WGM May 2019 Minutes

Based on our review of our role from the GOM and in the light of current situation in HL7 particularly with reference to the UTG (Universal Terminology Governance).

There are a significant number of code systems that exist in HL7 (e.g. in the MIF) that need to be transitioned in the the UTC process but for which all the required information (OID, URL etc.)  is not available - e.g. the NUBC National Uniform Billing Committee codes used in V2 specifications, come from a US Realm code system but which (theoretically at least) iswithin the remit of the HTA.   Note that for most "realm specific" code systems, identification (such as OIDs) is managed within the realm, either by a national body (e.g. NICTIZ in the Netherlands or DIMDI in Germany) or by an HL7 affiliate.  

See also UTG section below.

Update post Sunday 5th May: As the week progressed, and particularly with the joint meeting with the Vocabulary Work Group (see Minutes May 2019 - HL7 WGM - Monday Q4 Minutes) it was agreed that HTA focus on policy and Vocab focus on implementation.  HTA need to work with the TSC to action this, and to get the GOM updated.  Several topics for policy development were assigned to the HTA and are gathered together on this page: HTA - Policies and Processes to be created/developed 

HTA will meet jointly with the Vocab WG at the next WGM.

Global Patient Subset- how should HTA promote this? https://www.snomed.org/snomed-international/learn-more/global-patient-set

The GPS contains the IPS and the DICOM subsets (and possibly other content).

Use of GPS is not restricted to any particular specification in HL7 (Note: agreement not yet totally finalised). So the intent and the request from HL7 was that content from the GPS can be used in ANY HL7 specification or implementation guide.  BUT countries like Germany still cannot use this because Germany cannot do a translation as this is against the terms of the license.  We understand that the GPS is likely to be a csv file with the US English PT.  There is no semantic tag, as there is no FSN.  There is therefore the risk of semantic ambiguity for some content. There are no relationships and no status (we assume that a concept is active when it goes into the subset - does it stay .  Version can be assumed based on the timing of the release of the set.

We understand that the IPS Specification sees value in this, but the HTA cannot promote the use of the SNOMED GPS if it is provided in this way because without semantic tags/FSNs it will be difficult to correctly identify which concepts to use (e.g. edema).

Rob H: IPS free set.....then SNOMED on FHIR in parallel...has led to the GPS.  The IPS submission does have semantic tags.  IPS is only for use in IPS and therefore the semantic context is available from the IPS information model.  IPS Free Set will be maintained in the RefSet Tool - so the FSN is present.

SNOMED on FHIR - value set authoring and maintenance

IPS is an EU recommended standard for xborder healthcare information exchange; but EU cannot yet use it because of all the issues we have listed above.

HL7 IPS in the SNOMED International refset tool: https://refset.ihtsdotools.org/#/directory?refsetId=10975166 

Motion: The HTA Position is that for IPS, it accepts the value of it in IPS but notes the issues in translation for EU countries and distribution and unambiguous use in SNOMED non-member nations.  For GPS, HTA cannot promote it based on the current description of its content.  The IPS Specification should include a warning about the use of the Subset based on these concerns.

Proposed HG; RB Carried unanamiously.

SNOMED CRS (on TSC Calendar): WG need to make requests to the HTA for new concepts in external code systems. UTG will manage requests for changes to value set content.  CRS needs to an electronic form linked to JIRA and also linked to UTG

Julie shared the slides for the Co-Chair Dinner; the group was happy with these but requested an additional slide about content request, which was added.

Need to get links from HL7.org to HTA Confluence pages

Encourage Specifications and IGs to use these links that reference external terminologies

Will be replacing Harmonization process for terminology

Workflow (in JIRA) for proposal - V2 Tables, V3 Vocab, FHIR Vocab, CDA Value Set, CIMI Vocab, External Vocabulary; Realm Specific Vocabulary, Other

CCDA - is this US realm?  Not sure yet. 

What about Affiliate Value Sets?  Discussions with AH and KH to work with Art-Decor; UTC not taking on more than it has to at the moment but there are particular concerns about managing identifiers.

"External vocabulary" - anything not curated by HL7.  If there is a request for additional concept content - this will need to come to HTA and will need to make sure this is seamless.  If it is for a value set using external vocab content, then that is UTC.