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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:

Austin - austin.j.kreisler@leidos.com Host

Susan Langford - Susan_Langford@bcbst.com

Holly Miller, MD - hmiller@medallies.com

Jeff Brown - jeff.brown@cigna.com

Dave Carlson (NMC) - dcarlson@mieweb.com

Andrew Statler - astatler@cerner.com

Matt Szczepankiewicz - mszczepa@epic.com

Thomson - tmk000@gmail.com

Dave deRoode - david.deroode@lantanagroup.com

Becky Gradl @ Academy of Nutrition and Dietetics - bgradl@eatright.org

Sheila - sha8@cdc.gov

Scott Brown - sbrown@advaultinc.com

Brett - brett@waveoneassociates.com

David Riddle - driddle@cerner.com

Benjamin Flessner - benjamin@redoxengine.com Host

Natasha Kreisle - nkreisle@max.md

Joe Lamy - joseph.lamy@ssa.gov

George Dixon - george.dixon@allscripts.com

Didi Davis - ddavis@sequoiaproject.org

Sean McIlvenna - sean.mcilvenna@lantanagroup.com Host

Rob McClure - rmcclure@mdpartners.com

Lisa Nelson - LNelson@max.md

Thomson - tmk000@gmail.com

Linda - linda.michaelsen@optum.com


Agenda:

  1. Call to order
  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Approve minutes from 2020-03-26 Agenda and Minutes
    3. HL7
  3. External Updates - ONC and others
  4. Project Updates
    1. Value Set Issues (@ Lisa R. Nelson and Rob McClure )

    2. C-CDA Rubric Informative Guide Matthew Rahn or Gay Dolin (From Gay:  Draft for review should be available next week)
    3. Conflict between CDA constraints and a RIM 2.07 Constraint (Brett Marquard Didi Davis )
    4. Provenance (Lisa R. NelsonBrett Marquard@David Riddle)
    5. Other Project Updates
  5. Additional Items
    1. HAI R3 Normative Ballot David DeRoode
  6. FHIR Tracker Items (if time is available)
  7. Adjournment

Notes/Minutes

  1. Call to order
    1. Meeting started at 11:03 EST
  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
      1. Agenda was reviewed, no changes
    2. Approve minutes from 2020-03-26 Agenda and Minutes
      1. Meeting minutes were approved by general consent
    3. HL7
      • RIM (Austin Kreisler)
        • No updates
      • Steering Division / TSC (Austin Kreisler)
        • No updates
      • CDA-MG (Lisa R. Nelson, Brett Marquard)
        • Consolidated CDA Implementation-a-thon that will be Virtual and will happen the second half of May. Stay tuned.
      • Vocab (Sheila Abner)
        • Sheila - Healthcare Service Locations. May need Rob for that and so may need to push to another call.
      • PEST Facilitator (Alexander Henket)
        • only need one contact for the combined group
      • Electronic Services and Tools (Andrew Statler)
        • Andrew will be the contact for PEST
        • Zoom is being used
      • Patient Care (Emma Jones
        • no updates
      • Example Task Force (Brett Marquard)
        • Yes, we are meeting today. COVID-18 and C-CDA
  3. External Updates - ONC and others
    1. No external updates
  4. Project Updates
    1. Value Set Issues (@ Lisa R. Nelson and Rob McClure )

