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Facilitator: 

Austin Kreisler

Date:

 


Agenda:

  1. Call to order
  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Request to address Format Code Harmonization proposal in first hour Sheila Abner
    3. HL7
  3. External Updates - ONC and others
  4. Project Updates
    1. CDA R2.1 Project
    2. Value Set Issues (Next VSAC Release Package - June 2019)/C-CDA value set review

      1. Operationalizing UTG capabilities
      2. Progress on shared ValueSets across Product Families
    3. Cross-WorkGroup CDA Template Review
    4. C-CDA Companion Guide Updates (Lisa R. NelsonMatthew Rahn)
    5. C-CDA Rubric Criteria (Matthew Rahn)
    6. Consolidated CDA STU 2019 Updates (Lisa R. NelsonBrett Marquard)
  5. Additional Items
    1. Davinci CDex IG Review (Lisa or Viet?) 15 minutes
    2. Block vote for HAI FHIR IG David DeRoode 10 min
    3. Block vote for HAI CDA IG David DeRoode 10 min
    4. Harmonization proposal to add concept mp4 (video/mp4) to the MediaType code system Lisa R. Nelson and Rob McClure 15 min
    5. Harmonization proposal for Format Codes Sheila Abner 15 min
      1. 2019Jul_HARM_INITIALPROPOSAL_SDWG_sheila_abner_FormatCodes_20190613.doc
  6. FHIR Tracker Items
  7. Adjournment

Notes/Minutes:

TimeAgenda ItemNotes

14:06

  1. Call to order

Called to Order by Austin Kreisler at 


  1. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Request to address Format Code Harmonization proposal in first hour Sheila Abner
    3. HL7
  1. Business Updates
    1. Additions/modifications to the agenda
      1. Andrew Statler to update the template and remove the US Core reconciliation from the template as well as change the Patient Care representative to be Emma Jones.
    2. Will take care of this early in the meeting.
    3. HL7
      1. RIM (Austin Kreisler)
        1. None
      2. Steering Division/TSC (Austin Kreisler)
        1. June 14 - Initial Harmonization Proposals due
        2. June 17 OOC ballot final content due
        3. June 21 - OOC Ballot Open
        4. June 30 - NIBs due for Sept. Ballot
        5. June 30 - FHIR IG proposals due to FMG
        6. July 13 - Final Harmonization Proposals due
        7. July 17&18 - Harmonization meeting
      3. CDA-MG (Lisa R. Nelson / Brett Marquard )
        1. June 19 - Presentation at the CDA Management Workgroup meeting from the folks working on the tooling to support the C-CDAr2.1 updates.
      4. Vocab (Sheila Abner )
        1. Requested feedback from Rob McClure  and John Moehrke to see if they agreed on an idea to merge the code systems and transition ownership of the four existing HL7 codes.
          1. Get feedback from them on the impact on production systems. 4 existing codes and 2 new ones. 
          2. http://wiki.hl7.org/index.php?title=CDA_Format_Codes_for_IHE_XDS 
          3. Austin Kreisler Descriptions are still missing. We need to do that before tomorrow.
          4. Rob McClure This same structure is used for IHE, DICOM and other areas and they use a different pattern for numbering. They established the numbering.
          5. Austin Kreisler We cannot necessarily change the numbering.
          6. Rob McClure If we need to pack more info into the release structure, we can do that.
          7. Lisa R. Nelson In HL7 SD, we reverse engineered what we thought it needed to be. IHE does not have an official pattern. They don't have rules of what that has to be.
          8. Rob McClure That's not Rob's understanding. IHE publishes a specific structure on their wiki.
          9. Lisa R. Nelson No place on IHE.net for format codes. SD made a wiki page to make format codes. We made a rule to see the discussion of trying to do that.
          10. https://wiki.ihe.net/index.php/IHE_Format_Codes
          11. Austin Kreisler STU release 1 vs. PACP release 1.0
          12. Rob McClure People will need to be able to distinguish that.
          13. Lisa R. Nelson We need to escalate to some joint group. We use them this way for SD. When we release these as errata, this is how we release them.
          14. Austin Kreisler Normative release 1 and STU release 1 are different beasts and the way this is presented does not convey this.
          15. Rob McClure Agrees with Lisa.
          16. Austin Kreisler Once PACP 2.0 is published as normative, it will still be 1.0. Trying to steer this back to the fact that we have a whole column of missing information and we have to fill that in.
          17. Rob McClure  The Display and the Description can be the same.
          18. Austin Kreisler The Display name is probably the last two pieces of that structure.
          19. Lisa R. Nelson It should probably be IG as well. And C-CDA. 
          20. Austin Kreisler The pattern does not show that. Also it doesn't show a colon in the Codes we are using and it doesn't include IG which looks to be a literal.
          21. Rob McClure That pattern, then IG..
          22. Austin Kreisler The brackets are probably optional.
          23. Austin Kreisler We need to get this done today. If we have so much discussion that we can't agree, are we ready for harmonization. The codes do not conform to it currently. 
          24. Austin Kreisler Edited the pattern to match what we have done and is entertaining a motion.
          25. TypeMotion
            MotionTo submit this harmonization proposal
            By
            Second
            Date 
            Ref #2019Jul_HARM_INITIALPROPOSAL_SDWG_sheila_abner_FormatCodes_20190613.doc
            For18
            Neg0
            Abs0
            Status

