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 (3):  Yes   


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 - done

Moved Jean and seconded Julie that the minutes be accepted.


16:08 Confluence Issues

  • Confirm access permissions - Julie is now OK.  
  • the HL7 Calls now have a link to the confluence page

No other issues reported - item closed.

16:15 SNODENT  (Jean)

Confirm additional data required for external terminologies page: 

Additional information is needed:

Full title    Systematized Nomenclature of Dentistry (SNODENT)

Owner:               American Dental Association

Scope of content (semantic space): - see web site

Technical Identifiers: 

  • URL - Link to information about the code system:
    • there is a browser there and additional information about the code system.   

  • will need a URI for SNODENT - the preference is that this be a resolvable URI where you can get descriptions, content etc. can be used provided the address does not change.

Licensing information 

  • HL7 users of this information  - a license is required please see the web site for details
  • Information current as at: 2018 July 20


Heather Grain  Page to be developed which explains what is needed as a recommendation of the information to be provided by code system owners.  URI, code system identifier, OID and V2 neumonic are required.  HG to draft and share with Ted to confirm.

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

There is no entry for SNODENT in Table 396.  If there is an intent to use this in V2 an entry is needed.  

CDT2 codes - American Dental Association terminology entry has been around for 20 years.    This is a claim for classification.  The name is now CDT2018 and needs to be updated  the neumonic will still be CDT.

To make this update: code:  CDT2018 Source description

Jean Narcisi  to provide updated description and code name to Ted who will update the system (note the code CD2 won't change.

Harmonisation question:  is it OK that the new orthodontic value sets are maintained within HL7 (OIDS and URIs) or does ADA want to own and manage the content.  If the responsibility for maintenance is to be by HL7 this is fine, otherwise the ADA becomes the source of trueth.

These value sets are not currently on the ADA web site and they would need to be if ADA is to be the owner.    After discussion it was agreed that the source of truth will remain in HL7 value sets.

16:30  CIMI - promotion from HSPC to international edition

CIMI create new content in the HSPC extension to SNOMED.  That extension is being used for SOLAR project and is tightly aligned with CIMI.  Concepts are being added.  When those concepts are stable and agreed a request to move the content into the international release CIMI.  CIMI would bring this content to HTA for submission to SNOMED International for promotion.  

Process discussion:  SNOMED International review the request and conduct the same quality review as they do for new content.  

Heather Grain send copy of request for and procedure to Susan Matney.

16:45 SCT Content Request Process

SCT Content Request process review status (HG)

  • Karen has agreed to be the contact email and to forward to the HTA members list any communications received.
  • the contact email for SNOMED International has been updated to be Karen's
  • load the instructions for content request into confluence  Heather Grainto load the document and send an email to the members.  members to review prior to the next call and include this on the next call agenda.

Where does content request process fit with UTG (TK)

Ted is updating the tooling workflows and we will discuss this in more detail on the next call.  There are multiple potential places where content requests should appear.

Related to this publication of external releases within UTG need to be considered.  the URIs are elsewhere and we need people to be able to browse out and get to them.  Is the HTA external terminologies page the place   Needs further discussion.  Need to make sure that when people are working in a particular area they need to be able to go quickly and easily to the information they need. is being developed.

16:50  Currency Guidance

Document review status (HG)

See   Members to review this document and provide comments to Heather.  

16:55  Other Business

Heather Grain find out how to use the macro for actions required.

HTA List - how to manage most effectively.

Next meeting: 2018 August 2nd

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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