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OO Main - Meeting Information

Meeting Details

Date: July 6, 2023

Time: 1 - 2PM ET


Meeting Status

Chair:  Hans Buitendijk

Scribe:  Hans Buitendijk, Riki Merrick

  • Quorum (Co-Chair + 4) Met 

OO Events 


OO Calls Next 7 Days (check if happening)

  • Catalog
  • LAB
  • v2-to-FHIR
  • Specimen
  • HCP
  • OO on FHIR
  • Cancer Pathology Reporting
  • IHE SDC/eCC on FHIR 
  • v2-to-FHIR
  • Main Call
  • Nutrition  - every 4th of Month

Upcoming Topics/Due Dates

Sep 2023 Connectathon / Ballot / WGM
FHIR Core substantive Content freezeJuly 8, 2023
FHIR Connectathon Track Proposal dueJuly 11, 2023
Prior ballot recon dueJuly 16, 2023
Ballot FHIR IG approval July 18 - July 27, 2023
Final ballot content deadlineJuly 30, 2023
WGM Agenda postedAug 11, 2023
WGM Minutes postedSep 29, 2023
Other Deadlines
TSC Representative ElectionJuly 31, 2023
2024 Jan Connectathon and Ballot
TSC Approved PSS deadlineAug 11, 2023
FHIR IG proposals to FMGOct 22, 2023
NIB deadlineNov 11, 2023
FHIR Connectathon Track Proposal dueNov 17, 2023
FHIR Core substantive Content freezeDec 5, 2023
Prior ballot recon dueDec 3, 2023
Ballot FHIR IG approval 
Final ballot content deadlineDec 17, 2023
WGM Agenda posted
WGM Minutes posted


(Names of people present are BOLDED)



Ralf HerzogRoche
Rob HausamHausam Consulting
JD Nolen
Hans BuitendijkOracle
Riki MerrickVernetzt, LLC / APHL
Yanick GaudetGlobal Star
Sarah GauntLantana
Andrea PitkusUW
Marti VelezisSonrisa / FDA
Jackie Hemenway
Dan RutzEpic
Jose Costa Teixeira
Olga Volk
Bob DieterleEnable Care
Kathy WalshLabcorp
Lorraine Constable
Elliot SilverResMed
Donna Pertel

Agenda and Notes:


Approve Minutes

    • 2023-06-29 Main - Motion to accept as published.  JD Nolen, Ralf Herzog

      • Against: 0; Abstain: 1; In Favor: 9

OO Project Proposal Triage

  • PSS-2231 - Mapping PH Use cases for FHIR – Helios project

    • How can existing API FHIR queries for PHA query for additional information as part of case investigation
    • These are examples to work in connectathons to see what works and provide guidance to PHA on how to do this in FHIR
    • For the specific use cases identify the way to specifically use the query – identify the resource and search parameter
      • Assume this is based on US Core – which version?
        • is up for discussion (goal is not to ask for new work for HIT vendors)
        • will use what is in use now, so the version that supports USCDI v1 until USCDI V3 is adopted:
          • USCDI would be 3.1.1 and 4.0.0 – is specific for USCDI V1, any later version will do that, too
    • LIS supported? – only if the system does this – no new work
    • How to deal with patient “ordered tests” – OOS, unless there is a queriable system
    • Excludes use of V2 for query
    • EHR and HIE – if TEFCA PH use case picks up, this make pick up
    • Goal is that ANY system that supports FHIR APIs, can be queried this way
    • Leave this as comment: Since this project is not focusing on profiling OO resources, we have no direct interest, but support the effort.  We also note to clarify that the scope involves any FHIR based sources that have the relevant data (not limited to EHRs) and where PH/STLT has the ability/right/interest to access.

Other (Project Approvals, NIBs, etc.)

Today's topics:


  • V2-25401 - on INM agenda for vote on 7/18 - should add our recommendation into comments before then (even if not V2.9.1)
    • Added comment and motion: Upon further review by OO, we don't believe this is worth to deprecate even though it seems mathematically "odd" to use an "=".  Furthermore, in V2.9 it does state that if SN.1 is absent, the default is "=".  Also, we want to clarify that one need not switch to NM if the value is meant to be "=", rather that one can consistently use SN as some results for the same test may be specific, e.g., "^60" or "<^35" as shifting data types for the same test would be confusing.

