Chair: Caroline Macumber
Scribe: Davera Gabriel
Tuesday, October 26 5:00-6:30PM USA ET
Tuesday, October 26 9:00-10:30PM UTC
Wednesday, October 27 7:00-8:30AM (AEST)
Zoom link - https://hl7-org.zoom.us/j/91305750131?pwd=UEVkMzJOV25NQ3lUVU9POUZKWi9lZz09
Find your local number: https://hl7-org.zoom.us/u/ahGd9dnCv
M - TSMG Member
O -Observer / Guest
P - present
A - Apologies
|M (Co-Chair)||P||Clinical Architecture|
Davera Gabriel (DG)
|The Johns Hopkins University|
Reuben Daniels (RD)
Wayne Kubick (WK)
|M (TSMG Rep to the TSC)||P|
Rob McClure (RM)
|MD Partners, Inc.|
Bryn Rhodes (BR)
Jessica Bota (JB)
Lisa R. Nelson (LN)
Michael Faughn (MF)
|National Institute of Standards and Technology (NIST)|
Peter Jordan (PJ)
|HL7 New Zealand|
Roel Barelds (RB)
Susan Matney (SM)
Sylvia Thun (ST)
Joan Harper (JH)
|Canada Health Infoway|
Patrick McLaughlin (PM)
|National Library of Medicine|
Robert Hausam (RH)
|Hausam Consulting LLC|
Suzy Roy (SR)
|O||P||Canada Health Inforway|
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Minutes Approved as Presented
2021-10-19 TSMG Agenda and Minutes
This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."
Minutes Approved, no dissent
Rob: Need to add the text per the TSC / Cochairs meeting
None of the three additions from the HTA is present, to be discussed in next agenda item. New members of the HTA are welcomed to the group.
Rob M: need to meet expectations as presented by the Product Families. Perhaps original wording perhaps was too restrictive - diversity of membership was emphasized. There may be roles to be filled that are not family product family specific. Everyone doesn't have to fill a product family role per se... but all of the product families must be filled. CTO, Vocab HTA, UTG/ THO ae the four required members.. and additionally there is the expectation that all of standards product families,. Implementation roles... the expectation is that there should be representation for all of these interests per the TSMG charter
Reuben: this list needs to be updated to reflect HTA-focused concerns, such as : external terminology representation. Need to assign roles to present members
Rob M: This was intended as a guideline and not immutable, this can be adjusted
Jess: UTG call would need to be rescheduled,
Tuesdays Carol has a conflict, SNOMED on FHIR conflict every other week
Wednesdays: conflict with FHIR tracker call - smaller group than the TSMG, looks like the best meeting to move
Bryn has a conflict on 1st and 3rd Wednesdays, Also a conflict with FMG during that time
later in the spring, the Wednesday spot will conflict with the standing HTA call
Mondays: conflict with Gender Harmony
Thursday: conflict with Vocabulary Main call
Members agreed to the change to Wednesday after discussing the options and the conflicts.
Reuben will follow-up with Carmella to change the FHIR Tracker call to the Tuesday slot the TSMG call occurs in now, and make accommodation for rescheduling the HTA call in the spring
This will additionally be changed / added to the call calendar
Update on Decision Making Principles (DMP) work
Draft interim DMP
2. The Terminology Services Management Group (TSMG) is a closed committee. Unless in executive or declared in-camera session, anyone may be present and listen to the discussion without voice. They must identify themselves and if attending for a specific agenda item, identify that area of interest. When that agenda item is presented, they may at the discretion of the presiding Chair, be called on to provide additional information.
5.1 Defining Quorum
Quorum for the TSMG requires at least 50% of the TSMG membership including the chair such that the chair has a casting vote.
7. Electronic Voting
a) At the discretion of the TSMG members, decisions “considered outside of scheduled meetings that meet quorum” may be resolved by eVote.
b) eVote may be requested for input on decision topics and for the approval of documents including Project Scope Statements (PSS), Publication Requests, and other documents as
c) A list of routine decisions may be distributed to the TSMG membership with options to vote affirmative, negative, abstain, or refer to telecon. A comment is required for a negative or refer to telecon vote.
d) The typical voting period “72 hours after the eVote is announced” TSMG co-chairs may choose to extend the voting period. Negative or Referred items will be on the agenda for the next TSMG meeting.
e) Quorum for electronic voting will as for in person TSMG meetings (section 5.1). Refer to Section 5 for WGM quorum requirements.
f) If quorum has not been achieved after 72 hours, the vote will be taken at the next TSMG meeting.
g) All TSMG subcommittee votes must be eVotes
Reuben: Any discussion except the red text?
RobM: DMP re: eVote.. folks have to request this. There has to be a motion and a second in the committees its up to the chair as to what goes into the eVote, so the membership doesn't have any say as to what goes into the eVote group.
Carol: are you restricting this to the 3x WGMs? discussed differences between eVoting and electronic voting
Reuben: days for limiting the eVoting discussion
RobM: the situation the voting can occur is the issue... the DMP is too restrictive, and this emulated that
Carol motions to accept these terms, RobM seconds this motion. 7 voting members present. no abstentions, no negative votes Motion passes 7-0-0
Rob: these are standing groups as contrasted from task forces. Rob moves to accept, Reuben seconds. Motions passes 7-0-0
Rob: comment: we discussed proxies last week.
