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Facilitator:

Austin Kreisler

Date:


Minutes Approved as Presented 


This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."

Attendees:

 Click here to expand...

Agenda:

  1. Call to order
  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Approve minutes from 2019-08-22 Agenda and Minutes
    3. HL7
  3. External Updates - ONC and others
  4. Project Updates
    1. Value Set Issues

    2. Consolidated CDA Ballot Comments
    3. Consolidated CDA STU 2019 Updates Lisa R. Nelson Brett Marquard
    4. C-CDA Companion Guide Reconciliation
    5. Other Project Updates
  5. Additional Items
    1. Precondition2 Extension - Motion to accept into SDTC
      1. Motion to accept the Precondition extension was tabled  pending updates to the CDA R2 Extensions page.
    2. Final ODH Publication Package approval
    3. Final HAI R3D4 CDA IG Package approval
      1. http://www.hl7.org/documentcenter/public/wg/structure/20190816_PREPUBLICATION_REVIEW_CDAR2_IG_HAIRPT_R3_D4_2019AUG.zip
    4. Block vote for CDA IG Quality Criteria ballot (Austin Kreisler)
      1. Friday's CDA IG Quality Criteria Ballot reconciliation call is canceled this week.
    5. CDA R2.1 Publishing (Lisa R. Nelson)
    6. Atlanta Agenda Review
    7. Update on the ISA Review Meeting
  6. US Core FHIR Trackers (second hour)
  7. FHIR Tracker Items (if time is available)
    1. Composition confidentiality #17301
  8. Adjournment

Notes/Minutes

Agenda:

  1. Call to order
  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Approve minutes from 2019-08-22 Agenda and Minutes
    3. HL7
      • RIM Austin Kreisler
        • No RIM
      • Steering Division / TSC Austin Kreisler
        • CDAr2.1 approved by TSC and approved by Steering Division
        • HQ has to submit to ANSI. That could take up to 6 weeks. Won't go up immediately. Through all HL7 processes.
      • CDA-MG Lisa R. Nelson Brett Marquard
        • Lisa R. Nelson Not on meeting yesterday
        • Not much more than approval of the CDAMG product pages.
        • Will be meeting on Monday Q4 at the WGM and will provide updates on Wed Q1 SD meeting.
        • Austin Kreisler Do CDAMG reach out to other Work Groups?
          • Patient Care, FM, and Pharmacy. Linda has been working on FM. Patient Care from Lisa. Pharmacy was going to be Kai or Jean Duteau, but that is not happening.
          • Austin Kreisler is concerned that the quality is not getting rolled out to the other workgroups and will come as a shock to other workgroups.
          • Lisa R. Nelson as soon as we finalize the IG quality criteria ballot, then we will have outreach to each of the workgroups.
          • Austin Kreisler we've already tightened the requirements on Structured Documents, but have we notified others.
          • Lisa R. Nelson can put Russ Ott on the to-do list. Handle it on a publication request.
          • Andrew Statler send out a message to say it's coming.
          • Lisa R. Nelson can do that.
          • Calvin E. Beebe a short educational session on how it is done.
          • Austin Kreisler an opportunity in Atlanta to get 5 minutes to pitch quality. Hoping to get the IG Quality Criteria wrapped up at the WGM. Austin gave Lisa 5 minutes at co-chair dinner.
      • Vocab Sheila Abner
        • nothing. call this afternoon
      • Pub facilitator Alexander Henket
        • Alex is not on.
      • Electronic Services and Tools Andrew Statler
        • FHIR issue tracking tool
        • CDAMG has been leading discussions for CDA comments
        • Need to work with Austin to coordinate a meeting on this
      • Patient Care Emma Jones 
        • None
      • Example Task Force Brett Marquard
        • Not meeting today
  3. External Updates - ONC and others
    1. ISA Comments
      • Calvin E. Beebe managed to pull together the comments for the ISA and get those posted before the deadline.
  4. Project Updates
    1. Value Set Issues