            PASSED

            Tally18-0-0
          26. We will get this submitted.
      5. Pub facilitator (Alexander Henket )
        1. None
      6. Electronic Services and Tools (Andrew Statler )
        1. None
      7. Patient Care (Emma Jones /Lisa R. Nelson )
        1. None
      8. Example Task Force (Brett Marquard )
        1. Yes, we will have Example Task Force today


14:27

  1. External Updates - ONC and others
  1. None

  1. Project Updates
    1. CDA R2.1 Project 
    2. Value Set Issues (Next VSAC Release Package - June 2019)/C-CDA value set review

      1. Operationalizing UTG capabilities
      2. Progress on shared ValueSets across Product Families
    3. Cross-WorkGroup CDA Template Review
    4. C-CDA Companion Guide Updates (Lisa R. NelsonMatthew Rahn)
    5. C-CDA Rubric Criteria (Matthew Rahn) - unless we get how June 10 went
    6. Consolidated CDA STU 2019 Updates (Lisa R. NelsonBrett Marquard)
  1.  Project Updates
    1. Calvin E. Beebe Andy got the publication process. Just waiting to hear on that.
    2. Lisa R. Nelson Need to do the work to solidify the Value Set package. It has the list of changes line by line that has the errata. Sent out to the co-chairs.
      1. Thumbs up from Lantana and Sarah Gaunt who reviewed.
      2. Lisa's skillset is sufficient to make the changes in Trifolia.
      3. Joint Motion by SD and CDA Management Group to approve the June errata list for C-CDA as distributed previously and posted on confluence by Lisa R. Nelson
      4. CDAMG - Lisa R. NelsonBrett MarquardGeorge Dixon 3-0-0
      5. Second by Calvin E. Beebe
      6. Lisa R. Nelson discussion. Can we amend the motion to show it as a joint motion by CDA Management Group and SD? 
      7. Austin Kreisler Yes if we have quorum. Need to note the attendance of CDA Management group in the notes.
      8. Calvin E. Beebe accepts the amendment.
      9. TypeMotion
        Motion

        Joint Motion by SD and CDA Management Group to approve the June errata list for C-CDA as distributed previously and posted on confluence by Lisa R. Nelson

        By
        Second
        Date 
        Ref #2019JUN_C-CDAR2.1_Errata_list.xlsx
        For18
        Neg0
        Abs0
        Status

        PASSED

        Tally18-0-0
      10. Rob McClure noted an error with the document
      11. Lisa R. Nelson will add an STU comment
    3. Lisa R. Nelson 6 months worth of meetings that have helped to improve the quality of the CDAs that will be noted in the Companion Guide.
    4. Lisa R. Nelson Showing the Confluence site for the Companion Guide.
      1. The file of what we are proposing to go to ballot with. The team is reading over and making sure the examples are complete. The editorial and technical nature of the document. All rolled into a single guide draft that you can look at on the Confluence site. It is late for edits. If anyone wants to make changes, make notes for comments on the ballot.
      2. Awesome team coming along nicely. Big Kudos to Emma Jones. Same structure. Much elevated chapter on semantic interop. Thing from last week is the Appendix for the UDI work. Need to get some names on the Appendices. There are two.
      3. Start the clock ticking on the one week requirement. All chapters file is there and both of these appendices. Anyone that wants to take a look you can. We will ask to take a vote next week.
    5. No Updates on the Rubric
    6. Next update on June 19

