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Becky Angeles Carradora Health
Bryant Wash State
Chris Baumgartner WA State Dept of Health
Chrissy Miner CDC/NCIRD/ISD
Craig Newman Altarum
Cynthia (Cindy) Bush CDC/NCHS
Dan Rutz Epic
Danny Wise Allscripts
Erin Holt Coyne TN Dept of Health
Forrest White Altarum
Heather Patrick CDC Contractor (Peraton)
Jamie Parker Carradora
Kathy Walsh Labcorp
Kristi Eckerson HLN Consulting, LLC
Laura Rappleye Altarum
Lina Saintus PHII
Maria Michaels CDC
Mike Yaskanin Altarum
Nathan Bunker American Immunization Registry Association
Ravi Kafle WA-DOH
Sarah Gaunt Lantana Consulting Group
Tony Winters Public Health Informatics Institute

Chair: Laura Rappleye 

Scribe: Danny Wise  

Discussion items





5 min.Welcome, agenda review, meeting minute approval Lauralast week's minutes approved as posted; no concerns or corrections raised
30 min.Immunization Jira TicketsCraig
  • FHIR-32392 - Getting issue details... STATUS
    • We’d previously added instantiatesCanonical and instantiatesUri to Immunization and ImmunizationRecommendation resources in R5 to point to the standard of care / source material referenced for administering / recommending that immunization
    • Current thinking is no longer to use “instantiates” elements and instead use standard extensions (e.g., "workflow-adheresTo”)
    • New proposal is to remove the “instantiates” elements and provide guidance to use the extensions for the same purpose
  • FHIR-27879 - Getting issue details... STATUS
    • Similar to previous ticket – for the ImmunizationEvaluation resource, we need to identify a protocol (e.g., ACIP recommendations) used to evaluate a previous immunization administration
    • Proposal now is to allow "workflow-adheresTo" and "workflow-generatedFrom" extensions to ImmunizationEvaluation
  • FHIR-36060 - Getting issue details... STATUS
    • Proposal is add "supportingInformation" element to Immunization resource to capture relevant info that’s not specifically a reason to administer (indication), nor a reason not to administer (contraindication)
    • Other similar resources (e.g., MedicationAdministration) have this element already
  • FHIR-37722 - Getting issue details... STATUS
    • "primarySource" element indicates whether the Immunization resource represents the original administration vs. a secondary report of a previously-administered immunization (a.k.a. a historical record)
    • "informationSource" represents the source of a secondary report when "primarySource" is false
    • Proposal is to update the narrative description of "primarySource" for better clarity
  • FHIR-32395 - Getting issue details... STATUS
    • This ticket is about some of the components of the "education" element in the Immunization resource
    • In  FHIR-32396 - Getting issue details... STATUS , we will be removing the "education" element in favor of a reference to a Communication resource – that will make this ticket moot
    • Proposal is to dispose as "Not persuasive with modification"
  • All 5 tickets' dispositions were approved together 28-0-0 (motion: Craign, second: Nathan)
10 min.MedMorph RA IG Review and Request for PublicationDragon

There are a couple outstanding questions before publishing the Reference Architecture IG:

  • What is the process to change the title from "Making EHR Data...." to "Making Electronic Data....?"
    • We discussed this recently but haven't formally approved the change as  WG yet
    • Becky had reached out to Dave Hamill, who indicated he changed the title in the PSS and in Project Insight
      • not sure if changes were fully applied (the "Project Name" field was updated in the PSS but not the page title)
      • are any other approvals needed?
    • Co-chairs will follow up with Dave
    • In case it's needed, the WG formally approved the name change 25-0-0 (motion: Maria, second: Genny)
  • Based on some previous Jira tickets (e.g., FHIR-30317 - Getting issue details... STATUS ), the names of some actors have been updated in the IG
    • "Backend Services App" renamed to "Health Data Exchange App"
    • "Public Health Agency / Research Organization" renamed to "Data Receiver"
    • all changes are on
    • Do they need to be updated in the publication package first before the 1-week review period can start?
    • WG agreed "no," but need to send a notice to the listserv referencing the build site so that 1-week period can begin 
5 min.WGM PlanningLaura
  • combined MedMorph / Public Health FHIR Profiles Library / eCR updates – Tues. Q4
  • Helios Birds of Feather – Tues. Q5
  • Helios in Public Health WG – Wed. Q2
  • Immunization Roundtable – Wed. Q4
  • Public Health FHIR Profiles Library ballot recon – Wed. Q1

Action items