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Date: Tuesday 22 September 2021

All Participants: Make sure you are registered with WHOVA and join the session through that.

Attendee type:

H - HTA Member

O - observer

L - liaison


P - present

A - Apologies



H (Chair)PCarol Macumber Clinical Architecture

Roel Barelds


HPSusan MatneyIntermountain Health
Sylvia ThunHL7 Germany
HPReuben DanielsSaludax
Davera GabrielJohns Hopkins University Institute for Clinical and Translational Research

Wayne Kubick


LPSuzy RoySNOMED International
Swapna AbhyankarLOINC
LPRob McClureMD Partners
Julie JamesBlue Wave Informatics LLP
Andrea MacLeanInfoway
OPJoan HarperInfoway
Jessica BotaApelon
Marc DuteauMD Partners
OPJohn SnyderNLM
OPAbdulMalik ShakirHi3 Solutions
OPRenato CalamaieHealthTech
OPBas van den HeuvelPhilips
Lenel JamesBlue Cross Blue Shield Association

Minutes Approval

Discussion items

Please note: order of items may change due to availability/practicality

ManagementMinutes approvalCarol
ManagementNomination of HTA Chairs and HTA relationship to TSMGCarol/Wayne
  • Nominations were open for seats held by Roel Barelds, Carol Macumber, Reuben Daniels and Davera Gabriel. Wayne reports that all three were reappointed by the HL7 board. Julie's position was not filled, thus there is one seat open
    • RD - Election of HTA chair and vice-chair - hold over to next meeting
  • With the formation of the TSMG, as they have similar responsibilities on a broader scale, what is the future of the HTA – subgroup or be merged? GOM changes will be necessary with either.
    • SM - currently the HTA and TSMG seem to have two separate missions. HTA - gathers information to use the terminology whereas TSMG manages how the terminology is used across HL7 product families
    • RM - three people here (two members and one liaison are on the TSMG, believes they overlap, different in a sense that TSMG has a broad set of responsibilities in regards to making things work...terminology capabilities work and HTA function is a subset. Without a question the biggest part of HTA is to make terminology work. Not UTG, not THO...interacts and integral in "making terminology work".  If HTA remains a separate entity, we have work to do to ensure information flows between the groups. Someone like Suzy/SCT , would be interacting be both, in addition to Vocab. 
      • TSMG will manage THO - presumably we would publish anything we know about external terminologies at THO. We need to also improve how we utilize Providing usable access to these external terminologies, sits with TSMG. 
      • To ensure continued functionality - how do we manage the membership of HTA in relation to TSMG?
    • RD - also on the TSMG as interim-chair - aligned with Rob - design of TSMG - two functions 1) policies, delegated from the TSC and 2) deliver on a set of services as agreed upon by TSMG, TSC and HL7 HQ – first focused on UTG and THO as the single source of truth, but likely additional services, including the function that HTA currently serves to engage external stakeholders. Support transition of HTA into TSMG. May reduce confusion if there aren't more than one management group within HL7.
      • Formation of TSMG is a testament to HL7 recognizing that terminology standards must be supported independently from the communication standards
    • WK - TSMG has a set on the TSC - who is simplifying it's structure. within the org, HTA's role is better understood but not as much as it should be. TSMG member on the TSC would still be accountable for reporting outcomes from HTA, representing the community at TSC. From an org structure perspective, it makes sense to bring them together.
      • Limited number of expertise and availability to participate in the roles/groups. we want to utilize our volunteer time as efficiently as possible.
      • Firm decision is not required today, but a communication about how the two groups relate needs to be crafted and communicated to the HL7 community. "one stop shopping" is very attractive.. That being said, changing the GOM takes a cycle or two.
    • SR -  from an external terminology provider perspective, representing SCT INT, having the HTA has been a nice way to know where to go, who to engage at HL7 to keep up-to-date on the use of external vocabularies and their use in HL7. Further, it provided a good "landing place" for external terminology liaisons to collaborate with HL7. Will be necessary for HL7 to clearly communicate where external terminology providers should go and for what if the groups exist separately.
    • RB -  agree with SM, local terminologies from other terminologies should be added to THO, thus local liaisons need to also be supported. Need a group that can work with international members around local use of terminology in HL7 products. Separate terminology standard from communication standard? HTA, or whoever, should be responsible for terminology standards.
    • CM - Management vs. Methodology - if TSMG is management, then who is methodology? Vocab?
      • RD - Vocab is the methodology group. Maintaining the content in THO is expected to be one of the services that TSMG provides. Comes down to responsibilities. Vocab has standards and how it's specified. TSMG is responsible for the execution and setting policy
      • WK - The groups will need to work together. Clearly there is a lot of work that still needs to be done with limited resources. Governance is done in many places, including board, TSC and TSMG
        • Ultimately the board will be notified of recommendations from CTO and TSC. No fixed preconception of how the decision will be made. ESC informing the board and approval. 
      • RM - creation of standards and implementation divisions – no idea how that may impact HTA (and TSMG who clearly has a role in both areas).
        • HTA as part of Vocab? Tactical work fits with vocab work/methodology 
        • RB - could be a good combination, merging focus on internal (vocab) and external (HTA) support into one group
        • RD - A lot of what the HTA is doing (external engagement etc..) is a service and form of policy setting. Seems far more reasonable to be with TSMG.
      • AMS - as an impacted stakeholder, it would be useful to take lessons from the other management groups. SD takes care of methodology for CDA MG, FHIR-I takes care of FMG methodology. Vocab would serve that role for TSMG
TopicFHIR Tracker: OID specified on page for ICD-9CM is registered for ICD-9Reuben

Jira ticket FHIR-33023 - Getting issue details... STATUS

Summary - Policy decision is needed as the .103 and .104 splits are in use in CCDA validation. The use of .42 by HTA and FHIR is incorrect as that oid represents the WHO international version (ICD9) not the US clinical modification (ICD9CM).  RD suggests that the following may be a solution

  1. Restore a single OID for ICD9CM (6.2) and state the .103 and .104 as alternative OIDS in THO
  2. document .42 as a new code system metadata record for ICD9

NOTE: Group confirmed that VSAC is using both.103 and .104. Examples here and here

  • The OID 2.16.840.1.113883.6.42 is stated in
  • The OID 2.16.840.1.113883.6.2 is stated in
    • THO/UTG's ICD-9-CM Code System Metadata Record as the OID for ICD-9-CM
    • the HL7 OID Registry as a retired OID for ICD-9CM with the following note: Note that this has been retired in favor of an explicit split between the diagnosis codes and the procedures codes as per the Vocablary TC decision on Wednesday Q4, January 21, 2004.  Replaced by 2.16.840.1.113883.6.103 and 2.16.840.1.113883.6.104 as voted by committee.  -T. Klein
  • The OID 2.16.840.1.113883.6.103 is stated in
  • The OID 2.16.840.1.113883.6.104 is stated in
    • the HL7 OID Registry as the OID for ICD-9CM (procedure codes)
  • Requirement:
    • What are the correct OIDs for
      • ICD-9; and
      • ICD-9-CM 


ManagementPlans for the futureCarolFuture planning

Action items

  • TBA