      1. Rob McClure lot of JIRA tickets. Not a systematic way to deal with C-CDA JIRA tickets. Some of which impacts ValueSet tickets.
      2. Need to start dealing with this. Can't just deal with this as a side project.
      3. Austin Kreisler clarification - it is still STU comments
      4. Lisa R. Nelson Each year we look through the STU comments. Place to record issues. Don't really have another spot for that. No good way to say which of these STU comments has been addressed and implemented where. Last year we did a major effort. ValueSet and errata update to fit these together. Static sets turned to Dynamic. Created a definitive list of which errata issues were updated. All of the STU tickets in the range were in the Excel sheet were addressed. Anything below the blue, can't really say what the status is. If it is marked with pink, it is ValueSet, but don't really know what the status is.
      5. Lisa R. Nelson Above the green line. 29 pink STU comments. 4 orange ones that are maybe issues. Only have a few weeks to go through the heavy lift of what is going to be covered in the next release. The timeline. Concern or call for additional resourcing help. Package release request 5 weeks or so. What do these 29 comments or so need?
      6. Austin Kreisler We cut the meeting time down because of availability. If we go back to 2 hours so that we can work through these, would Lisa R. Nelson be available? (Lisa R. Nelson Yes)
      7. Lisa R. Nelson Smaller group will meet to identify issues to bring to the group. It is a google sheet.
      8. Sheila Abner 1856 is an important one for the testing program.
      9. Rob McClure One of the things we need to do is to have people go in and highlight or go to the small group meeting and triage.
    2. C-CDA Rubric Informative Guide Matthew Rahn or Gay Dolin (From Gay:  Draft for review should be available next week)
      1. No updates
    3. Conflict between CDA constraints and a RIM 2.07 Constraint (Brett Marquard Didi Davis )
      1. Deep topic. Few examples and then go from there. C-CDA Companion Guide. DiDi's group did some testing. Did testing against the RIM. When using a UUID they shall all be uppercase. There are documents where UUID documents where the UUID is not uppercase.
      2. NPI with a root where it doesn't align. That has been validated with M&M as the correct approach.
      3. Sequoia or other implementations out there, is there something where we need to bring those issues out there. How do we want to do that?
      4. C-CDAR2.1 and the rules in the guide are the rules you follow. Schematron + the Schema of 2.0?
      5. When the implementer has something that doesn't make sense.
      6. Don't do the onsie/twosie.
      7. Not a full pros/cons
      8. Don't want to see the enforcement of RIM rules in place 10-15 years ago getting in the way of current practice.
      9. issues with the old version of the RIM have been addressed in the more recent version. But that would be the more recent.
      10. In an ideal world, we could put some of these things on Confluence and then create a JIRA tracker.
      11. in 2005 we could track and report and put these to rest. There are millions of documents out there and they are not compliant.
      12. people did not design to the original RIM requirements in the US
      13. Andrew Statler going forward, we need to look at the dates on the documents and hold them to be compliant.
      14. Austin Kreisler We could look at the documents as being warnings. Don't want to impose a bunch of extra work on people when it doesn't impact interop.
      15. Didi Davis agree that we don't want to impact interop.
      16. Brett Marquard there are some things that impact interop. The only way to do that is to go line by line and determine which ones will. It is not a slam dunk. Someone has to go through them. Does it increase the value of the exchange? Some of them it is difficult to determine. It will create a lot of warnings.
      17. Andrew Statler A standard is a standard. I want to be accountable as a vendor.
      18. Brett Marquard limited resources... want to fix relevant issues like allergies vs. irrelevant issues like UUID
      19. Austin Kreisler We will have one more phone call in two weeks. We want Calvin to be involved. We'll schedule a separate call to go through the details.
    4. Provenance (Lisa R. NelsonBrett Marquard@David Riddle)
      1.  
      2. It's about the Header. The author is the author and there is no linking between the two.
      3. Lisa Anderson Author and the Assembler 
      4. Lisa cleaned up the example from last week.
      5. Personal Advanced Care Plan Document
      6. The organization. The people can record their wishes in the system. Helps them create interchangeable documents with the hospital or care system.
      7. The situation is how to represent the additional authoring provenance. The engagement of the system of the system and organization of the document itself.
      8. No question of the patient authored document.
      9. How do we express the system and the org that is involved in expressing this.
      10. A non-templated author 
      11. Authoring device that is the software. 
      12. The org that produces the platform is listed as the represented organization
      13. In the header, listed a participant as the type of assembler. Also represented the scoping organization as the same organization 
      14. Assembler being an organization that pulls information together without altering information.
      15. Proposed solution for the comment of how to represent the author in this situation.
      16. Where we were last week. not doing anything special to try and invoke bloat reduction by utilizing id
      17. TypeMotion
        Motion

        Motion to accept this representation as a way to semantically represent this in C-CDA

        By
        Second
        Date

         

        Ref #
        For19
        Neg00
        Abs00
        Status

        APPROVED

        Tally19-00-00
        Discussion


    5. Other Project Updates
  5. Additional Items
    1. HAI R3 Normative Ballot David DeRoode
        1. Austin Kreisler anyone identify issues that need to be corrected?
        2. One typo that we are going to fix.
      1. TypeMotion
        Motion

        Motion to approve the ballot as submitted

        By
        Second
        Date

         

        Ref #
        For18
        Neg00
        Abs00
        Status

        APPROVED

        Tally18-00-00
        Discussion
        1. no discussion
  6. FHIR Tracker Items (if time is available)
  7. Adjournment
    1. 11:55am Adjourned
    2. Example Task Force is next.

 


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