Presiding Co-chair:  Heather Grain

Minutes Author:  heather Grain

Meeting Coordinates


Password: hl7termauth



Attendee type H - HTA Member

O - observer

L - liaison



P - present

A - Apologies

N - not present without apologies





Heather Grain

Global eHealth Collaborative


Rob McClure

MD Partners



Sandy Stuart

Kaiser Permanente



Jean Narcisi

American Dental Association



Julie James




Ted Klein

KCI Inc.



Roel Barelds

ICT Group



Jim Case

National Library of Medicine/IHTSDO



Wayne Kubick




Robert Hausam

Vocabulary Co-chair



Jane Millar

SNOMED International



Carol Macumber

Vocabulary Co-Chair

Russell HammVocabulary Co-Chair


Quorum Requirements Met:    


16:00  Agenda Confirmation

16:05  Minutes of Previous Meeting

Minutes of conference call on 24 May 2018.

Actions not covered below:   HTA calls – schedule updated - HG

16:10 Confluence Issues

  • Confirm access permissions

16:15 SNODENT  (Jean)

Confirm additional data required for external terminologies page: 

Additional information is needed:

Full title

Owner:               American Dental Association

Scope of content (semantic space):

Technical Identifiers: 

  • URL - 

Link to information about the code system:  

Licensing information 

  • HL7 users of this information
  • Information current as at: 


V2:  Table 396 This needs to be discussed with ADA and resolved. 

16:30 SCT Content Request Process

SCT Content Request process review status (HG)

Where does content request process fit with UTG (TK)

16:40  Currency Guidance

Document review status (HG)


16:45  SNOMED CT Free Subset

The issue of free subset has recurred – Grahame Grieve has been discussing the ability to have free content available in FHIR with SNOMED International.  There are verbal agreements with SNOMED International already that there will be a free subset for some FHIR content.  Grahame has asked for content to include relationships.  Rob H. has indicated that we would ask for the full procedure hierarchy in the free subset.

HG to report on discussion with grahame - expectations, agreements, process.

16:55  Other Business

HTA List - how to manage most effectively.

Next meeting: 

17:00 Adjourn Meeting


Not planned for discussion this call



Policy for publishing value set definitions referencing external terminologies (current and future) (Ted)

When a value set definition refers to external terminologies without listing the content we need to:

  • Ensure licensing requirements for use is appropriately attributed and defined
  • When value set definitions are published there is a need to automatically reference the page of external terminologies and licensing links for use.
  • Every published document will include that information.
  • Include in this policy and process in the external terminology web page.




1         Appendix: Known issues and Watch Items

1.1        Publishing

  • LOINC survey instrument attribution – attribution information included in web and publishing guidance (listed above).


  • Additional issues associated with publishing for HTA. 
    • The way value set definitions are persisted in the families do not have populated content about the source/owner.  This field is often not populated at the moment. 

7/12/17 steward is included – but need to consider the owner (who is responsible for the value set).  There is a need to indicate the purpose or scope of the value set content.   This is a Vocabulary issue rather than HTA.

Additionally, tooling in the MIF does not permit publication of the steward of the value set.  It is held in the database, but the tooling is not captured for V3 value sets.  This is being addressed in the UTG.  V2 has the steward and owner is algorithmic according to the chapter the content is used in, but where tables are used in multiple chapters.  Not for further discussion in HTA as Vocabulary will work on these issues

  • Inclusion of maps in publications.


1.2        Tooling

1.3        FHIR content request updates

Awaiting information from Grahame G about how FHIR will update terminology resources to match the international release.

1.4        policy statement on SCT allowed binding strengths in FHIR for clarification (Ted)

On hold at the moment until other processes are determined more clearly.

Ted suggested this be moved to the watch list.  We need to determine semantic implications of binding strength of expansions which are subject to profiles.    This issue is not restricted to FHIR.

1.5        External Web Page Content

Reference to HTA – link  - Done.

Link to the document on external vocabularies (policy document) – to be submitted to TSC for their endorsement.

List of terminology products and organizations with whom we have agreements:


              SNOMED International

              American Dental Association SNODENT

List of known external terminology products and organizations used in HL7 products:

     ICD (WHO)

     Others….., including content from V2 tables 396 (external code systems used in V2 standards), link to V3/CDA and FHIR external terminology pages.  These are known terminologies and this information is known to be incomplete and less than what is required. 


External content should be brought through Harmonization.  The Harmonization and balloting process will be the trigger updates to the information provided on this page.  If these requests, go through harmonization the HTA can be informed and take on the liaison and organization of licensing agreements.  Working Groups are not empowered to make such arrangements. 

The tooling below aims to provide a quick reference to find tooling and information about external terminologies used in HL7 standards.   This provides a traceable process to assist standards users.

Develop a table of information about each code system including:

  • Formal name of the code system
  • Short name or abbreviation of the code system
  • Owner of the code system
  • Technical identifier/s of the code system
  • Link to information about the code system – this should contain information about how to obtain the content.
  • IP information and Licensing - link
  • HL7 users of this information – e.g. HL7 product use link?
  • Information current as at





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