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OO Main - Meeting Information

Meeting Details

Date: September 21, 2023

Time: 1 - 2PM ET


Meeting Status

Chair:  Hans Buitendijk

Scribe: Riki Merrick

  • Quorum (Co-Chair + 4) Met 

OO Events 


OO Calls Next 7 Days (check if happening)

  • Clinical Order Workflow (COW) in FHIR/FHIR Orders Exchange (FOE) (DME/Acute/Admin)
  • Catalog/OO on FHIR
  • LAB
  • 2-to-FHIR
  • Specimen
  • HCP
  • OO on FHIR
  • 9/26 - LIVD

  • Cancer Pathology Reporting
  • Nutrition - 4th Wed
  • v2-to-FHIR
  • Main Call

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
Hans BuitendijkOracle
JD NolenMercy Children's Hospital
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 Silver
David Barwin
Donna Pertel
Michelle Ashafa
John Moehrke

Agenda and Notes:


Approve Minutes

    • 2023-09-07 Main

      • Motion to accept as updated/published.  JD Nolen, David Barwin
        • Against: 0; Abstain: 0; In Favor: 12
    • 2023-09-11-15 WGM
      • all please review and add where indicated or edit as needed
      • To be posted by 9/29

OO Project Proposal Triage

  • None for today

Today's Topics

  • USCDI Comments
    • were submitted
  • ISA Comments
    • CPT-PLA were submitted
    • if any others would need to get on the agenda ASAP
  • FHIR R6
    • Will have 2-3 for comment ballots before normative starts
    • Use priority list ( to determine focus and then the dashboards to tackle.
    • See if we can focus on getting block votes together on open jiras – in special calls prep, then vote on main
    • Implementer survey on where we want feedback on for normative resources
      • Need to pull this together ASAP
    • Regardless if a resource is marked as normative, implementers expect ALL R6 content be normative
    • Basically the privilege of not following the normative rules will go away with R6
    • So we will need to time box and focus on major topics and patterns.
  • WGM Recap
    • Meeting Highlights
      • Families JIRAOO Families/Household/Workplace/Event JIRAs page has been updated with Patient Care resources;
        • Scope changed to include workplace and events
        • For some actor roles group makes sense, not for others
        • FHIR-I is setting up a taskforce to make this consistent
          • OO indicated that our analysis of OO owned resources be considered by tis group
          • This group should include reps from all WGs that have affected resources
          • TSC may review this once the work is completed
        • need to pull from notes prior to sharing this with the Task Force that will be pulled together to discuss this across FHIR Resources
      • See Information Modeling from CG - re: MolecularState Resource (along with Sequence)
      • Backport Extension - January 2024 ballot
      • Gender Harmony Cross Paradigm IG publication request went to TSC, some planning around future maintenance
      • Reviewing the minutes by quarter
        • 9.1 comments related to use of OBX will be discussed in V2 Management – Fridays 11 AM – will coordinate with submitter and V2 Management co-chair on the date for this meeting
      • GC introduced new resource alongside sequence called molecularState
      • Did some FHIR ticket prep work – these will be in a block vote for next OO main call – Marti will review these to find candidates
      • Jan WGM is 4 days - there is discussion on being on UTG+5
  • Panel Discussion Update
    • Goal is to have just one option
      • Currently there are 2 options:
        • Option A = observation.code has panel code and all members are in the observation.hasMember
        • Option B = Panel code in DiagnosticReport.code
      • Both options support reflex testing
      • In option B you are losing the option to use composition for overall report structure = represented form and overall report status
      • Should DiagnosticReport be a specialization of composition to resolve this, so that you could use the composition
      • You would need to have separate compositions for each DiagnosticReport and that should be different from the
    • Will continue on this topic tomorrow on the lab call
    • Jose will revive the zulip thread of specialization on observation = parameterized resources
  • COW call:
    • can we find a new call time, so Jose can join?
    • BPM+ could join at current COW call time
  • Characteristics Project - Next week

Adjourned 2:03 PM ET

E-Signature Update

  • Yes
  • No

Any updates?


  • Yes
  • No

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) 

  • Yes
  • No

Projects/Feedback (Updates in BOLD)

  • Yes
  • No

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: 

  • Yes
  • No

Block Vote Pulled JIRA

JIRA Status



Block Vote Pulled JIRA

From June 2023



Hans pulled FHIR-32154FHIR-25552 

From May 25, 2023

JIRA Triage

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

Modules - Updates on progress

  • Yes
  • No

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)

  • Yes
  • No
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