      1. Lab Report Narrative with Attachments that affect C-CDA. PIE workgroup will be taking this up. Document ontology. Tuesday Q1.
    2. Consolidated CDA Ballot Comments
      1. No comments
    3. Consolidated CDA STU 2019 Updates Lisa R. Nelson Brett Marquard
      1. Will talk about at WGM with Wayne. Still seems possible, but seems like a longer timeframe. May take longer to get there.
    4. C-CDA Companion Guide Reconciliation
      1. Block vote for today

        TypeMotion
        Motion

        Motion to approve the 08-29-2019 block vote for the Companion Guide ballot

        By
        Second
        Date

         

        Ref #7, 93, 139, 146, 149, 150, 154, 173, 182, 195, 199, 200, 202, 203, 204, 209, 210, 211, 212, 215, 217, 218, 220, 222, 223, 230, 231, 243, 244, 246, 247, 248, 249, 250, 261, 263, 268, 277, 279, 286, 287, 293, 296, 301, 302, 305, 314
        For22
        Neg00
        Abs00
        Status

        APPROVED

        Tally22-00-00
        Discussion

        Austin Kreisler asked if anyone would like to pull any items?

        No response.

      2. Lisa R. Nelson has some items she is preparing for workgroup meetings to discuss, but none to discuss here.
    5. Other Project Updates
      1. None.
  5. Additional Items
    1. Precondition2 Extension - Motion to accept into SDTC
      1. Motion to accept the Precondition extension was tabled  pending updates to the CDA R2 Extensions page.

      2. The page was not yet updated to show the precondition2
      3. TypeMotion
        Motion

        Motion to untable the Precondition extension from  

        By
        Second
        Date

         

        Ref #2019-08-22 Agenda and Minutes
        For22
        Neg00
        Abs00
        Status

        APPROVED

        Tally24-00-00
        Discussion


        Lisa R. Nelson is wondering if we need more information 

      4. missed the current ballot. Can get it on the Feb 2020 ballot. Will need to get NIBs together for the Feb ballot soon.
    2. Final ODH Publication Package approval
      1. Not ready to move forward yet. Number of issues identified and the new package has not been identified yet. Expecting that later today. Will move this to next week.
    3. Final HAI R3D4 CDA IG Package approval
      1. http://www.hl7.org/documentcenter/public/wg/structure/20190816_PREPUBLICATION_REVIEW_CDAR2_IG_HAIRPT_R3_D4_2019AUG.zip
      2. Calvin E. Beebe reviewed. It looked really good. We had an item about descriptions and templates. Based on a closed community and they know the documents they want.
      3. Austin Kreisler ran all the schema files through and they were clean.
        1. Did anybody else review the package?
        2. Is there a publication request. for us to review?
      4. David DeRoode needs to provide the publication request. Sarah did not provide it.
      5. Publication request is not in the package.
      6. TypeMotion
        Motion

        Motion to have them submit it to the co-chairs for review and approval

        By
        Second
        Date

         

        Ref #

        HAI R3D4 CDA IG Package

        For22
        Neg00
        Abs00
        Status

        APPROVED

        Tally22-00-00
        Discussion


    4. Block vote for CDA IG Quality Criteria ballot (Austin Kreisler)
      1. Friday's CDA IG Quality Criteria Ballot reconciliation call is canceled this week.

      2. Contains comments from Lisa R. Nelson 

        TypeMotion
        Motion

        Motion to approve the block from last call

        By
        Second
        Date

         

        Ref #52,53,54,55,56,57,58,59,60,61,62,63,64,65,67,76,78
        For22
        Neg00
        Abs00
        Status

        APPROVED

        Tally22-00-00
        Discussion

        Does anyone want to pull anything from the block?

        Any discussion?

         Call is cancelled. Will pick it back up next week. Austin Kreisler will post the triaged version. If people can review those, we may be able to complete it on the next call.

