Skip to end of metadata
Go to start of metadata


Chair:  Joginder Madra

Scribe: Danny Wise



  1. Welcome, agenda review, meeting minute approval - 5 min
  2. Presentation of Syndromic IG Publication Request (Dave / Emilie / Peter) - 5 min
    1. HL7_Publication_Request_2019_0627.docx
    2. reconciled IG
      1. word doc
      2. html doc
  3. eICR CDA ballot recon - discussion of manual and alternate initiation/eICR STU1.1 Extension (John) - 20 min
  4. BSeR FHIR IG ballot reconciliation (AMS) - 15 min
    1. ballotcomments_FHIR_IG_BSeR_R1_D2_2019MAY (version 2).xls
  5. VRDR FHIR IG ballot reconciliation (AMS) - 15 min
    1. ballotcomments_FHIR_IG_VRDR_R1_D1_2019MAY (version 2).xls
  6. v2.6 VRDR IG ballot reconciliation (Mead) -15 min
  7. CDC VR implementation (Cindy Bush / Hetty) - 5 min
  8. NCHS NIB Approval/NCHS Ballot comment spreadsheet approval (Sarah) - 10 min
    1. NIB: NIB_CDA_NHCS_R1D3.xlsx
    2. NCHS Ballot comment spreadsheet: Amalgamated-ballotcomments_CDAR2_IG_NHCS_R1_D3_2019MAY.xls
  9. CDS FHIR IG reconciliation (Nathan / Craig) – 5 min

Discussion items





5 min.Welcome, agenda review, meeting minute approval
  • Last week's minutes approved (motion: Sarah, second: John L.) 15-0-1
  • Next week's call (July 4th) is cancelled due to the Independence Day holiday in the US
5 min.Presentation of Syndromic IG Publication RequestDave Trepanier / Emilie Lamb / Peter Hicks
  • Publication request approved (motion: Dave, second: Craig) 16-0-1
  • Dave will submit the approved request form to the TSC
20 min.eCR CDA ballot recon - discussion of manual and alternate initiationJohn Loonsk
  1. Manual and alternate initiation – there were a number of ballot comments about this topic
    • providers have a use case to manually trigger a case report if they suspected a reportable condition, even when not completely sure yet
    • PHWG had previously requested a field in the CDA document for free-text explanations in this scenario
    • Policy is that manually-initiated reports should be sent to all relevant jurisdictions even if not specifically a reportable condition in all of them
    • Some EHR vendors wanted to automatically send some reports to meet PH needs even when trigger code was not in RCTC – they were using the “manually-initiated” flag in this scenario
    • Due to the policy, those reports could be inappropriately sent to other jurisdictions
    • The proposed plan:
      • Add an additional “alternate initiation” flag with associated coded value as well as free text fields
      • Rename “manual initiation reason observation” to “initiation reason observation” to be applicable to both scenarios
      • Adjust policy to only route “alternate initiation” to the jurisdiction where care was provided
    • Richard – when aggregating data into a report, there is a use case for all 3 (triggered, manual, and alternate) types in one report
    • Sarah – may need to adjust flags
    • John L. – type of initiation is really about what action triggered the report
    • Question about how an aggregated report would fall into the different routing policies
      • Or should there be separate reports for each trigger type?
    • Reach out to John L. off-line if there are further thoughts
  2. Extension for eICR CDA STU period
    • STU comment period expires June 2019 – request to extend for another year
    • Extension approved (motion: Laura C., second: John L.) 19-0-0
20 min.VRDR FHIR IG ballot reconciliationAbdulMalik Shakir

See ballot reconciliation spreadsheet.

