Presiding Co-chair:  

Minutes Author:       

Meeting Coordinates   Teleconference (see details on Meeting page)


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): 

Introductory Business

Agenda Confirmation

Minutes of Previous Meeting

Minutes of the face to face meeting Baltimore 30th September 2019

Review of UTG requirements Documentation (TK)

Ted to have sent link and all members 

Currency Guidance

Heather Grain to forward to TSC - done


No activity this call

Scope of HTA

Updated scope from GOM discussed and approved by Vocab WG, sent to the Board for their approval.

Awaiting response - then forward to TSC for GOM update

Translation of value set content

Ongoing discussion and resolution of the Question raised:

1) A German translation (of HL7 Vocabulary display values) is produced by a third party "X" for HL7 Germany, according to 6.8.2 Affiliate Agreement.

2) The German translation is uploaded by "X" to a secured terminology server (CTS) located in Brussels, i. e. outside of German territory

3a) The German translation is downloaded from the CTS by an authorized party "Y", located _in_ Germany and used by "Y" under HL7 International rules and HL7 Germany Affiliate Agreement.
3b) The German translation is downloaded from the CTS by an authorized party "Z", located _outside_ of Germany and used by "Z" under HL7 International rules and HL7 Germany Affiliate Agreement.

This issue is: who owns, validates and distributes translations.  This will involve external code systems but also internal code systems.  

Answers to the questions raised

Legal situation regarding cross boarder change.

Situation regarding SNOMED CT

  • the international release includes English and Spanish - we may use these directly.
  • If the terminology is a licensed terminology - the Affiliate would require a license to undertake this process (e.g. SNOMED CT)

HL7 terminology governance issues:

  • there is a need to ensure that the quality of the translation is safe for use
  • that the process of translation is appropriate
  • what is the approved authenticated official canonical translation for these value sets and where do people go to get them.  Should we be the distribution centre as an approved translation of HL7.  We seek to avoid multiple translations of a value set for a given language.
  • Where does responsibility lie for translation and for quality assurance

Affiliate licensing regarding publication needs to be further investigated.

Free Subset  

Heather to report on SNOMED international and Rob Hausam discussions

Other Business

Call Schedule:  .  Heather Grain to schedule the calls fortnightly continuing the current schedule.  - Done

San Antonio meeting - rooms booked for Q1 and Q2 Sunday. - Heather has requested rooms

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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