ANSI Anti-Trust Policy:  Professional Associations, such as HL7, which bring together competing entities are subject to strict scrutiny under applicable antitrust laws. HL7 recognizes that the antitrust laws were enacted to promote fairness in competition and, as such, supports laws against monopoly and restraints of trade and their enforcement. Each individual participating in HL7 meetings and conferences, regardless of venue, is responsible for knowing the contents of and adhering to the HL7 Antitrust Policy as stated in §05.01 of the Governance and Operations Manual (GOM).

AGENDA

• R5 Ballot JIRAs
• Workflow Topics (if completed R5)
• AOB?

MEETING MINUTES

R5 Ballot Issues

Observation

• FHIR-38633 -Target Awareness Element or Extension
  • RE: Observation, Condition
  • Should this be external to the resource - for all "Status-like" information - this need additional discussion
  • Discussed using "Communication"
  • Still pending resolution - comment to Gay Dolin to find out if this needs to be included in R5 publication as an extension? or can it wait for R5 STU?
  • Sent Gay a direct email on this JIRA and cc: Co-chairs 
• CR/Examples: 
  • FHIR-32947 - Example has old valuseset
    • Discussion that there may need to be additional work to move this to THO, but that will be taken as a separate action

• • • • Robert Hausam Please create a separate JIRA/THO request as necessary for the codeSystem to be elevated to THO maintenance

• • • Motion to find with Persuasive with Modification
      • The examples will be updated with the correct codeSystem (https://www.hl7.org/fhir/codesystem-observation-statistics.html )
      • Marti Velezis / Rob Hausam : 10 - 0 - 1
      • Assigned to JD Nolen

Transport

• FHIR-39141 - Transport reasonCode and reasonReference should be merged to CodeableReference
  • This was discussed that we have been including codableReference for these types of requests and will do so for Transport.reason 

    • Remove 

      • reasonCode (CodeableConcept): Why transport is needed
      • reasonReference (Reference): Why transport is needed

      and replace it with 

      • reason (CodeableReference): Why transport is needed

      with a cardinality of 0..*

  • Motion to find with Persuasive with Modification
    • Rob Hausam / Jose Costa Teixeira: 13 - 0 - 0

ServiceRequest

• FHIR-32265 - Support the storage of parameters related to the procedure/devices in the ServiceRequest in a structured way
  • This was deferred to be done in R5 based on previous comment:
  • We will make the following proposed disposition to the submitter (as this is an In Person comment) 

    • Ricardo Quintano and Bas van den Heuvel we have updated the JIRA and added a comment to find out if the following proposed changes are acceptable.

      Attribute	Card	Data Type	Comments
      .orderDetail	0..*	BackboneElement	Additional information about the request
      >>code	1..1	CodeableConcept	Indicates the details of the order being requested
      >>value[x]	1..1	Quantity | Ratio | Range | boolean | CodeableConcept | string | Period	Indicates a value for the order detail
      >>Focus	0..1	CodeableReference (Device | DeviceDefinition | DeviceRequest | SupplyRequest | MedicationRequest | Medication | BiologicallyDerivedProduct | Substance)	Indicates the context of the order details by reference

ObservationDefinition

• FHIR-38953 - quantitativeDetails is not flexible enough, incomplete and overly complex
  • See comments - Partial proposed resolution
  • From 1/27/2023 Call - For conversions – depending on the use of element 
    • Concern in limiting units to UCUM 
    • Note: This should not be used when different methods are being used
    • This is on the ObservationDefinition (i.e., not specifying the actual (instance) of the observation)
    • Action item to determine the requirement for quantitativeDetails
      • Need to understand how this was intended to be used 
      • Revisit the list of issues noted by the submitter
      • Ralf Herzog will draft an email on customaryUnit
      • Also - consider jurisdiction for the units of measure 
      • Follow-up: Jose Costa-Teixeira applied the change to add the quantitativeDetails in 2017 (will need to inquire if he remembers the update)
  • From 2/3/2023 call
    • That still leaves one topic unaddressed: the conversion factor is not sufficient to describe conversions like Fahrenheit/Celsius or db/db(A)
    • Motion to find Persuasive with Modification
      • Rob Hausam / Jose Costa Teixeira : 12 - 0 - 0 
      • Assign to Jose Costa Teixeira

-----------Adjourned the meeting at 11:03AM EDT------------------

Other Workflow Topics

Transport

• FHIR-40310 - Change Transport.reason element name to something else (confusion) and fixed missing codes for TransportReason