Reuben: We put that into the DMP, but need to discuss this at the next meeting
Publishing terminology to the FHIR Ecosystem
GG: Requests have been for terminology service(s) fro IG publisher / validator. There are requirements to make this work. Grahame doesn't want to maintain terminologies other than what is required by the validator. Validator is gaining a lot of interest with the community. Not all content must be loaded on tx.fhir.org... if folks have viable terminology servers, then they should be allowed / supported to use these. example: VSAC - have used some of that content in the past, but not all of that content. TermServer could provide content to the publisher validator, without being responsible for publishing ALL terminology. Grahame developed tools to permit utilization of outside terminology resources via (three) modalities. Service would need to be registered to access this "ecosystem" to make a term service "authoritative" to be available to this purpose.
Reuben: would these registered TermServices "own" & be responsible for their content
Grahame; not sure... in some cases, like VSAC, the registree may not "own" anything
RobM: restated... and authoritative distribution point, an entity
Peter: demonstrable conformant implementation, rather than "owner" focus on what the term server can do, capability not ownership
Grahame: no an owner of the content is desired
Peter: this is will limit participation
Reuben: agree with Grahame
Davera: could there be more than one criteria to participation?
Graham: need to have appropriate certification that the code system content is authoritative sufficiently to preform as needed
Carol: this criteria would open you up to some liability re: the content
Graham: needs to "authoritative"
RobM: needs to have some statement / measurement of having authoritative content that isn't the role of "owner" of the terminology
Grahame: TermServices doesn't have to be free / open. Must have a way for folks to register for its use, the restrictions need to be documented, and the path to access to the content would work. Grahame will have an Authenticated header that could be configured for the toolsmith. Accordingly, there needs to be an agreed-to path to configure and maintain registration and said header, token etc.
Reuben: Identification for code system... is the workflow tx,fhir.org first?
Grahame: workflow: tx.fhir.org, then to term server, the tx.fhir.org complexity with many code systems utilization
Reuben: what happens with versions (ie: SCT) the header will handle a range of versions in the header.
RobM: "conformant" is a description that may work for this case. in some cases, the content is not available for the authoritative source, ie: CVX. in VSAC CVX is available as a conformant content set, and not from its owner. Sometimes use the term "convenience copy."
Grahame: tx.fhir.org is the authoritative source for now, will revisit this later. The FHIR tooling is what is intended to be supported for the time being. There are some unusual circumstances that occur from mixing content from many standards. Validation becomes difficult & complicated. Some issues cannot be aligned efficiently. if tx.fhir.org is the primary point of validation for toolsmiths, this lowers the complexity of having to check many sources of reference content.
RobM:. This is a good example of the value of a collaboration between the TSMG and publishing vis tx.fhir.doc. This proposal is a good first step to bring transparency to the alignment processes required to support FHIR publishing.
Grahame: agree - this has been needed for quite some time, and this is a good step toward providing solutions re: terminology validation. This document sections represent what the tooling folks have been asking for awhile. There is additional content / details that will be needed to fill-out this proposal document. In some cases not quite sure what is technically feasible. Some of this is to document what exists. Will follow pattern registration used in the SMART code - file will contain everything the tools need to know to process the content needed.
RobM: this is a solid stab at what might be conducted as a part of the terminology Services tasks for the Connectathon
Grahame: We did this at the last Connectathon - validation issues with performance. (these are now tickets)
RobM: is would be great to get a list of code systems & begin to start listing what kinds of things that we want to do at tx.fhir.org... list a number of attributes / requirements that would be needed to support this, as a punch-list for the TSMG to work as a way to initiate interactions with the terminology server providers. This would be a good way to start to interact with tx.fhir.org. This document is a start at improving / broadening the use of terminology by tx.fhir.org
RobM: where is there information about content that is not in tx.fhir.org not THO - but its just a package? where is that built into the publisher
Grahame: have been asked about human readable & implicit value sets - where is this? There is no proper place for this at the moment. This (...) is the "master place" for content that are "packages"
Peter: need to discuss this use case... instance / specific artifact
Grahame: I get bug tickets because the terminology servers are not validating the same way the validator on tx.fhir.org does. the trouble is with the terminology severs
Reuben: there are tasks re: maintain the content of the proposal. Does this propose that the TSMG would be responsible for this?
Grahame: asking TSMG to comment of the proposal, and the methods employed. Longer term bigger question: how do we maintain the burden of maintain publishing for other organizations. This is a part of the bigger picture therein that's true for all of HL7. This implies there is a dedicated resource that's not Grahame to do that.
RobM: Highlight that statement... that statement applies. Bigger picture: tx.fhir.org should be cloneable resource to be used by others. It doesn't make sense to have one version that's used for standards and a different approach that others use to do validation. This is thematic re: the resources to maintain this approach.
Reuben: Wayne comments
Wayne: Grahame stated we do not know what to do.. will keep us posted.
Reuben: all members and attendees should look at the proposal and be presperd to discuss in an upcoming meeting
Not covered, ran out of time: Statically Bound Value Sets
TSMG Members should read through Grahame's proposal, provide feedback, be ready to discuss at the next meeting
- Agreed-upon definition of proxy voting should be discussed at the next meeting
- Reuben Daniels will update the TSMG calendar transactions, zoom registration re: updated time for this call & send notification to the list etc.