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Chair: Caroline Macumber 

Scribe: Davera Gabriel 


Wednesday, March 09, 8:00-9:30PM UTC

Wednesday, March 09, 3:00-4:30PM USA ET

Thursday, March 09, 6:00-7:30AM AEST

Thursday, March 09, 9:00-10:30AM NZDT   


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
OPNational Library of Medicine
Hausam Consulting LLC
SNOMED International
Joe FlackJohns Hopkins BIDS
Office of the National Coordinator for Health Information Technology (ONC)
John SnyderNational Library of Medicine (US)
Ted KleinTK Consulting
Ravi KafleWashington State Department of Health

Antitrust statement

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Minutes Approved as Presented 

2022-03-02 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 sent a doodle poll to the Zulip channel for an updated time yesterday
    • Doodle poll results -  Mondays 1pm UTC
    • HIMSS in March (meeting impacted: 16th) week - Carol & Jess will not be able to attend TSMG meeting
      • next weeks meeting will be skipped
  • Policy & Process Documentation Repository
    • Requirements
    • Disposition - library approach
    • Each TSMG Subgroup should have their own pages
TSMG Standing Subcommittee Updates

  • May Connectathon Management
      • Terminology Services track offerings
        • Office Hours Experts
  • OMOP + FHIR harmonization group
      • Closing-in on a URI for OMOP Vocabulary
        • impacts OMOP-to-FHIR transformations
          • Dan V suggestion: explore use of CodeSystemSupplement
          • developing other examples
          • AI: invite Dan V to discuss this approach in TSMG meeting
      • Vulcan FHIR-to-OMOP proposal vote by Friday
  HL7 Terminology Authority10


    • Meeting this week: 10Mar22
    • 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.
      • CM to JB: gather THO examples to support this discussion with V2MG, work with MF to ensure the available content supports assertions / concerns re:  THO being the source of truth, and socialize both the THO solutions as well as the concerns expressed by the V2 community.  Close any gaps between these perspectives
    • V3-based metadata record for SNOMED CT international edition is not utilizing the correct url: is for SNOMED CT, not the international edition.  It needs the international elements et al in addition to this base URL. There is a Zulip chat topic on this issue here.  What is of issue is the THO doesn't reflect the correct international edition URI:  Of additional issue is if there are any additional realm-specific resources we could create metadata resources that would include examples of these editions such as the Canadian edition here.
    • RD: this would set a policy precedent for handling a family of code system identifiers using the version element to identify which specific edition a specific URI would pertain to.  
    • CM: this would require that there be documentation re: to how this policy would be implemented, including information about the specific instances in which this approach is applied 
    • BR:  if this approach is leveraged, then both the edition and version would be required to be a part of this documentation
    • CM: the issue with that would be there would be a need to develop a separate THO entry for each edition
    • RD: the issue with creating new records is that HTA doesn't have a distinct publisher for each combination pertaining to each family member (combination of edition and version)
    • RM: if the version element is used as suggested, will this break anything?
    • JB: doesn't think it will break anything, can have separate resources cannot have separate resources use the same URL
      becuase that would break things.  This has been discussed previously.  Need a page that explains the process for SNOMED.  if this element is used as being discussed this mean that the resource cannot be versioned
    • RM: are there FHIR terminology servers that have more than one edition?  (Yes)  then how are these supported on these FHIR TermServers?
    • PJ: there's no such thing as a SNOMED common core anymore because of the many editions of SNOMED. As such there is a requirement to deal with both versions and editions. in FHIR will need to treat every separate edition as a different CodeSystem
    • BR: technically the SNOMED CT international edition is an edition, and not a version.  The right way to do this would be to put the right edition information in the URL and put the version in version. this resource is metadata, and thus that resource should have the canonical URL and its not the code system, and should never be used as the code system.
    • RD: the issue is that IG publishers look at the records to create IGs and would see this & use this as a code system
    • BR: then a solution might include a record indicating the record is to indicate this is how SNOMED is referenced in the publishing tooling and not to be used as a code system identifier. Leave the THO version and then create a SNOMED family of identifiers.
    • CM:  the THO / HTA records are supposed to be the source of truth  which validation for publishing is meant to be used
    • RM:  another issue is that any instances will not be able to be validated against records that use this approach, would mean there's a special code for SNOMED
    • PJ: is already tricky becuase there's an implicit requirement to validate codes against editions and versions already
    • RD: these metadata records do not have a role with any terminology server instances, its supports publishing only
  HL7 Terminology / Unified Terminology Governance (THO/UTG)10RD/JB
  • THO release schedule
    • Need feedback from TSC/HQ 
    • Info sent to Rob and Bryn and will be passed along to TSC
  • THO post-release cleanup
    • JB Motion, DG Seconds: Motion passes 8-0-0 The THO/UTG subcommittee recommends a policy that UTG GitHub branches be removed that have been implemented prior to the current and previous releases of THO and that all BitBucket branches will be kept as backup
    • Jess will follow-up with Mark to get those extra branches cleaned up in BitBucket
  • Adding CDA Value Sets missing from THO ( UP-116 - Getting issue details... STATUS )
    • These Value Sets can be build from the V3 code system representing the V3 concept domains: (some changes will be required)
    • Will collaborate with Jess, Lisa, Marc, Rob H and others (including Rob M) to get this task done. Ted has more info on missing attributes.
  • Call for UTG OSG Voters
    • Email sent yesterday/this morning to Management Groups for Product Family OSGs
      • Asked for responses by 3/31
    • Ask Rob and Peter for help recruiting for Realm-Based OSG
    • Decide if all Vocab/TSMG members should be in the Vocab OSG (IF they are not assigned another 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
      • FYI: Vocab added an extension for steward, there is a proposal to update the definition of publisher (which was intended to represent steward) and remove the extension
        • The current cardinality of publisher is 0...1, and there are a couple code systems with two Steward values
    • Michael Faughn performed analysis on the number of code systems without a Steward value
      • Out of 797 code systems, 236 do not have a Steward value
    • Subcommittee believes a possible solution is to assign codes systems without a Steward to Vocab
      • Code system Stewards could be updated as a new Steward is identified (i.e. when someone brings up a UTG change proposal to Vocab for approval)
  • Status updates
    • Sprint 2 of UTG Jira development items with a focus on release tracking in progress
      • Buttoning up implementation of release tracking based on meeting today, 3/9
      • Held kickoff call for Jira automation work that should automate branch creation and commit
        • May also be able to eliminate need for local clone and Sourcetree
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 Approval2022-03-02 TSMG Agenda and Minutes