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Chair: Caroline Macumber 

Scribe: Davera Gabriel 


Wednesday, March 02, 8:00-9:30PM UTC

Wednesday, March 02, 3:00-4:30PM USA ET

Thursday, March 03, 6:00-7:30AM AEST

Thursday, March 03,, 9:00-10:30AM NZDT   

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Attendee type:

M - TSMG Member

O -Observer / Guest


P - present

A - Apologies

X - (Apologies with Proxy)



M (Co-Chair)PClinical Architecture
M (Co-Chair)PThe Johns Hopkins University
M (Co-Chair)PSaludax
HL7 International
M (TSMG Rep to the TSC)PMD Partners, Inc.

P (first 60 minutes only)

Reuben Proxy for last 30

MPApelon, Inc.
MP (conflict w first 30 minutes)MaxMD
MPNational Institute of Standards and Technology (NIST)
MPHL7 New Zealand
MPPrecipius b.v.
HL7 Germany
Health Intersections
OPCanada Health Infoway
National Library of Medicine
Hausam Consulting LLC
SNOMED International
OPJoe FlackJohns Hopkins BIDS
Office of the National Coordinator for Health Information Technology (ONC)
John SnyderNational Library of Medicine (US)
Ted KleinTK Consulting
OPRavi Kafle

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Minutes Approved as Presented 

2022-02-23 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."

Agenda Topics 

Meeting was recorded

Agenda Outline

Time allocationLead

Agenda Item

  • Note that meetings are recorded
  • Welcome to members and observers


  • Announcements 
  • Meeting times in March - with seasonal time zone changes (on March 13)
    • Reuben will post a doodle poll to the Zulip channel for an updated time
    • HIMSS in March (meeting impacted: 16th) week - Carol & Jess will not be able to attend TSMG meeting
      • Reuben to chair meeting 3/16
  • Policy & Process Documentation Repository
    • Requirements
    • Disposition - library approach
    • Each TSMG Subgroup should have their own pages
TSMG Standing Subcommittee Updates

  HL7 Terminology Authority10


    • Case sensitivity in identifiers 
      • What to do with numeric-only identifiers
      • OrphaNet... others revisited
      • RM Motion, Second BR. All concept identifiers should be treated as alpha-numeric for the purpose of considering case-sensitivity, And we should assume that codes are case sensitive unless specified by the Terminology Authority or further investigation has determined they are case insensitive and change when necessary.  Restrict concept identifier to align with the FHIR identifiers for code and where it is not aligned, evaluate case sensitivity flag for that code system on a case by case basis.  Motion passes 7-1-0
        • example: UCUM is case sensitive & also provide a version that is case insensitive that happens to be all upper case
        • Currently there was no default applied - no value was available and the publication tool requires a value & was generating hundreds of errors.  The interim value should be set to "true" in order to avoid publication issues. External code systems, each should be reviewed for case insensitivity or both cases to set the flag appropriately
        • BR:  in FHIR there are specifications as to what can be a component of a code here in the code data type
        • AI: updating metadata records, goes to decision log / policy directory
    • Gender Harmony: V2 tables in publication
      • THO is the source of truth now or not?
      • When will the V2 management be ready to switch over? 
      • MF: currently working on porting the information out of the V2 UTG GitHub repo. Q: is this a full compliment of info - note that there is some information that appears to be missing.  MF:  will take responsibility to assuring the V2 information is up to date.
  HL7 Terminology / Unified Terminology Governance (THO/UTG)10RD/JB
  • Released THO v3.1.0!!!
    • Release process finished on 2/25 and took 6 days
    • Includes many new external code system resources as well as identifiers systems (from FHIR)
  • THO release schedule
    • Need feedback from TSC/HQ 
    • The following information was emailed to Rob and Bryn to provide to the TSC
      • Release process is documented in Section D on Curator Processing of Proposals
      • Release can take anywhere from 3 days to 3 weeks
        • Release is very dependent on the IG Publisher
        • Terminology Curator has not been able to perform a release without assistance from Grahame due to issues popping up with tooling
  • THO post-release cleanup
    • Started discussions on cleaning up branches that have been implemented prior to older THO releases
    • Subcommittee is weighing pros and cons of removing old branches
      • Removing old branches will break Published Example links in older UTG proposals
      • Removing old branches is likely a manual process prone to human error
      • Keeping branches increases the size of the repository
      • Marc Duteau is investigating further to see what our options are and weigh pros/cons further
  • Lisa looking into CDA Value Sets missing from THO ( UP-116 - Getting issue details... STATUS )
  • Call for UTG OSG Voters
    • Send email draft to Management Groups for Product Family OSGs
      • OR have our TSMG reps for V2, V3, CDA, and FHIR bring this to the Management Groups?
    • Ask Rob and Peter for help recruiting for Realm-Based OSG
    • Ask TSMG main call for Vocab/TSMG members for the Vocab OSG
  • Vocab WG follow-up: Policy Requiring Identification of Stewards for HL7 (Internal) Code Systems
    • In Vocab WG - Motion passed: Vocab WG recommends that TSMG implement a rule stating that:
      Every HL7 code system in THO must have a steward WG.  The steward WG has to be one of the WGs that are authorized to propose making changes to an HL7 code system in THO. 
    • THO/UTG Subcommittee referenced and propose that the Steward is defined as:
      • The WG responsible for the maintenance and upkeep of the code system (not to be confused with Publisher who makes the content available)
        • This implies that the WG has the domain expertise/knowledge related to the code system
      • The primary point of contact for questions or issues with the code system
    • The main issue is assigning all code systems a Steward
      • We could assign them all to Vocab and then reassign the Steward if needed
  • Status updates
    • Will create business requirements for a UTG Editor
    • Sprint 2 of UTG Jira development items with a focus on release tracking in progress
      • Scheduling call mid March to finalize release tracking requirements
      • Scheduled kickoff call for Jira automation work
R5 Release timing

Grahame G is soliciting opinions on our future course for FHIR R5. TSMG membership to discuss potential responses. 
Technical Steering Committee (TSC) matters10RM
  • Decision Making Practices
  • (deferred until next week)


Supporting Documents

Outline Reference

Supporting Document

Minute Approval2022-02-23 TSMG Agenda and Minutes