Friday Q4 PHWG WGM Minutes

Confirm Facilitator assignments

• Do we really need work group facilitators anymore?
• Project teams are expected to come with their needed facilitators identified.
• With the move to UTG, and away from the harmonization process, we may need to have a terminology UTG rep.
• AMS- publishing and vocab facilitator could be really useful. He ends up doing all the facilitating on his projects. Vocab hasn’t been as bad. With publishing, especially with FHIR, can be problematic if you haven’t been really following any changes to the FHIR publishing which seems to be common.
• It would be helpful to have someone from the UTG WG to come to the workgroups to talk through expectations.
• AMS is following UTG for MnM, and comments and coordinates votes for MnM.
• TO DO- Will reach out to someone (Jess Bota) from UTG to come to one of our Co-chair calls to discuss.
• TO DO- Could Sarah G possibly serve as publishing facilitator? She could provide updates to the workgroup on FHIR publishing

Schedule for conference calls for next period

• Thursday’s at 4pm eastern, no change
• Meeting agenda page updated

• Danny has been reviewing
• Erin will take over for this next period
• Proposal worth noting-Project to increase consistency & quality of FHIR Implementation Guides (IG of IGs) PSS-1801
• While this project is needed, should it be an implementation guide?
• We need documentation classification scheme
• There seems to be three types of guidance documents that manifest as Implementation guides but are actually very different.
• Other management groups have developed quality criteria
• What is the relationship between this for FHIR and the other management groups? Instead of sponsors, should they just be interested parties?
• Conformance guidance should be consistent, but quality guidance may very
• The title indicates that this is specific to FHIR, however comments on the project page suggest that this extends to other products.
• There is increased interest in creating reusable libraries of profiles. The more a profile is used, its likely that it becomes more and more abstract as its relaxed over time to accommodate new/additional use cases. May need another method of constraining to allow for overriding inherited constraints, to avoid a situation where the profile becomes relaxed.
• PH WG submitted comment on the project to seek clarification on the scope of the project.
• PH WG also submitted a comment to suggest development and use of a classification scheme for FHIR IGs so that libraries, architectures, guidance, and implementable workflow IGs can be sorted and distinguished.
• This guidance is expected to impact existing tooling supporting the development and publishing of the FHIR IGs

New Vaccination listserv

• VCI will be setting up a new vax list serve.
• PH now has two list serves for which members can sign up
• Access this through the main webpage
• Manage My Listserv Subscriptions | HL7 International

 https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2022-medicare-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care

• Comments due to PAC by June 14^th
• COPY EMAIL for notes
• Promoting Interoperability – Hospitals will now have to do Imm, Syn, ELR, and eCR in order to get the 10 points for their score. They could also exchange with an additional registry for bonus points. There is also a change for Syn, moving from Urgent Care to ED. This seems to make it easier for implementing. May want to make a comment on this.
• Three RFI questions were posed to PH:
• How could technical approaches utilizing the FHIR® standard enhance existing data flows required under the public health measures? What are promising FHIR-based approaches to public health reporting use cases that ONC and CMS should explore for potential future consideration as part of the Promoting Interoperability program and the ONC Health IT Certification Program?
• To what degree are PHAs and individual states currently exploring API-based approaches to conducting public health registry reporting? What other factors do stakeholders see as critical factors to adopting FHIR®-based approaches?
• What potential policy and program changes in CMS and other HHS programs could reduce health care provider and health IT developer burden related to measures under the Health Information Exchange and the Public Health and Clinical Data Exchange objectives?
• Need to put this out to the workgroup and then discuss on the next call. Will schedule time for the call on the 10^th to discuss and leave us time to formalize response to PAC.
• Deadline to PAC is June 14, deadline to CMS is June 28^th.
• This is definitely focused on Hospitals. As long as the EHRs support these items, the burden then falls on the hospitals to implement. Not all EHRs can currently support.
• Questions regarding certifications for implementations using the APP versus direct connections
• Provider version of this expected later in July

Review project portfolio

• Not much ballot recon coming up
• Plan to spend time going through projects, confirming project health metrics and deadlines, and outstanding STU/JIRA comments
• Will notify the WG on the June 3^rd call that co-chair project liaisons will reach out to project leads to schedule time on a call to review:
• Current Status
• Short term goals
• Overview of JIRA issues and plan to deal with them
• Document Library/pointers
• Update Project page on Project Roadmap
• Publish reoccurring project call schedule and details

Project scope statement (PSS) status and plans

• Nothing that we didn’t already know about
• International Patient Access – less about profiling clinical content, and more about how you access. It might relate to IPS.
• Not sure of the impact on us. We will likely hear more about it when they get to immunization

Ballot and harmonization planning 

• Expecting a handful of items to go to ballot in sept. Probably a good idea to get your nibs in now

Draft agenda for next WGM 

• Meeting expected to be in eastern time zone for the next meeting
• Will keep Kickoff on Monday Q3 since this meeting is a plenary (MQ1)
• Wed Q4- Split with CIC ‘all things registry’ meet up
• Tues Q4- Split with Pharm (Joining Pharm)
• Fri Q2- admin wrap up. Not meeting Friday Q3 and Q4

Room request for next WGM

• Will look for a notice from HQ

New business

• We have a lot of projects and need to be efficient in their management. But have we become so efficient in our ballot recon and project management that we loose awareness and insight into the details and nuance of the project and resolutions. With some projects, blocks aren’t even reviewed and the process seems a bit like rubber stamping. Some projects are really good about providing summaries. What is the threshold? Right now we have a 50 comment max for any block vote. Do we need to reduce this? Also need to emphasize need to ID who the comment was from.
  • A lot of projects hold their own calls outside of the workgroup for drafting resolutions. Need to remind folks that these calls are open to the public (or open to anyone in the workgroup) and maybe we need a confluence page outlining the general pattern of these calls. Also concerns with where project materials are being stored and accessibility by the workgroup.
  • Will add a discussion on ballot recon and block votes for next Thursday’s agenda.
• Co-Chair elections
• Erin, Laura, Danny, Craig all planning to rerun
• Terms are 2 years
• Election is in July, term begins in January
• Must get an affirmation from a current co-chair and a work group member that person running is an active member of the workgroup and capable of serving