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Chair:  Danny Wise

Scribe: Craig Newman 





AbdulMalik Shakir Hi3 Solutions
Cindy Bush CDC
Craig Newman Altarum
Danny Wise Allscripts
David deRoode Lantana
Erin Holt Coyne Tn Dept of Health
Johh Roberts Tennessee Dept of Health
Karla Norsworthy State of North Carolina
Mead Walker Mead Walker Consulting
Sarah Gaunt Lantana


  1. Welcome, agenda review, meeting minute approval - 5 min
    1. NIB Deadline approaching (June 30)
    2. Call for co-chair elections
  2. VRDR FHIR IG ballot reconciliation (AMS) - 15 min
    1. Comment group 5: Sequencing and other traits of Cause of Death
    2. Comment group 11: Death date vs Effective date vs Comment
    3. Comment group 12: NCHS encoding of a cause of death
    4. ballotcomments_FHIR_IG_VRDR_R1_D1_2019MAY (version 2).xls
  3. v2.6 VRDR IG ballot reconciliation (Mead) -15 min)
    1. V26_IG_VRDR_2019MAY_forBlockVote.xls
  4. CDC VR implementation (Cindy Bush) - 15 min

Discussion Items

Agenda Item

Meeting Minutes from Discussion

 Welcome, agenda review, notes approval
  •  No agenda additions
  • The Notice of Intent to Ballot (NIB) deadline for Sept is on June 30th
    • If you intend to ballot anything, work with a co-chair to enter a NIB and then make sure it gets on a call agenda before the 30th so that the WG can approve it
  • Two co-chair spots are up for re-election in September
    • Craig and Laura's spots
    • Call for Nominations start on June 26th
    • Talk to a co-chair if you want more information 
  • Reminder that there is an early September ballot phase for Da Vinci and CDA templates for Clinical Notes
    • The sign up period is open and the ballot period begins June 21st
  • Motion to approve last week's minutes (Craig Newman/AMS 8-0-0)
VRDR FHIR IG ballot reconciliation (AMS)
  • Block 5 - Cause of Death Condition profile
    • The Structure Definition was pointing to the wrong referenced profiles (it should point to the constrained VRDR profile, not the base resource) - this will be updated
    • The IG will be updated to indicate that the death certifier and asserter should be the same person (points to the same resource)
    • The Cause of Death Conditions are provided in a List which is ordered by priority
      • List.entry.flag will give the Line Number (1, 2, etc)
    • The Cause of Death profile is being proposed to be changed from Condition to Observation to accommodate the idea of the onset amount before death (eg 3 months before death)
      • Pull comment 111 until we can see it mocked up
    • Motion to approve Block 5 minus comment 111 - AMS/Craig Newman 8-0-1
  • Block 11 - Death dates
    • The death date profile has 3 dates (valueDateTime, effectiveDateTime and date pronounced dead
    • Text will clarify the difference between these 3 concepts
    • Motion to approve Block 11 - AMS/Mead Walker 8-0-0
  • Block 12 - Cause of Death encoding
    • The conditions of death start out as text before they go to NCHS but come back from NCHS as coded content
    • Text will be added to explain this better
    • The same profile will be used for both directions
      • A business rule will require a code (ICD-10) coming back from NCHS
    • Motion to approve Block 12 - AMS/Craig Newman 8-0-0
  • ballotcomments_FHIR_IG_VRDR_R1_D1_2019MAY (version 2).xls
v2.6 VRDR IG ballot reconciliation (Mead)
  • Block vote
    • All are persuasive
    • No comments requested to be pulled
    • Motion to approve the block Mead Walker/AMS 8-0-0
  • Comment 13
    • Harmonization of names for state vital record offices
    • Motion to approve as persuasive with mod Mead Walker/Cindy Bush 8-0-0
  • Comment 42
    • A requirement will be added so that MSH-9.2 in an ACK message will be constrained to values appropriate for the initiating message types
    • Motion to approve as persuasive Mead Walker/Craig Newman 8-0-0
  • Comment 43
    • Duplicated conformance statements will be removed from Composite and Conformance profiles
    • Motion to approve as persuasive with mod Mead Walker/AMS 8-0-0
  • Mead will present more dispositions next week
  • V26_IG_VRDR_2019MAY_Craig_N_ReconUpdate6.6.xls
 CDC VR implementation (Cindy Bush)
  • Some jurisdictions are ready to send VR death reporting data via v2.6 but others want to use FHIR
    • There currently isn't a FHIR spec for birth/fetal death reporting
  • The NCHS is trying to figure out if they should support both or if they should be looking to come up with a "translation" solution that would allow submitters to submit in either format while NCHS ends up processing only one format
  • HAI only supports CDA now but they are working on FHIR IGs and will be supplying transforms from FHIR to CDA
  • This discussion will continue on June 20th

 Adjourned at 5:05 Eastern