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Facilitator:

Austin Kreisler

Date:


Call Details:


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Zoom Information

https://us02web.zoom.us/j/465862913?pwd=cUllR1BndVpYNVpyR3dzc3VIUERTZz09

Meeting ID: 465 862 913

Passcode: 310940

Phone Information:

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Find your local number: https://us02web.zoom.us/u/kb1hK2eKvz




Attendees:


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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."

Agenda:

10:00am EST

  1. Call to order
    1. Call for Attendance - Please click the "Sign In" button at the top of the Agenda Page for today's meeting. Once you have signed in, it will indicate you have already signed in and place your name in the Attendees drop down list.

  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Approve minutes from 2020-04-29 Agenda and Minutes

    3. HL7
  3. External Updates - ONC and others
  4. Project Updates
    1. C-CDA Rubric Informative Guide Gay DolinMatthew Rahn

      1. Review Publication Request
    2. Provenance
      1. Review the Assembler Participation design sent by Brett Marquardon  for approval
      2. Approve commensurate changes in the PACP made to align with the new Assembler Participation design sent by Brett Marquard and previously approved on  
    3. Other Project Updates
  5. Additional Items
  6. STU Comment Resolutions until 11:00am EST

11:00AM EST

  1. Discuss Deprecation deprecating C-CDA R2.1 UDI Supplemental Template – or somehow “pulling it” from the set of published IGs that are reported as the “active” supplements to C-CDA R2.1.
  2. VSAC Value Set 2020 Updates: (Rob McClure (second hour)
    1. 1768 follow-up
    2. PSS for 1954,1955,1956
  3. Adjournment

Notes/Minutes

10:00am EST

  1. Call to order
    1. Meeting began at 10:07am 
    2. Call for Attendance - Please click the "Sign In" button at the top of the Agenda Page for today's meeting. Once you have signed in, it will indicate you have already signed in and place your name in the Attendees drop down list.

  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Approve minutes from 2020-04-23 Agenda and Minutes

      1. Minutes Approved by Consensus
    3. HL7
      • RIM (Austin Kreisler)
        • UTG live today.
        • TSC live today at 3:00 EST. co-chairs should try to attend.
      • Steering Division / TSC (Austin Kreisler)
        • No other announcements.
      • CDA-MG (Lisa R. Nelson, Brett Marquard)
        • Nothing new this week.
      • Vocab (Sheila Abner)
        • no
      • Publishing, Electronic Services and Tools (PEST) (Andrew Statler)
        • Continuing to work thru FHIR spec process in JIRA
        • Updated Confluence to a newer version to fix an issue some folks were receiving
        • PSS roll out coming
        • JIRA process for documenting Normative document comments
      • Patient Care (Emma Jones
        • MCC eCare plan - discussions eCare coordination connectathon track. 
        • voted FHIR version of IPS to be published. Rob is taking to co-sponsoring workgroups
        • Having call this afternoon with logical people. Symptoms profile. Call today at 5:00pm EST.
        • MCC is not formally part of the connectathon, but it will be informally done prior to the connectathon.
      • Example Task Force (https://cdasearch.hl7.org/) (Brett Marquard)
        • Yes, plan to meet today and will prioritize on the call.
        • There is a link to the page from the agenda.
        • There is not a project scope.
        • We will work with Brett Marquardto set up a page on the Structured Documents Confluence Space for this Task Force
  3. External Updates - ONC and others
    1. Matthew Rahn at noon, Dr. Rucker is talking about the 21st Century Cures Act. Some timelines coming out. Test procedures for the new and revised criteria on June 1. All the test tools will be released as well. May 1,2020. The 24 month timeline, will be enforced on May 1, 2022. There will be a 3 month enforcement discretion, so August 1, 2022.
    2. On May 20, 2020. There will be a C-CDA Implementation-a-Thon. Matthew Rahnwill be showing the Scorecard.
    3. https://protect2.fireeye.com/url?k=dc48de6d-801dd77e-dc48ef52-0cc47adb5650-b77b93a7e2526bc9&u=https://www.himsslearn.org/washington-perspective-fireside-chat-onc-national-coordinator?source=ONC Link above is for the HIMSS chat with Dr. Rucker.
    4. On May 6th there will be a API Q&A at 3pm ET. You can register at https://www.healthit.gov/curesrule/resources/webinars
  4. Project Updates
    1. C-CDA Rubric Informative Guide Gay DolinMatthew Rahn

      1. Review Publication Request
      2. This was approved last week. It has been reviewed by the SDWG today and we are forwarding to the CDAMG for their approval. Andrew Statler Brett Marquard Lisa R. Nelson
    2. Provenance
      1. Review the Assembler Participation design sent by Brett Marquardon  for approval
        1. TypeMotion
          Motion

          Motion to approve Assembler Participation design

          By
          Second
          Date

           

          Ref #
          For14
          Neg00
          Abs00
          Status

          APPROVED

          Tally14-00-00
          Discussion

          No Discussion

          Action
      2. Approve commensurate changes in the PACP made to align with the new Assembler Participation design sent by Brett Marquard and previously approved on  
        1. TypeMotion
          Motion

          Motion to approve inclusion of the updated Assembler Participation design in the PACP

          By
          Second
          Date

           

          Ref #
          For14
          Neg00
          Abs00
          Status

          APPROVED

          Tally14-00-00
          Discussion

          No Discussion

          Action
    3. Other Project Updates
  5. Additional Items
  6. STU Comment Resolutions until 11:00am EST
    1. 1946? - don't want to take that one up. That needs more discussion
      1. This is language codes and it uses ISO-3166-1 which gets into country-region coding and gets complicated.
    2. 1945 - Encounter Diagnosis from Brett Marquard
      1. Brett Marquard - a few weeks back Didi Davis Rimm rules and CDA schematron and historical guidance. Time box to 15 minutes. 
      2. https://gazelle.ihe.net/cda/cda-basic-req.pdf
        Language approved on SDWG (Brett/Calvin – 13-0-1):
        1. The CDA R2 Schema establishes a base set of requirements for CDA implementation.


