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Date

Attendees

Goals

  • BSeR-Ballot Recon

Discussion items

TimeItemWhoNotes
5 min

Welcome and introductions 

Craig
70 minBSeR-Ballot Recon
Abdul Malik
  • See Ballot recon sheet posted to Wed Q4
    • FHIR 3 IG Recon
    • This specification did not pass. Would like to go through reconciliation and address issues so that commenters might withdraw the negatives and they wouldn’t have to reballot and could proceed to publishing. However if that’s not the case they would then reballot.
    • Will confirm deadlines. Looked at R4 publication schedule. There is a different set of timelines for the FHIR IGs for January.
    • IF we need to reballot, we would need to get a NIB in by Oct 28th and the materials in by November 11.
    • Some of this may depend on the changes and whether or not they are substantive. Something like updating value sets might be considered substantive because no one would have the ability to review and comment.
    • Would like to avoid reballoting, if they do have to reballot, would like to go for January.
    • Get ballot spread sheet

    Comment Group #3

    Discussion

    • Guide was developed in Simplefhir and all the links worked there. Putting it through the IG generator and was problematic. Appealed to the TSC and got an additional week. Was able to get it to go through the IG publisher and was able to see issues that needed to be resolved. Was able to make the deadline, however the IG publisher broke the links in narrative text. You could still navigate through the structure definition, just the links were broken.
    • There were problems with various tools that were tried. Used the HL7 supplied version of SimpleFHIR
    • Will need to reach out to submitters and find out if the broken links impaired their ability to review the ballot. The commenters are free to not withdraw their comment, could have a conversation to discuss if necessary.

    Motion: AMS moves to resolve group 3 as persuasive and will be fixed. Will need to reach out to submitters and find out if the broken links impaired their ability to review the ballot material and consider that information within committee when deciding to reballot or not.

    Second: John Loonsk

    Abstain:0

    Against:0

    For: 14

     

    Comment Group #4 Typos/Grammar

    6, 43

    Discussion

    Motion: AMS moves to resolve group 3 as persuasive and will make the corrections as suggested.  

    Second: John Loonsk

    Abstain:0

    Against:0

    For: 14

     

     

    Comment Group #1 Diabetes

    2, 3, 9,11

    Discussion

    • Referrals to orgs that would typically not be covered entities. When sharing outside of covered entities you can only share information specific for that purpose (minimum necessary).
    • Created bundles of observations that would be applicable by program. For the Diabetes bundle most of the observations are for PRE-Diabetes.
    • Each of these comments are suggesting that this should reference PRE-Diabetes not Diabetes

    Motion: AMS moves to resolve group 1 as persuasive and will update references to Diabetes to Pre-Diabetes as suggested.   

    Second: John Loonsk

    Abstain:0

    Against:0

    For: 13

     

    Comment Group #2 New Data item proposals

    5, 7, 8, 10, 12

    Discussion

    • Recommending considered for future use.
    • When developing the ballot materials, the associated programs were consulted. Would like to take these recommendations back to those programs for their vetting.
    • Should publish as is if we don’t have to reballot. When STU could address these and then reballot before going to Normative
    • May include additional documentation in the guide explaining where the use cases come from.

    Motion: AMS moves to resolve group 2 as considered for future use and will vet group 2 with the appropriate stakeholders.    

    Second: John Loonsk

    Abstain:0

    Against:0

    For: 13

    Comment # 37

    Discussion

    • This guide simply constrained what CIMI had developed for blood pressure
    • Submitted as A-S
    • CIMI has no balloted model at this time. Could re-evaluate once CIMI has balloted materials.

    Motion: AMS moves to find as persuasive with mod and that the introductory materials will include narrative that all of the profiles are constraints on existing normative profiles from STU 3 and US Core and will reevaluate once CIMI has balloted material.

    Second: John Loonsk

    Abstain:0

    Against:0

    For: 13

     

    May need to consult with FHIR-I to address the organization and hierarchy within this guide

     

    Comment # 42

    Discussion

    • This comment is similar to the state above.
    • There is a difference between a structure definition and profile
    • Profiles include more than just structure definition
    • A Structured Definition describes the constraints on a resource
    • Sometimes people use these two terms interchangeably

    Motion: John L moves to find as not persuasive with mod because they are different, however additional documentation can be added for clarity for the reader.  

    Second: AMS

    Abstain:0

    Against:0

    For: 13

     

    Comment # 47

    Discussion

    • Concern about whether the structure definition conforms to the FHIR expectations
    • The comment isn’t clear and its recommended to consult with the commenter and FHIR-I.
    • Will bring back to the group.

     

    Comment # 48

    Discussion

    • Could expend the instruction text, or develop an additional narrative space to address.
    • The comment was specific to allow for narrative within each bundle
    • Bundles can contain multiple compositions
    • The base bundle doesn’t have a place for an optional narrative
    • A bundle is a structural grouper that has no syntatical meaning

    Motion: AMS moves for not persuasive because bundle resources don’t have the ability to have text. There are places where a narrative text is permitted in association with the referral request and individual observations.    

    Second: John Loonsk

    Abstain:0

    Against:0

    For: 13

     

    Comment # 50

    Discussion

    • Who owns the request resource instance? It is constructed on the server of the referral initiator and communicated to the referral recipient.
    • Who is permitted to update the resource because now we have two instances.
    • FHIR REST has no ability to permit this, but FHIR transaction mode does
    • Are we choosing FHIR messaging? If so, this problem goes away. IF we choose REST, then this will need to resolved in a REST friendly way.

    END OF DISCUSSION FOR Q3.

Action items

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