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).

OO Main - Meeting Information

Meeting Details

Date:  September 7,  2023

Time: 1 - 2PM ET


Meeting Status

Chair:  JD Nolen

Scribe: Marti Velezis

  • Quorum (Co-Chair + 4) Met 

OO Events 


OO Calls Next 7 Days (check if happening)

WGM NEXT WEEK - NO Regular Meetings

  • Clinical Order Workflow in FHIR / FHIR Orders Exchange (DME/Acute/Admin)
  • Catalog
  • LAB
  • v2-to-FHIR
  • Specimen
  • HCP
  • OO on FHIR

  • Cancer Pathology Reporting
  • IHE SDC/eCC on FHIR 
  • Nutrition - 4th Wed
  • v2-to-FHIR
  • Main Call

  • LIVD (Tuesdays 2-3 or elsewhere?)

Upcoming Topics/Due Dates

Sep 2023 Connectathon / Ballot / WGM
WGM Minutes postedSep 29, 2023
Other Deadlines

2024 Jan Connectathon and Ballot
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
2024 Jan Connectathon and Ballot




Ralf HerzogRoche
Rob HausamHausam Consulting
JD NolenMercy Children's Hospital
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 ConstableConstable Consulting
Elliot SilverResMed
Jenizah Melendez JenkinsJMC
David Barwin
Alex MaysCAP
Joellen Carter
Michelle Ashafa
Donna Pertel

Agenda and Notes:


Approve Minutes

OO Project Proposal Triage

  • Nothing to review 

Other (Project Approvals, NIBs, etc.)

OO WGM 202309 - Agenda - Orders & Observations - Confluence (

  • Need to work with FHIR-I or Vocab on the following: 

    • FHIR-40437 - Link missing -  Note this is the expansion list

    • Robert Hausam will be checking it out to see where it should land - will update the agenda, when clear
    • 9/7 - Pending - need to determine which group needs to address this topic
  • OpenCDx Project proposal needs to be added to the agenda - Tues Q3 - Marti to verify
    • 9/7 - Sent follow-up message to Eric and Preston and waiting for a response
  • 9/7 - Joint Meeting
    • Todd Cooper - Devices related to Nutrition - PHN F&N and OO Nutrition- Tuesday Q4
    • Donna/Michelle - NutritionIntake - need to clarify where this topic is happening - CQI - Monday Q4 (at beginning of the quarter); RE: QI Core profile for NutritionIntake

---------Next week: WGM in Phoenix---------

FHIR JIRAs (link to below)

  • OO on FHIR Block Vote for August - VOTE TODAY

    • Tags to use for inclusion: OO-FHIR-Block-Vote  August-2023

T Key Summary Assignee Reporter P Status Resolution Created Updated Due


  • 9/7 - Motion to approve block vote:
    • Marti Velezis / Yanick Gaudet : 9-0-4
    • All tickets have been updated with votes (9/7/2023 - MJV)
  • Pulled Block Vote JIRAs from May/June 2023

    • FHIR-33042 - Getting issue details... STATUS
      • amended means something was changed elsewhere, but it did NOT affect result or interpretation or reference ranges
      • appended identifies the observation that was added to a report, it could be included in several reports
      • discussion if this is at the right level - or should this be at DiagnosticReport level
      • corrected is NOT a child of amended - move up to level 1
      • 9/7 - Will have to revisit today
        • Part of vote in July 2023 and should have been removed
          • Reopen the ticket today
            • Hans Buitendijk / Rob Hausam : 10-0-2 John D.L. Nolen 
            • Marti sent JIRA admin to get this ticket reopened to apply the updates to this ticket
              • Ticket reopened and vote recorded 
          • Add "appended between corrected and cancelled as a Level 1 term
          • Need to make sure that the Resource is more flexible than applying lab-related terms and/or jurisdictional requirements (which are better suited to "mappings")
          • Perhaps the "result" or "observation should not allow "amended" for labs
            • Should there be more prescriptive instructions for when to use these terms and the observation elements that are being amended
            • Should "amended" be removed?
            • Note - this is Normative content and needs community consultation
        • Note - "corrected" should be level 1 and we need to look up that request separately
          • Note - this is Normative content and needs community consultation
        • This ticket needs to be further discussed -
          • Added to Tues Q2 to discuss but not make any final decisions
          • We will pick up on another OO post WGM with recommendations

Reminder Next Meeting: September 21, 2023

Meeting Adjourned: 2:05PM EDT

From Chat: 

David Barwin to Everyone (Sep 7, 2023, 1:04 PM)
Will be dropping off at 30min mark
Andrea Pitkus to Everyone (Sep 7, 2023, 1:05 PM)
Will COW occur tomorrow?
Ralf Herzog to Everyone (Sep 7, 2023, 1:06 PM)
Andrea Pitkus to Everyone (Sep 7, 2023, 1:06 PM)
and will it resume next fri?
Andrea Pitkus to Everyone (Sep 7, 2023, 1:31 PM)
CLIA indicates reports with amended info is a corrected report.
per Kathy's comments
fyi, from CAP accreditation, "Amended/amendment - Any change in a previously issued anatomic pathology or cytopathology report
intended to correct an inaccuracy, including changes in the diagnosis, narrative text, clinical history, pre- and
post-operative diagnoses, patient identification, or other content."
Corrected/correction - A change in a previously issued clinical pathology test report intended to correct an
inaccuracy, including changes in test results, patient identification, reference intervals, interpretation, or other content.  (FROM CAP)

Andrea Pitkus to Everyone (Sep 7, 2023, 1:37 PM)
Note CAP indicates amend/amended would be used for AP or cytopath reports.
I realize it applies outside of lab too

Andrea Pitkus to Everyone (Sep 7, 2023, 1:52 PM)
agree ralf
corrections can occur whether amendments occur
Elliot Silver (ResMed) to Everyone (Sep 7, 2023, 1:53 PM)
“When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.’

Andrea Pitkus to Everyone (Sep 7, 2023, 1:54 PM)
unfortunately in healthcare, the same term is used with different meanings at times
According to CAP, amended wouldn't apply to the observation

  • Check back in August 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

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

FHIR Discussion Topics: 


Block Vote Pulled JIRA

JIRA Status



Block Vote Pulled JIRA

From June 2023



Hans pulled FHIR-32154FHIR-25552 

From May 25, 2023


JIRA Status



JIRA Issue Triage
  • 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 = 262Tickets in Submitted, Triaged, Waiting For Input (not ready to be applied)

    • FHIRCore = 226
    • FHIRCast=1
    • FHIRPath=11
    • FHIR IGs = 17

JIRAs to Be Applied (FHIR Core)

JIRAs to Be Applied (IGs)

  • Status of tickets

Total To be Applied:
  • 70 FHIRCore
  • 74 IG related
At Home testing

  • 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
JIRAS to be marked Published

Note - these are in the published R5 on

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

  • BiologicallyDerivedProduct
  • Devices
    • some work by devices WG
    • do we need to differentiate lab devices (pre/post- analytical devices from analytical devices in the lab)?
    • Need to decide to what level of detail this page should go, or if we need this then how to document some of this content = may not belong here, but rather on the device related resource pages
  • Nutrition Product
  • VisionPrescription

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

  • Project page link: 
  • Meetings

    • 4th  Wednesday ONLY 2-3 ET
  • Topics
    • LIVD IG - Ballot Reconciliation 
    • Next Call: Sep 26, 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