Skip to end of metadata
Go to start of metadata

Attendees Present

Chair:  @
Scribe: @ 


Calvin Beebe

Lorraine Constable

Russ Hamm

Tony Julian

xPaul Knapp

Ewout Kramer
xAustin Kreisler
xWayne Kubick
xThom Kuhn
xRik Smithies
xSandy Stuart
xMary Kay McDaniel

Friday Q1 and Q2 Agenda

Agenda topics, Q1:

  1. Vocabulary - Ted Klein
    1. UTG is intended to be a one stop shop. Anything published would have a link to terminology. 
    2. CIMI and SOLOR - Ted is treating it as an external content node. 
    3. We use some external vocabularies that are published on paper. Have been downloading them if they're free for use, converting them into a usable form and publishing on our site. 
    4. Does SGB own the work on this, or does HTA/Vocabulary? Setting the precepts to back it up is SGB. 
    5. From this group, policies, precepts are needed around the external stuff. 
    6. Have to respect the IP of external organizations and abide by the terms they provide. Ted: What about the ones where we have no information? Calvin; That's when it goes to HTA for assistance, relationship generation, or a position statement. 
    7. Ted notes confusion in the big projects over who is responsible for what. The rules in those circumstances are not clear. 
    8. As we run into these, do we feed these through HTA or SGB? Decision that they should mostly likely go through HTA. They need to bring to the board or TSC the list of things they can't establish a relationship that keeps us in line with the law. 
    9. There should be a registry of all of these things. Ted agrees and is working on one.
    10. Ted notes there are issues with ISO/IDMP as well. Calvin suggests an itemized checklist of issues that must be dealt with for review by HTA.
    11. When UTG is ready to start running, Grahame will issue a technical correction and remove all the browsable terminology and redirect to a terminology space on These are browsable web pages. Calvin: Are we standing up a FHIR service? Implementers primarily use value set expansions. VSAC made the decision years ago to distribute expansions and struggled. The demand is that we stand up an HL7-FHIR service that at least allows you to take the definitions that you can download, send them to the server, and get back an expansion. Austin: Need to make sure there are terms of service and they are explicit and state the limitations. Discussion over whether this issue belongs at SGB since it's implementation. Would likely be under the CTO and the TSC until the board does something that is a separate space for implementers.
    12. This could eventually be a revenue source/member service. May want to bring to the board as a potential service offering.
    13. There is a piece of this in standards development. Folks have to download a local code system and value set editor, as well as a locally running FHIR terminology service that basically expands FHIR value sets. Some say it's unreasonable to ask developers to download this in their environment. Calvin asks about the licensing for UTG? Licensed under creative commons.
    14. Would you expand only value sets that we manage? Ted's current working policy is that we expand the value set definitions that we publish in our product lines where we have the content that we're able to surface as the result of agreements (potential precept).
    15. Can we talk SNOMED into setting up a FHIR server? There is a project looking at that now. 
      • ACTION: Need to create precepts on stable identifiers for value sets, concept maps, and code systems
  2. SGB representation in the GOM
    1. GOM is being reworked. SGB is not yet represented there. Wayne describes the status of the work. Management groups are not in the GOM either. Discussion over board committees - they should have a reporting relationship with the TSC. Discussion over whether each single committee has to be listed/described or if the subcommittees can be noted in the TSC section. Decision that we'll wait to see the proposed updates.
    • ACTION: Review proposed updates to the GOM, then determine how/where to represent SGB
  3. Standards as a service initiative
    1. Wayne notes that the board commissioned a project to define this and put some parameters around groups like Da VInci and Argonaut using HL7 as a service to push through their specific topical standards. There are a number of other potential groups that may come forward to do this as well. They would have to pay, work under our structures, we would provide some support, etc. One question is what is in the GOM vs. what needs to be there to potentially support this. What approval levels are really required? 
    2. The notion that an external body could create an artifact that they bring to us to run through our machinery is anticipated in the GOM but would need to be expanded. Can't bring finished work here without expecting it to change. Must respect the consensus process. Consensus on review or creation? 
    3. What is our role in weighing in on this? An externally developed endorsed IG is a rubber stamp, essentially.  Da Vinci is now expected to go through a WG, although that wasn't the original intent. Need to work out the notion of the organization making revenue on the backs of the volunteers. Calvin states we've really been doing this all along but not getting any money for it. Raises fundamental questions for the organization, including how do we deal with the burdens and the fact that we have work that wants to go forward? The model of standards development here has transitioned significantly. We have an organizational problem when we service volume that exceeds our capacity. 
  4. Grahame here to bring forward a potential project coming through FM that is outside the scope of healthcare/HL7. Waiting for formal project proposal. In the end it's likely a board decision if we work on it but wanted to bring it here. The project is around risk assessment for insurance. Austin states there is some precedence around this in the 2x space. 