  1. Additional Items
    1. Davinci CDex IG Review (Lisa or Viet?) 15 minutes
    2. Block vote for HAI FHIR IG David DeRoode 10 min
    3. Block vote for HAI CDA IG David DeRoode 10 min
    4. Harmonization proposal to add concept mp4 (video/mp4) to the MediaType code system Lisa R. Nelson and Rob McClure 15 min
    5. Harmonization proposal for Format Codes Sheila Abner 15 min
      1. 2019Jul_HARM_INITIALPROPOSAL_SDWG_sheila_abner_FormatCodes_20190613.doc
  1.  Additional Items
    1. Lisa R. Nelson First time balloting FHIR artifacts. Taking us through the FHIR artifact. Will ask for our approval that this guide is ready for ballot.
      1. The DaVinci use case was broken in 3 parts.
        1. CDex - part one was focused on providers to payers. Sharing with other providers. SD
        2. PDex - Payer Data Exchange - exchange payer information. Formulary, etc. Not SD
        3. Quality  - Quality measure data put together with other DaVinci data. Not SD
        4. HRex - Health Record Exchange - for sharing CDex and PDex. An IG over the top of this that Rick Geimer owns that supports all of this. Not owned by SD.
      2. Background Information, Use Cases, Personas, and Patient STory, Profiles and Extensions, Information Exchange Interactions and Specifications
      3. DaVinci reuses profiles - US Core STU3 (FHIR R4) Profiles & Argonaut FHIR (DSTU2) Profiles
      4. Push (POST and PUT)
      5. Push (Unsolicited)
      6. Pull (GET)
      7. Request (Solicited)
      8. Subscribe & Bulk Data are not available currently
      9. Austin Kreisler Suggestion is that if it is not complete then it is not ready for ballot. That is for the product family to decide as far as what is required to be complete. If there is content that you are are intending to provide, then you should have it before you go to ballot.
      10. Rob McClure There may be some things that people should be able to provide guidance on. They should be able to pull content in for some things. Something like a capability statement you would need to write, but other things could be pulled in automatically in theory.
      11. Lisa R. Nelson Will take the feedback and will let Robert Dieterle know and he can decide what to do with it.
      12. Rob McClure One thing to tell Bob is that because the terminology is in that other ??? that may be why it is not pulling in... That should give him something to go on.
    2. David DeRoode Block vote. minor things HAI CDA IG
      1. TypeMotion
        MotionBlock vote to accept the disposition of 5,14,29,30 from the HAI CDA IG Ballot Comment Spreadsheet
        By
        Second
        Date 
        Ref #
        For22
        Neg0
        Abs0
        Status

        PASSED

        Tally22-0-0
    3. David Johnson Block vote, HAI FHIR IG
      1. 1,9,14,15 - The same nature. Small clarification notes. George's wording. 
      2. TypeMotion
        MotionBlock vote to accept the disposition of 1,9,14,15 from the HAI FHIR IG Ballot Comment Spreadsheet
        By
        Second
        Date 
        Ref #
        For21
        Neg0
        Abs0
        Status

        PASSED

        Tally21-0-0
    4. Austin Kreisler Who owns the MediaType code - it is in all of our standards. It is in a universal code. These strings get registered. The rest of the world doesn't consider them codes. The list grows. HL7 doesn't manage that. The underlying standards all post outside of HL7 for that. HL7 needed to create a ValueSet of values that were used in the V3 to assert some conformance requirements to create some conformance requirements.
      1. A code system contained that ValueSet for that very tiny use case. That has been picked up and used outside of HL7 to represent the entire data set.
      2. Rob McClure None of us on the call were there at the beginning. There were a small number of these to represent web content. Application/text. application/xml. the ones created were all text-based. application/word. Rob's memory of this were HL7's representation of this to be represented.
      3. You take one of these from this website and these from another to create this. IANA website. HL7 codeset that points to something that we created. It states that this is not complete. And we ran into because we were missing something, WMV. It became an internal coding system. V2, V3, FHIR all say this is an external code system. This is not an internal code system. This should use a fhir naming system. Part of what is going on here is that this needs new codes or uses codes that exists in the world that don't exist in the codeset.
      4. Austin Kreisler What needs to be done is some sort of technical correction. The mistake may be in the OID Reports for 2.16.840.1.113883.5.79 that defines the OID Type for  this as an OID for an HL7 Internal Code System.
      5. Rob McClure for the advanced directive template process - the structure is that why isn't WMV in the list since it has been there for so long. Noone is concerned that it isn't in the list event though it is a correct code.
      6. Lisa R. Nelson Reduced it down to MP4. This advanced directive has this type of video in it. j
      7. Austin Kreisler This is why the standards have punted on it. IETF is handling it.
      8. Rob McClure Change this to an actual Code System. Lisa has an issue that these are actual codes and can't seem to find evidence that these exist.
      9. Austin Kreisler The standards identify how the codes are structured and how to register them.
      10. Rob McClure There should be one place to find the list of them all. Is there any issue with the list of data types.
      11. Benjamin Flessner posted on chat that "WMV is video/x-ms-wmv so it may never have been registered..." 
      12. Rob McClure We can keep the ValueSet as is, but we wouldn't keep the CodeSystem any more.
      13. Austin Kreisler What we don't know is if that would break publishing. @Andy Stetchen might know.
      14. Austin Kreisler One of the mistakes years ago was to try and treat these as terminology.
      15. Rob McClure Will be easier if we try and treat these inside of UTG. Take these out of CDA.
      16. Austin Kreisler We would entertain a motion to submit a harmonization request. 
      17. TypeMotion
        MotionSubmit a harmonization proposal to change the media type code system to an external code system and keep the same OID.
        By
        Second
        Date 
        Ref #
        For21
        Neg0
        Abs0
        Status

        PASSED

        Tally21-0-0
    5. Covered at beginning of meeting

15:33

  1. FHIR Tracker Items
  1. No Items prepared to review

15:33

  1. Adjournment
  1. Adjourned