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Chair:  @ Carol Macumber

Scribe: @ 

Attendees

Attendee type:

H - HTA Member

O - observer

L - liaison

Present

P - present

A - Apologies

Name

Affiliation

HAJulie JamesBlue Wave Informatics LLP
HP

Roel Barelds

Precipius b.v.

HPSusan MatneyIntermountain Health
HASylvia ThunHL7 Germany
HPCarol MacumberApelon Inc.
HPReuben DanielsSaludax
HPDavera GabrielJohns Hopkins University Institute for Clinical and Translational Research
L

Wayne Kubick

HL7 (CTO)

LPSuzy RoySNOMED International
O
Andrea MacLeanCanada Health Infoway
O
Soraya AssarMathematica
O
Rob McClureMD Partners
O
Joshua ProciousHL7 International

Minutes of Teleconference 2020-02-19

Motion to accept proposed DG, seconded SM; carried 5:0:0

Agenda Topics


Agenda Outline

Agenda Item

StatusLead

Meeting Minutes from Discussion

Management

Quorum

Minutes Approval

N/ACarol

Quorum is met

Motion to approve Minutes proposed and accepted - Davera moves, Susan seconds, Motion passed 5-0-0

Julie received apologies from Sylvia who was unwell

Topic HTA JIRA queue to manage requests and workflowIn ProgressReuben 

Josh presented on the last HTA about the operational use of a JIRA issues queue to manage requests for the HTA to work with external SDOs.

Reuben worked with Josh to draft a workflow for the HTA queue and Josh will implement, However, Josh is unable to present the process today as he is meeting with Wayne for a few issues on the approval. No issues are anticipated with approval, but we await the results of that meeting. Reuben sent an email to the HTA for some clarification/validations on some assumptions that he made in creating the draft workflow.

Next Steps: HTA members to provide feedback on the process drafted by Reuben, plan is to have a demo on the next HTA call.

TopicExternal SDO Issues or addtional topicsContinuous

Carol and Suzy Roy 

No additional issues beyond those noted below

TopicExternal Code Systems Statement for IGs

Complete, 

with possible future action item 

(HTA to attend next TSC meeting)

Julie

HTA policy states that "Any publication or draft HL7 specification or implementation guide that references an external code system in any way must:

  1. Clearly identify the external content governed by IP restrictions beyond those of HL7
  2. Provide a web-link to the licensing information for the content and/or provide a short description of the requirements
  3. Reference the code system version when the artifact is published, and whether the version for use is important for the artifact
  4. If translations are involved...???
  5. Include, at minimum the following statement, prominently placed (e.g., black box warnings at the beginning of Structured Product Labels in the United States) :
    "This HL7 specification contains and references intellectual property owned by third parties ("Third Party IP"). Use of any HL7 specification and it's associated licensing terms does not grant any rights with respect to Third Party IP. The licensee alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize Third Party IP in connection with the specification or otherwise."

A proposal has been made to TSC that the following wording should be used:

"Implementers and testers of this specification SHALL abide by the license requirements for each terminology content artifact utilized within a functioning implementation. Terminology licenses SHALL be obtained from the terminology authority for each code system or other specified artifact used. It is the sole responsibility of each organization deploying or testing this specification to ensure their implementations comply with licensing requirements."

TSC are not entertaining this proposal until the HTA has discussed it

The wording is designed to go into HL7 products but is regarding use of external terminologies in those specs.  The HTA would prefer not to have such a heavy handed approach both of language and format.  Caroline Macumber has proposed an updated (as now shown on the HTA policy page) version as an attempt to integrate the two.

"This HL7 specification contains and references intellectual property owned by third parties ("Third Party IP").  Implementers and testers of this specification SHALL abide by the license requirements for each terminology content artifact utilized within a functioning implementation. Terminology licenses SHALL be obtained from the  Third Party IP owner for each code system and/or other specified artifact used. It is the sole responsibility of each organization deploying or testing this specification to ensure their implementations comply with licensing requirements of each Third Party IP."

Upon approval, Carol will send to TSC/Wayne. HTA rep will likely need to attend the next TSC meeting

Motion to accept this verbiage/policy and send on to TSC - Roel/Susan - Motion passes 5-0-0

TopicUTG UpdateIn ProgressCarol

From WGM: UTG Naming System page - is there anything obviously incorrect (to be included as task for HTA memebers testing)

UTG Project Management page: UTG Project Management

Jessica Bota , UTG PM, is arranging testing calls (first to occur this week). A technical resource has been brought on to aid in automating as much of the testing as possible.

TopicISO Codes  - updateIn ProgressDavera

STILL OPEN: Other ISO standards to check:

Process comment: Meeting minutes from meeting in which these items were originally discussed were updated after the fact. Requesting that assignments are tagged with a user name so users can be notified. 