Agenda topics, Q2:

  1. Grahame has requested committees to give him a one sentence roadmap statement for R5, as well as a list of resources intended to be brought forward as Normative. The Normative list is now up to 25. Current rules for normative state you should have 5 implementations in more than 3/multiple countries. Could say instead that you can have 5 implementations in one country with fervent interest in normative. Does SGB want to get involved in the evolution of the rules for progression to normative? 
    1. Are there precepts involved? Precept could be that thou shalt have a maturity model, but what the model is would come from methodology and reviewed by management. Would seek conceptual consistency only to the degree that it makes sense across the organization. If a maturity model is laid down, should it stay in place or should it be modified because people can't meet it? There should be the ability to adapt.
    2. Would support the methodology group in determining their criteria without bending to political pressure. 
    3. If we defend the gates, we may need to make sure to articulate what the override processes are in an appeal process. Need to define the appeal process. 
    4. Calvin: FMG or the methodology group were the first to create this concept. Need to give them latitude to find their footing, wherever that is. Grahame: We anticipate getting pressed but feel comfortable with the guidance on how hard to resist. TSC is a backstop if there is an official objection. After that it would go to the EC/board. ARB often functions as the supreme court.

  2. Precept on balloted vs. non-balloted feedback
    1. Reviewed Paul's slides. Need to have clear guidelines on how to manage.
    2. For ballot comments, we have notice, restricted comment period, payment for the right to participant, reconciliation, and publication.
    3. Non-ballot comments come anytime, no restricted pools or comment period, no payment, no time frame for reconciliation, and artifact is published with ballot comments and non-ballot comments OR non-published, which allows even further changes and ballot. 
    4. Calvin: What is the basis of the thinking - is it ANSI's requirements? Paul: The good can't change while it's in ballot. If you make a change, you have to reset the clock. Grahame notes they might fix typos, etc. but if it's substantive change they reballot. Austin notes one issue is where a non-ballot comment outweighs a ballot comment. 
    5. Grahame thought committees understood that ballot comments are ballot comments; anything that comes in outside of ballot doesn't have the same standing and is at the discretion of the committee. Paul: I don't think we have anything formal stating that. 
    6. Ted: There's another piece to non-balloted. Ballot bound terminology is controlled there, but non-ballot bound terminology is often commented on and may change during the ballot cycle. We get comments that are non-ballot material that are included in the ballot so we can solicit community input. Should not be subject to the same rules; Paul states that's not a problem.
    7. Calvin: We have a couple communities at play. The ballot pool, the committee that will vote on the reconciliation, and if it's normative with a substantive change, it has to go back to ballot. It's not uncommon in the process of going through a ballot that additional items will be found that the committee will fix to improve quality. There are degrees of latitude we've given the process. The committee can pick up and make a determination that applies, or is it the team running the ballot? 
    8. Reviewed Paul's proposal for handling non-ballot comments. 
      1. Could have a 30 day freeze of handling non-ballot comments before the ballot opening
      2. Could have restricted pools - only balloter comments and committee found items may be applied to the artifact for publication. ARB could address variance. Played out a number of scenarios for this situation. Discovered items open the door. If comment is substantive in an STU, it will theoretically still be balloted in the eventual Normative ballot.
        1. Grahame: The technical committees will be very unhappy not to handle little comments during the ballot. The chairs of the WGs determine if it's a big or little issue. They do prioritize ballot items over comments. We should just say that items not submitted through ballot will be managed at a time determined at the discretion of the committee. Wayne: We need to clarify this to the people submitting comments...if you submit via non-ballot comment rather than ballot comment, it may not be considered. This states value to being in the ballot pool.
        2. Grahame states the other thing we could consider is that when we move to JIRA, we could flag whether a comment comes from a member vs. a non-member. There are technical challenges with that, but then committees could still prioritize on that. 
        3. We should put a statement together that is clear and simple that we can suggest to the board or EC. Wayne: ANSI essential requirements demand openness. They care about the consensus body (ballot pool). We want people to join HL7 to participate in ballots. Being a member of the ballot pool guarantees that your comment will be considered. This is what we need to articulate:
          1. Need to give clear guidelines to committee members regarding prioritization
          2. Need to communicate to the outside world the advantage in participating in HL7 to have your comments addressed
          3. Calvin: If we have a process that receives comments - do the Essential Requirements allow us to ignore them if they're not part of a ballot pool? This is another issue where they can be dealt with at the discretion of the committee.
            1. Comments can be submitted at any point in time
            2. Comments will be considered/addressed at the committee's discretion
            3. All ballot comments must have a disposition for Normative, STU, and Informative white papers (this is a change for STU)
            4. Can set aside negative comments from unresponsive balloters
            • ACTION: Move proposal to TSC for Review
  3. Adjourned at 12:19 pm 

Action items



DescriptionDue dateAssigneeTask appears on
  • Paul Knapp to send documentation to the cochairs of HTA and Vocabulary noting that we've drafted precepts on external terminologies and highlight questions on their currency document.
Paul Knapp2019-11-06 SGB Agenda/Minutes
Paul Knapp2019-09-20 SGB WGM Agenda/Minutes
Paul Knapp2019-09-20 SGB WGM Agenda/Minutes
Austin Kreisler2019-09-20 SGB WGM Agenda/Minutes
Lorraine Constable2019-09-20 SGB WGM Agenda/Minutes
  • ACTION: Paul Knapp will work on a grid with types of change/degree of review
Paul Knapp2019-05-22 SGB Agenda/Minutes
  • ACTION: Need to create precepts on stable identifiers for value sets, concept maps, and code systems
2019-01-18 SGB WGM
  • ACTION: Review proposed updates to the GOM, then determine how/where to represent SGB
2019-01-18 SGB WGM
  • Add Calvin's document on continuous maintenance and the decision to the SGB site.

2018-11-14 SGB Agenda/Minutes