    5. CDA R2.1 Publishing (Lisa R. Nelson)
      1. on the HL7.org standards page, each of the standards for CDA was listed on a separate row. What we did with C-CDA is create a way to list them on the same page. It has also been applied to QRDA1 and QRDA2. We are proposing it be applied to the base CDA standard. Would like to generate a single page for the base CDA standard.
        1. Lisa went through the CDA publication request and in there, it populates the master grid. She found the corresponding areas where copy was put forward. She used that info to populate the new publication request for the consolidated page.
          1. CDAr2.1 and CDAr2.0 will be listed as Normative Releases without implying the previous version is no longer allowed. Each standard will eventually get tagged as Active or Archived.

            TypeMotion
            Motion

            Motion to approve the publication document that Lisa Nelson reviewed during the meeting.

            By
            Second
            Date

             

            Ref #
            For23
            Neg00
            Abs00
            Status

            APPROVED

            Tally23-00-00
            Discussion


    6. Atlanta Agenda Review
  6. US Core FHIR Trackers (second hour)

    TypeMotion
    Motion

    Motion to dispose of these three as not considered future use

    By
    Second
    Date

     

    Ref #237662371523716
    For22
    Neg00
    Abs00
    Status

    APPROVED

    Tally22-00-00
    Discussion


    TypeMotion
    Motion

    Motion to remove the CapabilityStatement rest.resource.profile elements

    By
    Second
    Date

     

    Ref #23779
    For21
    Neg00
    Abs00
    Status

    APPROVED

    Tally21-00-00
    Discussion


    TypeMotion
    Motion

    Motion to remove the "maxValueSet" extension from the definitions for the four profiles. Remove sections in guidance and profile summaries that mention the 'extensible+max' binding.

    By
    Second
    Date

     

    Ref #23773
    For21
    Neg00
    Abs00
    Status

    APPROVED

    Tally21-00-00
    Discussion

    Robert Hausam thinks that is fine as long as people think that is acceptable to have extensible codes that are not in the valueset. Are we okay with expecting people to. Add a statement of some kind making clear that the data could be sent using the ValueSet, then it must be coded.

    Serafina Versaggi coding and exchanging in FHIR. wouldn't they be coding for their own internal purposes?

    Brett Marquard Send whatever they want, vs. send a matching code, then they will send it the first way. We want them to send coded concepts.

    Austin Kreisler Does mover and seconder accept the amendment as stated.

    Robert Hausam will withdraw the amendment based on the idea that the base standard states the same.


    TypeMotion
    Motion

    Motion to add a discussion in the future work section about the importance of timezones and the time offsets

    By
    Second
    Date

     

    Ref #23778
    For21
    Neg00
    Abs00
    Status

    APPROVED

    Tally21-00-00
    Discussion

    If you just communicate a time - 5, that doesn't really communicate time. You really need to communicate timezone. A survey was sent out about time zone. 7 responses and the responses are across the board. Not require anything right now. Can't require anything right now without having a bigger conversation.

    Eric Haas This is where we are and these are the options. 

    Lisa R. Nelson What are the options?

    Brett Marquard There are many. Several EHRs have UTC or zulu time and have options to display the appropriate thing. Comes from US Realm or US Core. 

    Calvin E. Beebe US Realm is the solution for FHIR exchange. It would be really unfortunate if the US realm solution could not handle. At least get the offsets. Is that the result of saying nothing?

    Brett Marquard What did we say about offsets?

    Eric Haas Nothing said before about timezone offsets. They weren't forbidden but they weren't required.

    Brett Marquard Need to continue this discussion in the FQ updates.

    Calvin E. Beebe We have to encourage offsets.

    Brett Marquard Can add it to future work.

    Calvin E. Beebe let's call the motion.


  7. FHIR Tracker Items (if time is available)
    1. Composition confidentiality #17301
      1. Sean McIlvenna was not present today
  8. Adjournment

 

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