  • FHIR also uses the IANA Time Zones https://www.iana.org/time-zones
  • Davera Gabriel will look up more information about BCP-47 (a document authored by the IETF trust) for language codes in the US Core FHIR IG.  Davera will check if this is actually a "nested reference" and is actually a syntax using ISO codes https://tools.ietf.org/html/bcp47
  • (follow-up from Davera) Appologies for needing to step away & then not getting back to this in the meeting.  In the document linked above is the answer to the question.  On Page 8, under the section: "2.2. Language Subtag Sources and Interpretation" there is an explanation of the name spacing used to construct the BCP-47 "tags."  It is my read that the answer to the question as posited is a hybrid of the two options you propose in your question.  There is structure within the tags, but Im not sure that includes your posited definition of "syntax."  One would have to parse the tags to derive syntax, but as this is standard it could be done.  As such, what I intended to do in the meeting is discuss what was meant by question created the amended meeting minutes and NOT in the original meeting minutes: "Davera will check if this is actually a "nested reference" and is actually a syntax using ISO codes" to see if the tag / subtag structure fit your intended question definition of "syntax."  In practice, the subtags are intended to designate corollaries to portions of ISO 639.x designating spoken or written languages. 
  • I would further suggest we consult with the folks that suggested the use of BCP-47 as to their intentions.  I'd be very interested to learn whether they are interested in capturing a written versus spoken language.  My hunch is that there's a much simpler explanation than that, in which case splitting the BCP-47 tags is not implied, nor necessary for their use case, and if so:  we are overthinking a bit
TopicFHIR Tracker Items

#1 Complete

#2 In progress, Julie to send note

to FMG

Reuben/Carol

1) [#25207] Summary: Update Licence Note for Value Sets based on SNOMED GPS

Caroline Macumber and Suzy Roy  have submitted the following to the IPS team and it has been approved by SNOMED Int for use in HL7 products

"This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org"

2) Graeme  Grieve is (allegedly) dealing with new SNOMED content for Vital Signs to go into the GPS - discuss with Suzy.  FMG is requiring that anything that requires use of SNOMED is balloted as US Realm; HTA needs to challenge this.  Susan will investigate this further and come back to the HTA.

Reuben talked to Grahame - the FMG rule does not apply if using the free set, only applies if outside of the freely available reference set. the rule is NOT formally documented anywhere. Grahame has stated that the rule exists because they do not want to require implementers to be required to go through any additional licensing requirements.

Susan - will be requesting additional concepts via SNOMED Int into the free set. To do this, Susan sent concepts to Grahame for submission to SNOMED "free set" (what is this??? the GPS is a conglomeration of a number of free sets, concepts are not added to it directly) 

Julie and Carol met with Suzy and Monica from SNOMED Int and drafted a policy with regards to concept requests (which can be extended to determine how state HL7 realms apply to the use of SNOMED) that will be communicated in San Antonio, stating the following:

Universal Realm

Requests for new or changed content within SNOMED CT should be internationally appropriate and should be made to the HTA using the content request form present in https://confluence.hl7.org/display/TA/Request+content+in+external+terminologies, respecting the deadlines that the HTA have published for the upcoming SNOMED release cycle.  The HTA will then manage this according to the process documented at https://confluence.hl7.org/display/TA/SNOMED+CT+New+Concept+request+process

US Realm or HL7 Affiliate with a SNOMED NRC

Requests for new or changed content within SNOMED CT for inclusion in the national extension or requests for content (to be promoted to) the international release should be made directly to the Affiliate’s NRC.

HL7 Affiliate without a SNOMED NRC

To use the process above for the Universal Realm, dealing directly with the HTA.


HTA members agree with the above, however raise a question (especially the new members) about who/how the HTA submits those requests to SNOMED. By the rules above, Susan can submit the request for new concepts via the process above. So Susan is going to:

Value sets are in the IG hardcoded - no OID - they have SNOMED CT SOLOR extension IDs, we were waiting for a process from Rory to compare extensions to promote to international version. However, this development item has not yet been completed. Thus, all SOLOR content needs to be submitted as new content however, their codes will be retained. Susan is going to submit a request for all the Vital SIgns and Wound related concepts (ballot in Sept). Pain will be sumitted later (ballot in Jan).

Note: Cutoff for July SNOMED Int release inclusion is May 1st  The IPS Freeset (which goes through Rob H) is March 15th.


ManagementHTA in January HL7 NewsletterCompleteCarol

FYI: The HL7 January Newsletter 

http://www.hl7.org/documentcenter/public/newsletters/HL7_NEWS_20200108.pdf 

had a section about the HTA with thanks to our retiring members and welcome to new members

ManagementNext CallN/ACarolNext call, scheduled 18th March.

AdjournmentMeeting adjournedN/ACarol

At 21.04 UTC


Action Items

  • Julie James Caroline Macumber Reuben Daniels to arrange a call/meeting with the FHIR Management Group (FMG) to discuss the requirement for FHIR Implementation Guides to be realm-specific (not Universal) if they require the use of non-free SNOMED CT concepts. Email sent 17-March-2020
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1 Comment

  1. Updated post meeting to correct cutoff dates for July SNOMED release and IPS