      As a result, OO recommends that InM finds the Jira not persuasive.  This was agreed to by a motion by Riki Merrick and Craig Newman with a vote of Against: 0; Abstain: 3; In Favor: 8

JIRA Tickets on Families/Households:

OO on FHIR Block Vote (email sent on 6/29/2023)

Change Request

FHIR-41426TRIAGEDPersuasive with Modification

More guidance needed on applicability scope of Vital Signs profile

Javier Espina2023-06-122023-06-27
Orders & ObservationsObservationR6FHIR Core (FHIR)Actions
Change Request

Incorrect "expression" for the researchStudy SearchParameter definition

Xiaocheng Luan2023-05-172023-06-27
Orders & ObservationsObservationR5FHIR Core (FHIR)Actions
Change Request
FHIR-33042TRIAGEDPersuasive with Modification

Include Observation.status "appended"

Hans Buitendijk2021-07-122023-05-25
Orders & ObservationsObservationR5FHIR Core (FHIR)Actions

Change Request


"Preliminary" status differs between Observation and DiagnosticReport

Josh Mandel2021-05-062023-05-25
Orders & ObservationsDiagnosticReport
R4FHIR Core (FHIR)Actions

Change Request

FHIR-28354APPLIEDPersuasive with Modification

Cardinality questions for CatalogHeader profile

Craig Newman2020-08-252023-05-27
John D.L. Nolen
Orders & ObservationsCatalog Header Profile0.1.0Order Catalog (FHIR)Actions

Change Request

FHIR-25552TRIAGEDNot Persuasive

Proposal to add CodeableReference to .supportingInfo

Eric Haas2020-01-212023-05-25
Orders & ObservationsServiceRequest (Diagnostic/Procedure/ReferralRequest)R4FHIR Core (FHIR)Actions
Change Request
FHIR-17531TRIAGEDNot Persuasive

Extend Observation to include additional date/time for the result

Julie Evans2018-07-212023-05-30
Orders & ObservationsObservationSTU3FHIR Core (FHIR)Actions

Change Request

FHIR-17521TRIAGEDNot Persuasive

Extend Observation by adding a reference to Practitioner

Julie Evans2018-07-212023-05-30
Orders & ObservationsObservationSTU3FHIR Core (FHIR)Actions
Change Request

FormatCode valueset is missing XDS-I code

John Moehrke2018-06-022023-05-26
Orders & Observations
STU3FHIR Core (FHIR)Actions
Change Request
FHIR-17147TRIAGEDNot Persuasive

Best Practice rules of the JAVA RI validator aren't documented

Patrick Werner2018-05-142023-05-26
Orders & Observations
STU3FHIR Core (FHIR)Actions

Requested PULLS: also marked as strikethrough in the above:

  • FHIR-41426. (Javier) Looking at the comment trail, it needs discussion. In addition, it is marked as in-person.
  • FHIR-32154 (Hans) need clarification of scope of the observation status to be either the observation itself, or across its hasMembers as well.  Either way, language would need to be different.
  • FHIR-25552 (Dan) it appears that the requested outcome has already been accomplished but the logical chain of which trackers get us there doesn’t seem to add up

Motion to approve the proposed dispositions in the block vote minus pulls.  JD Nolen, Elliot Silver.

  • Against: 0; Abstain: 3; In Favor: 6

Discussing the pulled items:

September Connecathon Participation

  • LIVD - January, not September
  • v2-FHIR - not planned
  • Catalog - not planned
  • COW/FOE - will ask tomorrow
  • Target Resources for substantive changes for R6 - possibly - Check next week with interested parties/lead
    • Observation/DiagnosticReport (Panels) - possibly - Check next week with interested parties/lead - Marti to put a Zulip
    • Task - would be January target

privacy/consent/workflow zulip topic in v2

Hans to check


for discsussion on tomorrow's lab call

  • Check back in June for progress

UP-44 -no value set content defined for v2 table 963 value set 

  • Leaving UP-44 open for now – so that the new tickets and this one can be linked

V2-Jira Review (time permitting) 


Projects/Feedback (Updates in BOLD)


ProjectTopicsProject Information
  • Topics:
    • Need to add current topics
  • Project Page Link: 
  • Meetings
    • Every other Friday, 9-10am ET starting 10/1
  • Topics:

    • Need to add current topics

  • Project Page Link: 
  • Meetings:

    • Mondays 1 - 2 PM ET
    • Thursdays 11 - 12 AM EDT

Discussion Topics: 


Block Vote of old Jira trackers set for next main call - see:

JIRA Status



JIRA Issue Backlog
  • Should the extension be removed?
    • 4/27 NOTES:
    • Side-bar: There are also several extensions on other resources, for example for nutrition that we are not sure where the extensions came from
    • Related Jira referenced in comments = FHIR-29273
      • This jira mentions these artifacts
        • Blood Pressure Panel
        • Body Length
        • Body Weight
        • Head Occipital-Frontal Circumference by Tape Measure
      •  came from Rita Pyle
    • A component is different from a qualifier
      • It is not in the definition for component, but mentioned in text in we say “or may provide qualifying information to observation.code”
        • Can we find out how this text got added? – It is in R4, but not R3, so maybe we can find it
      • Is the bodyposition an observation that is part of the bloodpressure measurement procedure?
        • Diastolic pressure
        • Systolic pressure
        • Body position – this would have to apply to both of those measurement
      • The old jira came from Rita Pyle – let’s ask her to supply the list of qualifiers that are modeled differently – add comment to this Jira tagging her
      • Add Overall comment? We see a difference between qualifiers and components of an observation – let’s do some more research first
  • Total FHIR = 246 Tickets in Submitted, Triaged, Waiting For Input

    • FHIRCore = 219
    • FHIRCast=1
    • FHIRPath=11
    • FHIR IGs = 8

  • Add the ability to reference QuestionnaireResponse from DiagnosticReport
  • Pulled from Block for further Discussion by Dan Rutz 
    • Needs "a better evaluation of real examples of which workflow, procedures, and data structure truly invoke a DiagnosticReport which involves an embedded QuestionnaireResponse as part of the .result element.  It may be valid, but needs to be well-substantiated."

  • At-home Test - Deferred tickets that have been reopened.
  • This group is not meeting – how or when do these tickets get resolved?

  • Grouping the tickets with Observation.category changes
  • Need to determine where to have this discussion – at least to propose dispositions for a block
  • Discussed at WGM – need to determine outstanding JIRAs

Catalog JIRAs
  • Made progress on QA of IG Changes
  • Ballot Reconciliation Spreadsheet is ready to go

Block Vote Pulled JIRA




Elliot Silver pulled FHIR-33042

Hans pulled FHIR-32154, FHIR-25552 

From May 25, 2023

JIRAs to Be Applied (FHIR Core)

JIRAs to Be Applied (IGs)

  • Status of tickets


Total To be Applied:
  • 41 FHIRCore
  • 115 IG related
JIRAS to be marked Published


Note - these are in the published R5 on

Modules - Updates on progress


The following are draft pages to organize and author content for each of our health care product resources: 

OO Resource Coverage

  • Need to discuss developmental roadmap for each of the OO resources for R6
  • Added R6 planning to WGM agenda
  • Need to discuss what needs to be done prior to WGM to prep for discussions
  • Add Resource reorg comments to module pages


  • Marti revised related resource for each topic area to where the resources align to current modules
  • Definitional resources were in workflow (pattern is still there) but those are now in administrative – Marti and Jose to take off-line

Projects/Feedback (Updates in BOLD)


ProjectTopicsProject Information
  • Topics:

    • Need to add current topics

  • Project Page Link: 
  • Meetings:

    • Every Monday 2 - 3 PM ET
  • Topics
    • Device Association
    • Module for Device, BDP and Nutrition
    • Intake/Administration/Procedure Consistencies
    • otherwise Jira tickets for Device(Definition), BDP, Nutrition
  • Topics
    • Jira tickets work
Cancer Pathology Reporting
  • Topics
    • IG has been reviewed and approved by FMG with the caveat that it not be published until the MedMorph Reference Architecture IG is published (checking on ETA)
  • Topics
    • Publication Pending

  • Project page: 
  • Meetings
    • Every Wednesday 2 -4 PM ET
    • Note that the call is listed on call calendar only as 1 hour call, since conference center won't let calls overlap
  • Topics

    • Next Call July 26, 2023
  • Project page link: 
  • Meetings

    • 4th  Wednesday ONLY 2-3 ET
  • Topics
    • LIVD IG - Ballot Reconciliation 
    • Next Call: July 20, 2023

(FHIR in the Lab) Order Workflow project is merged with: FHIR Orders Exchange (DME/AcuteOrders) (Administrative)


  • FHIR in the Lab/Workflow - establishing boundaries for each project
  • FOE
    • Referrals/PriorAuths/Orders/Claims
    • Focus on exchanges between Ordering Provider and Performing Provider

Order Service Catalog
  • Topics
    • Preparing Publication request
    • Draft content has been sent out
  • Topics
    • LRI/LOI
    • Lab related topics