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Maria Michaels CDC
AbdulMalik Shakir Hi3Solutions
Becky Angeles Carradora Health
Craig Newman Altarum
Dan Rutz Epic
Danielle Sill Public Health Informatics Institute
Danny Wise Allscripts
Erin Holt Coyne TN Dept of Health
Jamie Parker Carradora
John Stamm Epic
Karen Bates MITRE
Karrie Schwencer HLN Consulting
Kasey Diebold CDC
Kathy Walsh Labcorp
Kristi Eckerson HLN Consulting, LLC
Ravi Kafle WA-DOH
Wendy Scharber CDC - Contractor

Chair: Erin Holt 

Scribe: Danny Wise 

Discussion items





5 min.Welcome, agenda review, meeting minute approval Erin Holtlast week's minutes approved as posted; no concerns or corrections raised
30 min.Rethinking FHIR IG contentWendy Scharber
  • implementers have expressed concern about having to reference different entire documents for similar reporting types in different "domains"
    • e.g., sending cancer data in the US vs. UK vs. Germany – due to local policy, some elements can't be made required in Europe but are necessary for reporting cancer cases in the US
    • difficult to determine the deltas at a glance
      • may only be minor differences, e.g., cardinality of a single element
  • IHE has included realm-specific constraints as appendices, or even separate volume, for "national extensions"
  • is it possible to do something similar within a given FHIR profile vs. creating separate profiles implementers have to search for and reference?
    • still difficult to easily determine the deltas between profiles
  • AMS: can adjust which profile is used as the "base" for a new profile so that the differential view shows the specific deltas between them
  • Craig: would it help to see a "lineage" of which profiles are "children" or "siblings" of other profiles?  right now, a profile only links to its own "parent"
  • Wendy: yes, that would help a lot
  • will put on the agenda for joint FHIR-I discussion during Thurs. Q1 at WGM next week
    • could also discuss during Wed. Q1 discussion about US Public Health Profiles
15 min.average blood pressure for inclusion within USCDIv4Danielle Sill


  • Average Blood Pressure has been proposed as a data element for USCDI V4 (
  • for self-monitored blood pressure, an average value can be a better indicator than a lot of individual readings
  • Why store average blood pressure vs. calculate it based on individual readings? – could be important to capture / document average values if individual observations are not available
    • USCDI doesn't specify whether to store vs. calculate, just how to exchange data – other existing USCDI elements (e.g., vitals percentiles) are often calculated
  • LOINCs have already been created for average blood pressure
  • the time period represented by average values is important to know, but how to support that can be figured out in more detail once the concept is closer to being included in USCDI
  • Public Health impact – while blood pressure is not currently reported to Public Health routinely, PHAs do work with clinicians to encourage monitoring of patients' blood pressure
  • comment submission period for USCDI V4 is currently open through Sept. 30th
    • folks in support of this new element should submit a comment indicating that
10 min.WGM agenda reviewErin Holt