Chair: Caroline Macumber 

Scribe: Davera Gabriel 


Monday, March 21, 1:00-2:30PM UTC

Monday, March 21,  9:00-10:30AM USA ET

Tuesday, March 22, 12:00-1:30AM AEST

Thursday, March 22, 2:00-3:30AM 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.


MPApelon, Inc.
MPNational Institute of Standards and Technology (NIST)
MX - proxy is ReubenHL7 New Zealand
MPPrecipius b.v.
HL7 Germany
Health Intersections
Canada Health Infoway
National 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
OPLloyd Mackensie
Ravi KafleWashington State Department of Health

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Minutes Approved as Presented 

2022-03-09 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 
    • R5 update from Lloyd M: ~ :45 past the hour
      • R5 will not go to Normative ballot.  New changes will go to STU and will be candidate to go Normative in next version.  Can make changes that are non-breaking - these will be STU, eligible to become normative in a subsequent release.
      • Technical changes to Normative content - will not happen.  Changes to become Normative will also not happen
      • After R5 comes out, there will be a reaffirmation of R4 (coming up to 5-year deadline for this).  R6 will be release approx. 2 years after R5 comes out
      • RD:  how will the elements be tagged in the spec as being TU? LM:  no decision about this as of yet.  But expect there will be some indication (verbiage) in the spec that there are mixed artifacts (nominative, STU ...). to see the changes - look at compare pages between the versions
    • Minimum requirements for TermServer Task Force is complete
      • Results are here
      • Once R5 is released, a server claiming to be a compliant R5 server SHOULD have these properties

TSMG Standing Subcommittee Updates

  • May Connectathon Management
      • Terminology Services track offerings
        • Office Hours Experts: Reuben, Rob M
      • Review tracks: develop Code Map testing stories, follow-up with Aegis?
      • Minimum Server requirements should be a track
      • Terminology representation syntax: TQL, ECL... topic?
  • OMOP + FHIR harmonization
    • Naming to change: "collaborative" or "initiative"
    • URI for OMOP Vocabulary
  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.  MF: this is still in process: JB will be sending this material over to Michael
    • 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.
      • Summary from previous discussion
        • IG publishers look at the THO records when creating IGs and would see this URL for validation (which is incorrect as it lacks the codesystem.version for SNOMED US Edition) 
        • BR: 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.
          • RM: Issue with this solution 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: Already tricky because there's an implicit requirement to validate codes against editions and versions already
        • THO subcommittee needs to develop a policy of what a version of an edition needs to look like. 
        • Also follow-up with a FHIR-I ticket to address the SNOMED CT special case needs
  HL7 Terminology / Unified Terminology Governance (THO/UTG)10RD/JB
  • Scheduling call following DST change
  • THO release schedule
    • Need feedback from TSC/HQ 
    • Info sent to Rob and Bryn and will be passed along to TSC
  • 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 3/8 to Management Groups for Product Family OSGs
      • Asked for responses by 3/31 - none received yet
    • 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
      • Finalized release tracking requirements
Technical Steering Committee (TSC) matters10RM
  • Decision Making Practices
    • (deferred until next week)


Supporting Documents

Outline Reference

Supporting Document

Minute Approval2022-03-09 TSMG Agenda and Minutes



1 Comment

  1. Advance apologies for my non-attendance at this and every future TSMG meeting that takes place at this time. I allocate my Proxy vote, in all instances, to Reuben Daniels (it's an 11pm start in Brisbane, so I'm assuming that he will be a regular attendee).