Meeting Information

Attendee Pass: HTAMeet

Chair:  Carol

Scribe: Carol


Attendee type:

H - HTA Member

O - observer

L - liaison


P - present

A - Apologies



HAJulie JamesBlue Wave Informatics LLP

Roel Barelds

Precipius b.v.

HPSusan MatneyIntermountain Health
Sylvia ThunHL7 Germany
HPCarol MacumberClinical Architecture
HPReuben DanielsSaludax
HPDavera GabrielJohns Hopkins University Institute for Clinical and Translational Research

Wayne Kubick


LPSuzy RoySNOMED International
OPAndrea MacLeanCanada Health Infoway
LPJessica BotaUTG/Apelon
Ted KleinKlein Consulting / HL7 UTG / Vocabulary WG CoChair
Rob HausamVocabulary WG CoChair
Mareike PrzysuchaHL7 Germany
Rob McClureUS Realm Liaison
Rory DavidsonSNOMED International

Minutes of previous teleconference (2021-06-23) 

Motion to accept DG and CM seconded;  

Agenda Topics

Agenda Outline

Agenda Item


Meeting Minutes from Discussion



TC Minutes Approval


Quorum was met

Motion to approve Minutes:

DG moves, SM seconds: Motion 4-0-0

TopicNew PSSContinuousCarol

No new PSS's noted for HTA review

Check here:

TopicAdministrative Update from CTOOnceWayne

Julie has officially resigned from her chair position as of today, ending a bit early. Carol is the current vice-chair and may step in as chair in the interim. New Chair and Vice-Chair will officially be elected at the Sept WGM

Motion: Susan nominates Carol as interim-chair, Second by Roel. 4-0-0

Terms for many of the HTA members (all but Susan and Sylvia) end as of the Sept WGM. HQ will send out a call for nominations, all are eligible for re-appointment. An announcement will go out next week with a deadline of end of August.


External SDO and Code System Issues

(review JIRA tickets


Variance with FHIR core spec

  • Core Spec, originating in FHIR V1, had a page of external terminologies which includes identifier and additional metadata. The HTA process has included the validation of existing URIs, documenting them and the associated IP and copyright information. The HTA process also includes working with external terminology owners to establish new URLs where one does not exist
  • Lloyd's request - take down any publication of URIs that have been published elsewhere and conflict (e.g., ATC). 
    • Through error, some identifiers may need to change. less likely in URI space, than OID space, but still possible (includes need to split what was once believed to be one code system into two).
    • External codes system owner desire for change is not an acceptable justification for imposing cost to implementers. HL7 has the authority to decide how to differentiate code systems in HL7 standards
    • Motion: Engage the WHO to let them know URI cannot be officially endorsed until policy decisions have been made via the TSC. HTA will also temporarily note on the HTA's ATC External Terminology, that the URI is undergoing further assessment and should not be used until further notice
    • RD Moves, DG Seconds - 4-0-0
  • Scenario: new code system URI is declared, documented, publicized via HTA and UTG process. implementers begin to use the URI. sometime later, another implementer indicates that a URI has already been used in their large implementation
    • LM: Where HL7 had not established a URI - comes down to implementer community, assessment of impact.  Where HL7 had established a URI - the implementer would be asked to utilize the HL7 endorsed URI
    • RD: Impact to implementer community -
      • Two schools of though perhaps: what's best long term is to use what is endorsed by the code system owner vs. what's been documented in current FHIR specification (or FHIR IGs). 
      • How do we effectively assess implementer impact?
        • LM: Impact is code system specific. Some are used far and wide (e.g., UCUM, where we decided to not change the identifier even though ownership of UCUM had changed) whereas others have lower impact. 
        • WK: For a published specification, FHIR is a different breed of STU. A technical correction can be used to correct issues.  STU process can be used to do an impact assessment. 
        • Systems that declare new URIs, that already exist, those systems are non-conformant
      • If HTA (HL7?) endorses something that the owner endorses, that's best long-term
  • Transition to THO as single source of truth
    • When R4 was published, THO was not mature enough to support implementer community. It is the expectation of FMG, HTA and Vocab that all the tabs in the existing FHIR terminologies page, will be removed (sans those maintained within the FHIR specification) and a reference will be added to the appropriate resource in THO
    • An assessment has been done to evaluate the completeness and accuracy of information currently captured in the FHIR Spec and the HTA External Terminology pages
  • HTA-10 - Getting issue details... STATUS ICD-O-3 page has been drafted - vote to approve International Classification of Diseases for Oncology, 3rd Edition (ICD-0-3)
  • HTA-45 - Getting issue details... STATUS ICCC, is someone working on this one already?

WK: Mark Duteau has been hired b HL7 to help with many aspects of HL7, including terminology related issues


HL7 Terminology Services Management Group 

Did not get to this item

Rob M

Final meeting of subgroup has happened and a proposal has gone to TSC for eVote/discussion next Monday in order to get a decision before the "retreats".  The TSMG will be allowed to set policy; the exact ringfencing of the "policy area" has not yet been defined.  Should be announced for September WGM

TSC eVote: TSC e-Vote 2021-07-05

TSC eVote Proposal: Terminology Services Management Group Proposal


UTG/THO Update

Did not get to this item

ContinuousJess and Reuben
  • Analysis of HTA External Terminology pages – Link to Google Sheet
    • For discussion: addressing the external terminology pages which do not use the new template (62 of 93 / 67%)
  • Proforma updated slightly for improvement

Updated CS Identifier process guidance

Did not get to this item


Carmela has offered to improve upon the current document process for external stakeholder engagement to procure CS identifiers.

The draft is located here: Validating and Requesting Identifiers for External Code Systems and Identifier Systems

HTA members and observers are asked to review the drafted text, directly edit where changes are needed and use the comment functionality to ask additional questions. We will review again (and hopefully approve on the next HTA call, which will be at the WGM).


Any Other Business

Did not get to this item


If no chair for 4/8/21 will cancel

AdjournmentMeeting adjournedN/ACarol

Call adjourned at 4:00 EST

Action Items

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