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Facilitator:

Austin Kreisler

Date:


Minutes Approved as Presented 

x

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 2019-10-10 Agenda and Minutes
    3. HL7
      • RIM Austin Kreisler
      • Steering Division / TSC Austin Kreisler
        • Approaching Deadlines
        • OCT 4th - WG PSS Approval Deadline 2020MAY (PAST)
        • Nov. 3rd - FHIR IG Proposals Due
        • Nov. 7th - Harmonization Initial Proposals Due
        • Nov. 17th - NIB Deadline
        • Nov. 17th - FHIR IGs substantively complete
        • Nov. 21st - Harmonization Final Proposals Due
        • Dec. 5th - Harmonization meeting
        • Dec 22nd - Final Content Deadline
        • Dec. 27th - Ballot Open for Voting
      • CDA-MG Lisa R. Nelson Brett Marquard
      • Vocab Sheila Abner
      • Pub facilitator Alexander Henket
      • Electronic Services and Tools Andrew Statler
      • Patient Care Emma Jones 
      • Example Task Force Brett Marquard
  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 Lisa R. Nelson
      1. Review Discovered Items
      2. Review of final content
      3. Approve final reconciliation package
    5. Other Project Updates
  5. Additional Items
    1. Vital Sign value set alignment follow up
    2. Support for SNOMED CORE Problem List Subset of SNOMED CT - Any SDWG actions for this issue?
  6. US Core FHIR Trackers (second hour)
    1. Tracker item discussion
      1. Add HCPCS to US Core Procedure.code value set (GF# 24925)
      2. Add ICD9/10 to US Core Condition.code value set (GF# 24924)
    2. Approve US Core publication request
      1. 20191011_HL7_Publication_US_Core_STU3.1.0.docx
  7. FHIR Tracker Items (if time is available)
  8. Adjournment

Notes/Minutes

  1. Call to order
    1. 10:04am EST
  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
      1. Rubrics we will review in a couple of weeks.
      2. e-mail to listserv last week.
        1. Yes - Rob has action
      3. 2nd hour - core tracker items.
      4. approve US Core publication request
      5. FHIR Tracker items if any
      6. Becky - need to add Supp. Nutrition Templates
    2. Approve minutes from 2019-10-10 Agenda and Minutes
      1. Minutes from last week are approved by general consent.
    3. HL7
      • RIM Austin Kreisler
      • Steering Division / TSC Austin Kreisler
        • Approaching Deadlines
        • OCT 4th - WG PSS Approval Deadline 2020MAY (PAST)
        • Nov. 3rd - FHIR IG Proposals Due
        • Nov. 7th - Harmonization Initial Proposals Due
        • Nov. 17th - NIB Deadline
        • Nov. 17th - FHIR IGs substantively complete
        • Nov. 21st - Harmonization Final Proposals Due
        • Dec. 5th - Harmonization meeting
        • Dec 22nd - Final Content Deadline
        • Dec. 27th - Ballot Open for Voting
      • CDA-MG Lisa R. Nelson Brett Marquard
      • Vocab Sheila Abner
        • No updates
      • Pub facilitator Alexander Henket
        • No updates
      • Electronic Services and Tools Andrew Statler
        • Tool Catalog Review
      • Patient Care Emma Jones
        • C-CDA US REalm set of templates and see how it compares to another realm set of templates
        • Nov 4 is the next call
        • Started reconciling the negation project. Meeting every other Tuesday. Trying to get that work finalized and done. Tuesdays at 5pm EST. 
      • Example Task Force Brett Marquard
        • No Example Meeting today.
  3. External Updates - ONC and others
    1. No external updates.
  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 Lisa R. Nelson
      1. Review Discovered Items
        1. best effort to bring together what we've learned around best practice with C-CDAr2.1 since we would not be able to do a C-CDAr2.1 update. The ballot we did in September did not pass. Over 400 comments. People holding over for improvements. 16 negatives withdrawn in order to pass. It is very important to get this to move forward. That is one of the biggest risks. Where we are today. The Confluence page is the source of everything going on. All the consolidation and reconciliation. One that we need to vote on.
        2. There is a hot-link to the members only area with the Draft-Final Package for Review.
        3. Care Plan samples will be finished later today or tomorrow. Not part of the sample package. There as a courtesy.
        4. In terms of risk mitigation. Had to drop two sample files. Did not have time to do an additional Consultation Note and an H&P.
          1. There are samples of Encounter Summaries, Discharge Summaries, others.
          2. There is a registry that is responsive and will have a current version on Confluence with an online resource if sample files come in.
        5. Package is out there posted.
        6. Brand new Provenance was born without a version. The technical correction being put forward is to approve adding the version label to that template. Added number 410 to the ballot reconciliation package.
        7. TypeMotion
          Motion

          Motion to approve item number 410, technical correction

          By
          Second
          Date

           

          Ref #410
          For27
          Neg00
          Abs00
          Status

          APPROVED

          Tally27-00-00
          Discussion

          This was pre-approved by the co-chairs

        8. TypeMotion
          Motion

          Motion to accept the ballot reconciliation package as complete

          By
          Second
          Date

           