  • Comments 7 & 8 – correct coding system for birthState; "Persuasive" disposition approved (motion: AbdulMalik, second: Craig) 12-0-0
  • Comment group 9
    • Comment 23 – apparent discrepancy in coding system / value set designations for Autopsy Performed Indicator; "Not Persuasive" since value set pulls from multiple coding systems
    • Comment 64 - changed cardinality of Autopsy Results to (0..1) with conditional requirement based on Autopsy Performed Indicator; "Persuasive"
    • Comment 150 - align Autopsy Performed Indicator value set with V2.6 IG; "Not Persuasive" since a future project will align the 2 IGs
    • Comment group 9's dispositions approved (motion: AbdulMalik, second: Craig) 13-0-0
  • Comment 171 – change "cause of death" from a Condition resource to an Observation resource; "Persuasive with Mod" (this is the same change as for comment 111 that was pulled from the June 6th reconciliation approvals so a mock-up could be demonstrated) approved (motion: AbdulMalik, second: Craig) 13-0-0
  • Comment 30 – change descriptive text and examples to better represent intended references; "Persuasive with Mod" approved (motion: AdbulMalik, second: Craig) 13-0-0
  • Comments 41 & 136 – Pregnancy Status value set and Disposition Location publishing issue, both approved as "Persuasive" (motion: AbdulMalik, second: Cindy) 13-0-0
10 min.

BSeR FHIR IG ballot reconciliation

AbdulMalik Shakir

See ballot reconciliation spreadsheet.

  • Comments 56, 58, 60, 64 pulled from last week will remain pulled; Craig and AbdulMalik will work together off-line
  • Group 9 (comments 55, 91, 107, 113, 128, and 146) – typo corrections approved (motion: AbdulMalik, second: Craig) 13-0-0
  • Group 10 (comments 27, 86, 90, 102, and 152) – style issues' dispositions approved (motion: AbdulMalik, second: Craig) 13-0-0
    • FHIR Mgm’t. is working toward a standardized IG format that should address a lot of these style concerns
15 min.v2.6 VRDR IG ballot reconciliationMead Walker
  • Comment 76 – comment text will be moved into field definition; approved (motion: Mead, second: Craig) 12-0-0
  • Comment 77 – value  set for PID-3.5 should be constrained to what is indicated in the IG; approved (motion: Mead, second: Cindy) 12-0-0
  • Comment 82 – clarification of HD data type flavors (HD_DR_AA requires OIDs) approved (motion: Mead, second: Craig 11-0-0)
  • Comment 83 – suggestion to remove primitive data types from IG if they’re not used – Mead will work with IGAMT to include descriptions and not just headers; approved (motion: Mead, second: Craig) 11-0-0
  • Comment 84 – conformance statement for MSH-9 will specify "version ID" instead of data type; approved (motion: Mead, second: Craig) 11-0-0
5 min.CDC VR implementationCindy Bush / Hetty Khan
  • Some states ready to send VRDR to NCHS as V2.6, but not in Prod yet
  • What about FHIR? Should NCHS still move forward with V2.6?
  • V2.6 has been demonstrated, can move forward now
  • FHIR would be another uplift
  • Should consider what senders / vendors are capable / willing to support
  • PH may already have investments in V2, so that might be easier
  • Suggestion to post question to listserv for a broader audience than just those on the call
5 min.NHCS NIB ApprovalSarah Gaunt
  • NHCS STU2 ballot reconciliation is now complete, final approval (motion: Sarah, second: Mead) 10-0-0
    • Will be posted to Ballot Desktop and negative comment withdrawal requests sent
    • STU2 will be published prior to STU3 ballot cycle
  • NHCS STU3 NIB for Sept. 2019 cycle approved (motion: Sarah, second: Craig) 10-0-0
5 min.CDS FHIR IG reconciliationNathan Bunker / Craig Newman
  • 2 comments that were missed during previous approvals:
    • Comment 25 – broken link
    • Comment 37 – alignment with QI Core
    • both dispositions approved (motion: Nathan, second: Craig) 9-0-0
  • Reconciliation now complete; final approval (motion: Nathan, second: Craig) 9-0-0

Action items