Chair:  @ 

Scribe: @ 


Attendee type:

H - HTA Member

O - observer

L - liaison


P - present

A - Apologies



HPJulie JamesBlue Wave Informatics LLP

Roel Barelds

ICT Group

HPSusan MatneyIntermountain Health
HPSylvia ThunHL7 Germany
HPCarol MacumberApelon Inc.
Reuben DanielsSaludax
Davera GabrielJohns Hopkins University Institute for Clinical and Translational Research

Wayne Kubick


Jane MillarSNOMED International
OPAndrea MacLeanCanada Health Infoway
OPSoraya AssarMotive Medical Intelligence
OPRob McClureMD Partners

Minutes of Teleconference 2019-11-26 

Motion to accept proposed RB, seconded SM; carried 7-0

Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion



Minutes Approval

Quorum is met

Motion to approve Minutes proposed and accepted

ManagementCalls between now and Sydney WGM

Cancel call on Christmas Eve

New year calls - Julie now has a conflict at this time every other week. – Parking this item for now, Julie is OK keeping the current cycle and time if necessary. 

TopicCode system translation for ehDSI

See Roel's email of 2019-12-06

The European initiative ehDSI (successor to epSOS) is going to be implemented in The Netherlands through a program PIEZO. This means cross border exchange of HL7 CDA based documents.

One of the borders to cross is a language border. The ehDSI Master Value Catalogue contains all code systems/value sets that are part of the information exchange. Some of those are based on HL7 terminology, which are US English only.

We are working towards of translating of those to Dutch, through a formal process comparable to how we work on SNOMED CT and LOINC translations. We think it would help Dutch implementations at large to be able to access these translations in close relationship to the base code systems. As such we are looking for guidance/process on setting up how that could work. For example translations could be added to UTG.

What we are currently looking at, because of ehDSI:

  • 2.16.840.1.113883.5.1 Administrative gender
  • 2.16.840.1.113883.5.25 Confidentiality
  • 2.16.840.1.113883.5.1008 Null Flavour
  • 2.16.840.1.113883.5.111 Personal relationship
  • 2.16.840.1.113883.5.110 Role class
  • 2.16.840.1.113883.5.1070 substanceAdminSubstitution
  • 2.16.840.1.113883.5.1119 AdressUse
  • 2.16.840.1.113883.5.139 TimingEvent

Roel is not sure if this should be a matter of the HTA. But I’m sure more Affiliates have this problem as well. So maybe we have to discuss this as well with the Affiliates during next WGM.

Syliva: In Germany, a translation is maintained, in collaboration with Hl7, but they are not submitted back to HL7. 

Resolution: HTA recommends that the issue around supporting the submission, management and sharing of foreign language translations shoud be brought to the vocabulary work group. Whereas HTA should support vocab in defining the process by which HL7 (UTG) supports translations. Both vocab co-chairs (CM/RM) present are in agreement. with the resolution

TopicAMA code system for FHIR accelerator

AMA and NUBC code systems for FM FHIR (Mary Kay email thread and Paul Knapp)

Paul - "We are seeing more FHIR R4 based IGs which need to refer to external codesystems, do we have the approach (nameingsystem I expect) now formally defined and implemented in the tooling? I presume it is possible to reference new codesystems in R4 IGs, do you have any guidance or know issues with doing so?"

Mary Kay - "AND a note that we will be doing some outreach to all around NUBC – AHA codes. We have to do some work for a project coming through FM for consumer EOBs. As part of that we are going to end up needing logic (translate to IP) in the NUBC Manual. We’d like to get everyone we need to have involved from the start. Is the best way just an email to the group on this email (and the NUBC/AHA Folks)?"

TopicURLs for External Code Systems

Reviewed the new parent page for this work and initial drafting of the process.

Review progress on Initial Code System Request Letter -

JJ - letter is written as HTA is making the request. She had imagined that the requestor (Vocab facilitator, Accelerator faciliator, IG author etc...) would utilize the template to make the request. Should we update so the authoer is positioned as the requestor

RM - HTA should be single point of contact, because we "the greater HL7 community" simply doensn't know how to "do this". Even where it's simple (ha), the process will not be executed consistently. The only way it would work, is if there is a REALLY clear guidance and process around how this gets done. Relatedly, who is responsible for creating a FHIR codesystem resource?

CM - I would be against assigning HTA as the responsible party for creating code system FHIR resources

RM - Agree that HTA was meant to create policies and proceses. But someone has to do the work of creating the resources

RB - Agrees with Rob that HTA should be the author/sender of the letter

RM - HTA also needs to provide guidance on how to make content into a codesystem so they can use it in a a HL7 product...

JJ - Should Wayne attend HTA meetings to discuss? Much has been mentioned by RM regarding Wayne's comments regarding HTA and it's role in supporting external codesystems.

From Zulip (RMcC)

  1. If the code system authority is immediately engaged and crafts a url they want and own - use that and stop
  2. If we need to create something because above is not happening fast enough, use the (or some tbd better base) where the xxx is an established (at HL7 OID site or other) short symbolic name
  3. Publish this via UTG
  4. Understand that this url can change when the steward decides to establish something that is better aligned with their domain. Obviously this is a big deal with implications, but it's a fact, as we see here. So we need a defined process to manage this and I'd except this is something HTA, with our help, will craft as the responsible entity in HL7 for external code systems. I'd like better clarity on how we technically help folks go through a transition like we see here. For now, @Eric Haas seems to describe the result of this process.
Topic (DID NOT GET TO THIS OR ANY SUBSEQUENT ITEMS)Code system statement for specifications

See updated policy at General policy on the use of external code systems in HL7 standards

To do: Close out the code system statement and send to FMG

Julie James Contacted Grahame and FMG, HTA to provide draft text to include in IG publishing process

Follow up on issues with translations

Andrea MacLean to review policy and comment

TopicISO Codes  - update

STILL OPEN: Other ISO standards to check:
ISO 11073 Nomenclature for Personal Medical Device Communication

FHIR also uses the IANA Time Zones

TopicVocab Facilitator EngagementHow to get vocab facilitators engaged and how to get project teams to engage with their vocab facilitator
TopicUTG EngagementHow will UTG engage to bridge the gap, especially as the IG publisher and UTG become more integrated (still a way off) 
TopicFHIR Tracker Items

 [#25207] Summary: Update Licence Note for Value Sets based on SNOMED GPS

Still needs to craft a new statement to use in the IPS Specification (and others) Caroline Macumber

AdjournmentMeeting adjourned

At 22.00

Items for next call

Action Items

  • Caroline Macumber to get information from UTG team as to the current level of support for foreign translations, enabling sharing of the translation
  • Julie James  to send information regarding translation issue to vocab-cc listserv
  • Caroline Macumber will attempt to address RM's zulip chat and Mary Kay's requests in the process page located here, will send a note to HTA-CC when it's read for review since we won't have a call on 12/24
  • Julie James reply to thread with Mary Kay and Paul regarding contacting AHA/NUBC letting them know we are working on defining the process and templates to be used, but they should likely proceed in the meantime and copy HTA (yah?)
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