  • Review of the financials have a 165,000 loss.  However Tom has declined that proposal and asked them to come back. 
  • Robert indicates that the International branch of the Health Ministry seems interested in potentially sponsoring the event.  There are two initiatives at the ministerial level.
  • Jason:  recommends that Netherlands to promote nn free seats to the event in return for a sponsorhip block.  Locks in revenue and ups attendance figures.
  • Tom: the venue has a history of hosting successful 
  • HL7 Chile:  1. How does this lose compare to other events?  Mark:  Losses have been as little as 5,000 to as much as 135,000.  2. Can there be some negotiation to reduce costs: 
  • Jason: as the IC we should be sure to endorse meetings outside North America.  He suggests that there are other methods to mitigate or reverse the loss based on his experience. 
  • Motion:   the HL7 IC seesk Board approval of producing the May 2022 WGM as the SS Rotterdam, in the Netherlands with an understanding the that WGM at present the event is forecasted to have a new operating loss of $165,000 USD.  HL7 International and HL7 Netherlands will continue their due diligence to reduce or eliminate the loss.  (Robert moves, Georgio seconds
  • Discussion:
    • Melva suggests that HL7 has historically accepted that one meeting a year generates a loss, and that as an International SDO, it is important we accept.
    • HL7 India:
    • vote 13, 0, 7

Affiliate Member Representation on HL7 committees and projects:

  • US Realm Steering Committee
    • Lorraine Constable has suggested she is not the most appropriate person to continue in this role.  
    • Asked for another volunteer - no volunteers
    • Suggestion 
  • Finance Committee
    • Robert has been the appointed IC representative to the Board committee
    • Robert
  • Leadership development and nomination committee
    • Diego in the past
    • Recommend Diego continues if he is willing
  • Recognition and Rewards Committee
    • Mikael of Sweden would be willing to stand for committees if there are not
  • Governance Operations Committee
    • Currently Peter who will stay
    •  Rober will join Peter as an additional representative
  • UTG (two positions)
    • Sylvia will volunteer for one position
    • Recommend to ask Francois Macory to also participate ACTION ITEM for minute taker
  • Motion to have the above members appointed as move by HL7 Italy, Seconded by HL7 Austria  vote 20,0,0
  • Amendment:  that designated members provide brief updates to the IC on their representation on their respective committees.

Affiliate Health

  • Peter: One question is - How much time do we wish to invest in affiliates that are not active or do not attend?

ADDC makes a recommendation to the HL7 Executive Committee on acceptance of new affiliates or de-listing inactive members

  •  HL7 India:  the greatest barrier to affiliate participation in HL7 Meetings is cost.  If the Affiliates are active at home in educating and promoting use of standards, they may not see value-add in costly attendance.  
  • HL7 Italy:  do you take advantage of HL7 Asia.  HL7 India is unaware of the Asia meetings and feels they are not part of that regional.
  • HL7 India: regional events may work, but what is the value beyond just being seen?
  • HL7 Japan:  next Asia regional meeting is Singapore.  Japan, Korea, China, Taiwan are the regular Regional 
  • Peter recommends we consider attendance at Regional meetings as a metric indicating engagement


No decisions to be made in this Quarter so we are not assessing quorum.

DMP Review: 

  • We can make suggested changes pending review from Karen or Mark.  Some notification is required to allow time to vote.
  • ACTION ITEM: Post the DMP as a document to Confluence and request IC members to review and comment or make proposed revisions before May 2020 San Antonio meeting.
  • Add review of the notification method to address the need to have critical voting emails to a second-in-command.

International Patient Summary Update

  • IPS SNOMED CT Free Set is updated once a year and submissions can be made to update it
  • Ed Hammond:  is anyone committed to testing the IPS.  Georgio:  the real idea is to prove the concept rather than the nature of the implementation.  Ed: he has been pushed about the relationship between FHIR and the EHR. 
  • Georgio:  considering a logical model, ex: future versions of the EHR FM using a logical model aligned with IPS
  • Robert:  there is no master plan for the IPS, it's evolution is a function of how the community embraces and adopts it.  However there are many good stories to be told about interest and adoption and perhaps this should be assembled in one place and promoted.
  • HL7 Chile: the IPS is a great candidate for a meaningful project, it would be good to have access to a shared set of resources.  
  • Robert: will IC / HL7 HQ put something together to promote IPS?  

HL7 India

  • HL7 India initiated engagement with promotion of FHIR
  • FHIR Open House is a one day event (expensive)
  • Monthly FHIR Meetups for 4 hours (1 hour presentation, 3 hrs of work)  Phillips hosted the first meetup.
  • 17 to 18 startups participating, growing daily
  • Governing Council Elections in May 2019
  • New technical committee will drive profiling work for India
  • Agreement with Government is that HL7 India is the best group to lead this work, and govt provides some resources
  • HL7 India is based out of Bangalore
  • Interest growing from Chennai, Mumbai, and Delhi
  • Jason: HL7 should consider going to India (even if a loss-leader) rather than have India come to HL7
  • Kumar asks that HL7 rationalize its virtual learning pricing 

Agenda Topics

Material - February 2020 WGM

Monday Presentations - February 2020

Minutes/Conclusions Reached

  • Ron G. Parker //Type your task here, using "@" to assign to a user and "//" to select a due date