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JD NolenChildern's Mercy Hospital
Freida HallQuest Diagnostics
Catherine Hosage Norm
Ralf HerzogRoche
Rik Smithies
Rob HausamHausam Consulting
Craig NewmanAltarum
Kathy WalshLabCorp
Peter Bomberg
Smita Hastak
Xidong Deng
Hans BuitendijkCerner
Marti VelezisSonrisa / FDA
Becky GradlAcademy of Nutrition and Dietetics
Lorraine ConstableConstable Consulting

Chair:Hans Buitendijk

Scribe: Hans Buitendijk


  • Minutes 
    • 2020-09-21-25 
      • Missing administration quarter
      • Links to be completed.  Co-chairs need to check
    • 2020-10-08 - Motion to accept as distributed.  JD Nolen, Craig Newman
      • Against: 0; Abstain: 4; In Favor: 9
  • Diagnostic Audiology Testing for Infants
  • OO-BR&R Topics
    • Various JIRAs of interest to enable DiagnosticReport and Observation to be more generally applicable as in part already intended.
    • There is general agreement to make DiagnosticReport and Observation more generally applicable and addressed the following JIRAs 
      • FHIR-29031 - Focuses on extending Observation.subject to include Medication, Substance, NutrutionProduct, and BiologicallyDerivedProduct as well.  
        • A discussion on adding organization, people, process will be separate as it is not yet clear what the right resources are for that.
        • Further clarification was that for Substance and Medication, only resources that are instances can be referenced.
        • For the motion see the JIRA with vote.
      • FHIR-29032 - Focuses on updating the Observation introductions to clarify the wider scope.
        • For the motion see the JIRA with vote.
    • Next week we will address DiagnosticReport related JIRAs and the discussion on process/organization/person focused updates.
    • Monday, October 19 – 3-4pm ET -  Substance/SubstanceDefinition/PackagedProductDefinition

  • v2 Change Requests - Not discussed

The repeatability of a message constituent MAY be changed. A sending system SHOULD be able to send the modified message constituent; the receiver, regardless of its version level, SHOULD be able to understand the message. Note that if a non-repeating message constituent is made repeating, information sent in the new repetitions couldbe lost to the recipient who is not expecting them.

If HL7 has given, or will give, semantic meaning to the first instance, to allow backward compatibility, the first instance of the repeating constituent SHALL have the same meaning as the non-repeating constituent had in the prior version of HL7. In this way, a receiving application that interprets the message based upon the prior standard would continue to find the same intent communicated in the message.

If HL7 has not given, and will/can not give, semantic meaning to the first instance, and one or more implementation-applied business rules exist to select one of several occurrences to populate a non-repeating constituent, those same rules SHOULD be applied when a newer version of the standard allows for repetition of the constituent. By applying the prior business rules to determine the first occurrence of a repeating constituent, a receiving application that interprets the message based upon the prior standard would continue to find the same intent communicated in the message.


That implies we can add an {} group to an existing message structure.

  • eDOS Publication Request - Not discussed

  • LRI Ballot Reconciliation - Not discussed

  • Project updates - Not discussed
    • Nutrition
      • Met this week (9/30/2020)
      • Reviewed updating DAM scope, aligning with MCC E care plans (PC is sponsoring) 
      • Meeting
        • Every other Wednesday 2-3 ET
      • Project page link: Nutrition
    • Specimen DAM
    • FHIR - OO on FHIR
      • No meeting next week
      • Meeting
        • Every Tuesday 2 - 3 PM ET
      • Project page link: FHIR
      • IHE needs to update Volume IV to reflect CMS vocabulary.
      • Also needs to consider alternative use of ORU to clarify how OBX could be used, plus mapping to FT1.
      • CDSM connection is still proprietary, interest to get CDS Hooks/Standards.
      • Change to the name of the LOINC Code. 
    • CIMI/Concept Modeling - NO UPDATE
      • Co-chair will meet to discuss the future of the group – Lorraine will check what’s up
      • Need to sort out Post-Acute Orders vs. DME (as in NIB).
      • Check with Bob Dieterle.  Needed before publication.
      • Project Page Link: DME Project
    • Healthcare Product: Device/DeviceDefinition/UDI
      • UDI DAM in ballot recon
      • 17 items in discussion 
      • BR&R - meeting October 12th on substance, substance definition, package products definition  
      • Resource Proposal Updates
      • Meeting: Every Monday 3 -4 PM ET
    • V2+  NO UPDATE
      • Still need to look at open tickets and message structure issues (debate continues) 
      • Meetings:
        • Every other Friday, 9-10am ET
      • Project Page Link: V2+
    • V2-to-FHIR 

    • US Realm Lab (eDOS/LOI/LRI) 
      • Frieda updating documents for publication 
    • Product Grid – no update, is not needed this cycle
      • Possible review at WGM  
      • Co-chair meeting to re-group.
      • Need to still review the status of our standards in the product grid:
        • Status definitions - Riki to follow up to see where those are in the grid - here are the ones given to TSC:
          • active, planned use or in use, future maintenance release
            • stable, in use, generate feedback, not active
            • review, not updated in foreseeable future
            • deprecated - deprecated - no further work planned - if not already using, it is not recommended to be implemented