          C-CDA R2.1 implementations must conform to the CDA Schema, and the requirements included in the C-CDA R2.1 publication.


          --> The CDA Schema is a serialization of the CDA hierarchical definition (HD). The HD is flat list of CDA elements/data types/cardinality/value sets/etc. embedded in the CDA R2 standard. When systems object to the serialization of the schema, the HD is the authoritative source.


          --> The interpretations supplied in the PDF (HL7 CDA R2 Basic Requirements) were not submitted to a formal community vetting process. If validators wish to implement these rules we recommend they be balloted through a formal HL7/IHE/standards review process. Some of the rules have been superseded by HL7 M&M guidance and RIM errata.



      3. TypeMotion
        Motion

        Motion to approve the language of the CDA schema reviewed during the meeting

        By
        Second
        Date

         

        Ref #
        For13
        Neg00
        Abs01
        Status

        IN-PROGRESS

        Tally13-00-01
        Discussion

        No further discussion

        ActionNeed to determine next steps with the language. Add this topic to next week's agenda. What to do with this language.

11:00AM EST

  1. Discuss Deprecation - deprecating C-CDA R2.1 UDI Supplemental Template – or somehow “pulling it” from the set of published IGs that are reported as the “active” supplements to C-CDA R2.1.
    1. This is a flawed IG. It is published and is an STU.
    2. There are three options:
      1. The workgroup can request to withdraw it.
        1. We can request a draft for comment ballot for should this be withdrawn.
      2. The second option is to update it and correct the deficiency.
      3. The third option is to just let it expire in November and remove it from the page.
    3. Suggestion is to reach out to the proponents of the IG and let them decide. Lisa R. Nelsonhas already reached out, but has gotten no response. We will let it expire. At that point, it is a much simpler process. We then fill out a form to withdraw it.
  2. VSAC Value Set 2020 Updates: (Rob McClure (second hour)
    1. One ValueSets that was referenced that is source of truth someplace else. The ODH supplement, there are 6 ValueSets referencing FinVads that are made up. Going to do the same thing. They will not be referenced to VSAC. Instead you will go here. They are in the supplement. Rob went through and found all of them. 
      1. NCHS was already there.
      2. There are a total of 6. Some of them are ODH. Some of them are FHIR ValueSets
      3. Employment Status, Industry CDC Census 2010, Job Supervisory Level or Pay Grade (ODH), PHVS_Occupation_CDC_Census2010, Work Classification, Work Schedule
    2. Substance Reactant for Intolerance
      1. a grouping of other value sets
      2. 2.16.840.1.113762.1.4.1010.1 - RXNORM - Grouping ValueSet
        1. Recommendation is to move to SNOMED CT for Drug class
        2. There was some concern express brought up about this and the relation to the Data Blocking Final Rule. We believe that SNOMED CT may still be the best course.

          TypeMotion
          Motion

          Motion to approve Substance Reactant for Intolerance move to SNOMED CT

          By
          Second
          Date

           

          Ref #
          For12
          Neg00
          Abs02
          Status

          APPROVED

          Tally12-00-02
          Discussion

          No further discussion

          Action
    1. 1768 follow-up
      1. From
        Lisa R. Nelson
         - "For the Disposition Comment #1768 Add another STU Comment to consider changing C-CDA R2.1 templates to explicitly disallow use of @nullFlavor where this value set is used if UNK were to be added to the value set. Add FHIR Issue to change value set binding of RelatedPerson.relationship (http://hl7.org/fhir/R4/relatedperson-definitions.html#RelatedPerson.relationship) to our new value set and remove binding to FHIR value set http://hl7.org/fhir/R4/valueset-relatedperson-relationshiptype.html There is a problem with adding ECON and NOK from RoleCode to the value set. These concepts are class codes, not role codes, so it would not be appropriate to add them into a value set used for role codes. The other V2 codes are not proper for this use. 2020-04-16 - Austin is going to talk with Ted about this issue to see what options we have to resolve/address this issue."
      2. Lisa R. Nelson was asking Austin about updating 1768 with the language above. Additional work needs to be done to 1768, but it was moved to Category 2 because of the complexity.
    2. PSS for 1954,1955,1956
      1. TypeMotion
        Motion

        Motion for an errata that is scoped to just the material for 1954,1955, and 1956 and it does not involve republishing the Companion Guide or the appendices 

        By
        Second
        Date

         

        Ref #

        1954,1955,1956

        For
        Neg
        Abs
        Status

        TABLED

        Tally00-00-00
        Discussion

        Calvin E. Beebe We make a motion as a committee, but then it only moves forward as a project.

        Brett Marquard We have a precedent of releasing a spreadsheet that doesn't seem great.

        Austin Kreisler Let's table the motion

        Calvin E. Beebe wanted the co-chairs to get together to figure out how we do it.

        Rob McClure what group pushed to get this work done. ONC pushed for this to be done for the fall.

        ActionTabled

        Companion Guide - Emma Jonesentered a comment for appendix B UDI template, and she entered a second one and wanted to know if those would be reviewed by this group.

      2. We can put that on the agenda for next week.
  3. Adjournment
    1. Meeting adjourned 11:48 am EST

 


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