          Ref #
          For27
          Neg00
          Abs00
          Status

          APPROVED

          Tally27-00-00
          Discussion

          no discussion

      2. Review of final content
      3. Approve final reconciliation package
        1. Will vote on  in conjunction with CDA Management Workgroup. The ballot needs to pass (people need to pull their negative ballots. 
        2. Sending a reminder at the end of the week and again at the beginning of next week would be enough, rather than every day.
    5. Other Project Updates
  5. Additional Items
    1. Vital Sign value set alignment follow up
      1. Rob McClure
        1. Multi-threaded process - FHIR group... SD is still the responsible party for C-CDA content. The FHIR approach is owned by I&O. CIMI is working on Vital Signs profiles. Susan is asking the CIMI group to look at the use cases and the various parties to utilize a common base for the parties. If CIMI does that, it may resolve to harmonization proposal to formalize that. Rob may put together a harmonization proposal to create multiple use-case directed views of Vital Signs directed base. An approach that could come to some base. Harmonization proposals are due Nov 7.
        2. What is recommended won't happen immediately, correct?
        3. 2 value sets that will change. Eric has already pre-applied them.  The biggest technical problem has already been addressed. The use case does not have a demanding timeline on it. When people agree there should be a common timeline on this approach, then we need to go through a harmonization process.
    2. Support for SNOMED CORE Problem List Subset of SNOMED CT - Any SDWG actions for this issue?
      1. regularly updated. VSAC is not. Will be. Why are things showing up that are not.
      2. Is there an action item. No. It is being handled outside of HL7. There is some confusion about what a Core problem list is.
      3. Lisa R. Nelson How does it compare to the Problem Value Set? Core problem list is a subset. (may also be from a different hierarchy?)
        1. Rob McClure to look at this question and report back.
      4. Austin Kreisler - if there is action to take, then there should be an STU Comment.
    3. Nutrition CDA IG Renewal
      1. Supplemental Nutrition for CDA IG. That is Expired. Expiration July 2019. 2 year STU period. Just balloted last year?
      2. Andrew Statler to work with Becky Gradl to create a publication request for Nutrition Templates.
    4. STU Comment 1872
      1. Withdraw Comment - Not a standards question - Disposition - Not Related
      2. TypeMotion
        Motion

        Motion to approve the disposition of 1872

        By
        Second
        Date

         

        Ref #1872
        For27
        Neg00
        Abs00
        Status

        APPROVED  

        Tally27-00-00
        Discussion

        None

  6. US Core FHIR Trackers (second hour)
    1. Tracker item discussion
      1. Add HCPCS to US Core Procedure.code value set (GF# 24925)
        1. TypeMotion
          Motion

          Motion to approve this tracker to add HCPCS

          By
          Second
          Date

           

          Ref #GF# 24925
          For31
          Neg00
          Abs00
          Status

          APPROVED  

          Tally31-00-00
          Discussion

          Haven't been able to use HCPCS without having HCPCS as part of this ValueSet.

          Can you have two CodeSystems in the same ValueSet where there are overlapping meanings?

          Rob McClure Need to manage that in some forum. This is not the forum to manage that. Forum is Vocab. Overlapping meanings is done extensively in other places and has happened for years.

          Peter Muir You shall always identify the CodeSystem when you send the value. When you send, should not send the CodeSystem and the codeable concept. It seems like it is worthwhile having that specified.

          Brett Marquard This motion is about adding a CodeSystem to a ValueSet.

          Linda Michaelsen Do these CodeSystems include the modifiers? Yes.

          Possible amendment was not accepted.

          Vote on original motion.

          Motion approved.

          Extensive discussion on SnoDent and how to handle the issue of publishing multiple CodeSystems into a single ValueSet.

      2. Add ICD9/10 to US Core Condition.code value set (GF# 24924)
        1. TypeMotion
          Motion

          Motion to approve the tracker item as documented in GForge

          By
          Second
          Date

           

          Ref #GF# 24924
          For29
          Neg00
          Abs00
          Status

          APPROVED  

          Tally29-00-00
          Discussion

          ICD-9-CM, ICD-10-CM

          The name of the ValueSet to be named to US Code Condition.code Value Set

          ICD-9-cm should only be used when querying for historical patient data. historical is data that was recorded prior to Oct 1, 2015.

          New data should be recorded using SNOMED and ICD-10-CM.



    2. Approve US Core publication request
      1. 20191011_HL7_Publication_US_Core_STU3.1.0.docx
        1. TypeMotion
          Motion

          Motion to approve the publication request

          By
          Second
          Date

           

          Ref #20191011_HL7_Publication_US_Core_STU3.1.0.docx
          For29
          Neg00
          Abs00
          Status

          APPROVED  

          Tally29-00-00
          Discussion

          No Discussion

  7. FHIR Tracker Items (if time is available)
  8. Problem Value Set Technical Issue
    1. Core Problem List & Problem ValueSet
      1. Rob McClure Opinion - those two events causing misalignment
        1. fall in home - in the problem hierarchy
        2. term info did include events
        3. It's a bigger issue.
        4. That would be a comment that we need to pass (not an errata).
        5. Lisa R. Nelson Now that we have guidance around it.
  9. Lisa R. Nelson - trying to find the current version of C-CDA on FHIR
    1. Sean McIlvenna can send the build location
  10. Adjournment
    1. 11:54am EST

 

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