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AbdulMalik Shakir Hi3 Solutions
Alaina Gregory CDC
Cindy Bush CDC
Craig Newman Altarum
Crystal Snare State of WA
Dan Chaput ONC
Danny Wise Allscripts
Dave deRoode Lantana
Floyd Eisenberg iParsimony
Jim Jellison Public Health Informatics Institute
Joginder Madra Madra Consulting Inc.
Laura Rappleye Altarum
Melanie Epstein-Corbin CA Dept of Public Health
Mike Yaskanin Altarum
Rita Altamore State of WA
Sarah Gaunt Lantana Consulting Group


  1. Welcome, agenda review, meeting minute approval - 5 min
  2. VRDR FHIR IG Pre-Publication Approval (AMS) - 5 min
  3. BSeR FHIR IG Pre-Publication Review (AMS) - 15 min
  4. Review of gForge ticket for immunizations (Craig) - 5 min
  5. Review of gForge ticket for address classification (Craig) - 5 min
  6. Review of gForge ticket for immunization route (Craig) - 5 min
  7. Review of gForge ticket for ImmDS patient reference and broken links (Craig) - 5 min

Discussion items





5 minWelcome, agenda review, meeting minute approval Joginder
  • Motion to approve last week's minutes (Craig Newman/Danny Wise) 11-0-1
5 minVRDR FHIR IG Pre-Publication Approval AMS
  • The VRDR FHIR ballot had many comment which have been disposed of
  • AMS is in the process of applying the changes
  • AMS presented a list of changes to be made, which he proposed that we will have a week to review the proposed changes and we can approve them next week
    • We decided that we don't need to formally approve these changes before he finishes applying them
    • This file will be useful when the publication request comes to the WG after all changes have been applied
    • Anyone interested in reviewing the proposed changes are welcome to review the changes and send feedback to AMS
    • VRDR Change Tracker.xlsx 
    • Revised VRDR FHIR Resource
  • Some changes have been applied in XML files also provided in a zip file (the changes are not yet available in the FHIR current build)
15 minBSeR FHIR IG Pre-Publication ReviewAMS
  • Same discussion as for VRDR
5 minReview of gForge ticket for immunizationsCraig
  • gForge ticket 22805 notes related but inconsistent value sets for Immunization.subpotentReason and ImmunizationEvaluation.doseStatusReason
    • Currently the value sets only have a binding of Example
  • Typically if an immunization event is recognized as being subpotent for a particular reason (partial dose, product was recalled, etc), that means that the dose will be recognized as invalid for that reason
  • Because these two elements are so intertwined, it makes sense to harmonize the value sets (even if they are just examples)
  • We don't know of any existing codes in the v2, CDA, FHIR (US Core/QI-Core) or SNOMED spaces which are available to use
  • Proposal to bind the elements to two overlapping value sets with the following haromonized codes:

partialdose - both

coldchainbreak - both

recall - both

adversestorage - both

expired - both

outsideschedule - only doseStatusReason

  • We will consult Rob Hausam to make sure there aren't appropriate SNOMED codes to use
    • If there are appropriate SNOMED codes, we will use those codes instead
  • Motion to approve the disposition (Craig Newman/Floyd Eisenberg 14-0-0)
5 minReview of gForge ticket for address classificationCraig
  • Someone proposed to add a new element to the Address data type to "classify" the address (eg Long term care facility, school, correctional facility)
  • Grahame is asking for our input on the need for this
  • This sort of classification is more about the location than the address but there is no way to link a "location" to the patient's address
  • Crystal indicated that Washington state sometimes struggles with identifying the "best" address and an additional classification may help
  • We want to talk more on a future call after we've had some time to think about it. We'll provide an update next week (11/7)
  • We documented this in the gForge

  • Remaining topics were deferred to next week

Action items