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Chair: Reuben Daniels 

Scribe: Davera Gabriel 


Monday, April 18, 1:00-2:30PM UTC

Monday, April 18,  9:00-10:30AM USA ET

Monday, April 18, 11:00-12:30AM (next day) AEST

Tuesday, April 19, 2:00-3:30AM NZDT   


Attendee type:

M - TSMG Member

O -Observer / Guest


P - present

A - Apologies

X - (Apologies with Proxy)



M (Co-Chair)AClinical Architecture
M (Co-Chair)Available at 9:30aThe Johns Hopkins University
M (Co-Chair)PSaludax
M (CSDO)PHL7 International
M (TSMG Rep to the TSC)PMD Partners, Inc.


MPApelon, Inc.
MPNational Institute of Standards and Technology (NIST)
MX – RD ProxyHL7 New Zealand
Precipius b.v.
HL7 Germany
Health Intersections
Canada Health Infoway
National Library of Medicine
Hausam Consulting LLC
OPSNOMED International
Joe FlackJohns Hopkins BIDS
Office of the National Coordinator for Health Information Technology (ONC)
John SnyderNational Library of Medicine (US)
Ted KleinTK Consulting
Lloyd Mackenzie
Ravi KafleWashington State Department of Health
Doug DeShazoLexisNexis
MaryKay McDanielFM/Markam
Corey Spears

Antitrust statement

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Minutes Approved as Presented 

2022-04-11 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
    • SNOMED International meeting updates?
      • SNOMED on FHIR (question)  update next meeting
    • Fall meeting (Lisbon, Portugal) registration not yet open
      • Business meeting immediately prior 
        • September 2022: September 24th to 28th, 2022 Pestana Palace Lisboa, Hotel & National Monument Lisbon, Portugal (and online)
    • May 2022 WGM agenda is available
  • RM:
    • It would be useful for TSMG to look at the recommendations from the HITEC interoperability committee to HITEC
    • Spectre of WHO ICF being used - may need to be on our list.
PSS Review

Principles for Use of External Terminologies
  • Principles for Use of External Terminologies in HL7 standards
    • Policy framework from Dan V. presented to HL7 executive committee
    • Discussed in TSMG 4/4 meeting, notes are here
      • Lisa suggested change: "... Because of its non-profit, mission-oriented work to create global public goods, HL7's general policy is to not pay fees or royalties for external terminologies used in specifications and implementation testing. Additionally, to support the community of users who use HL7 specifications in production implementations, HL7 prefers to use terminology which does not require the community of users to secure paid licenses to meet vocabulary requirements included in HL7 specifications."
    • Discussion is not concluded - RSMG will communicate with Dan V as a follow-up
TSMG Standing Subcommittee Updates

  • May Connectathon Management
      • Track Schedule is here (informal),  Track detail page is here
        • External Kick-off Meeting: 4/27 5-6p EASTERN, In-track Welcome: 5/2,11-noon 
        • Minimum Server requirements activity
          • Will reflect testing scenario Peter Jordan developed for AUS / NZ Connectathon
        • Terminology representation syntax: Breakout session based on Zulip chat
        • Late Breaking Changes
          1. Clinical Genomics terminology-involved Operations, Tuesday, Noon-1:30p
            • not a standalone TermServer per se, but interesting Terminology-focused requirements: (from eMail) 
              • "token vs. codeSystem|code searching: Patterned after FHIR Search. We did this mainly to help folks that may not know precise code systems - e.g. you may just want to search for a gene, or you may just want to search for an HLA allele. One of my favorite examples - you want to search for a patient with a particular HLA genotype, and here is how it is coded "|hla#3.33.0#HLA-A*02:302+HLA-A*23:26/HLA-A*23:39^HLA-B*44:02:13+HLA-B*49:08". A token-based search here could be helpful.
              • mapping / normalization: We are still exploring this, but the idea would be that, where for instance we have a mapping between DO and SNOMED, that we let the user search by either DO or SNOMED. (We'd presumably use a ConceptMap, but haven't gotten that far yet, still working on the mappings themselves. A lot of the mappings we're coming across are more 'draft' - for instance, missing a target SNOMED code, or having >1 target SNOMED code)"
          2. Listing Clinical Reasoning / QM Value Set session on TS track schedule. Bryn Rhodes doing a joint session - is flexible w/re to timing
    • OMOP + FHIR Initiative
      • Per Dan V - is not a formal WG 
      • Terminologies subgroup will assume (Vulcan) FHIR to OMOP canonical mapping development
        • seeking / announcing a Vulcan co-lead, other volunteers
        • targeting September Connectathon
          • can we use Term Services track for this activity?
      • May Connectathon track:  Oncology Use Case
      • Quality Measures "ontology" proposal / discussion (Thomas White)
        • Codify stable measures: numerator or denominator definitions resulting in reduction of computation overhead
  HL7 Terminology Authority10


Meeting this week - Thurs 8a EASTERN 4/21

  HL7 Terminology / Unified Terminology Governance (THO/UTG)10RD/JB
  • Subcommittee work in progress
    • THO release schedule
      • Need feedback from TSC/HQ 
      • Rob is following up with TSC
    • Call for UTG OSG Voters
      • Email sent 3/8 to Management Groups for Product Family OSGs
        • Asked for responses by 3/31 
          • FMG nominated John Moerke for the FHIR ISG
        • Will collaborated with MG reps to bring to the MGs
    • 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. 
      • Out of 797 code systems, 236 do not have a Steward value
        • 38 V2, 147 V3, 47 FHIR, 3 unified code systems
      • Current supported solution is to make corresponding Management Group responsible (by either having them assign the WG responsible or by assigning them to the MG itself)
        • In the FHIR space, it could be the resource owner
        • V2 - make the V2 management group responsible
        • V3 - will be a multi-management group exercise.  CMG will take a look at the V3 sets first.  FMG will take a look at the list next to determine which is the appropriate responsible party.
      • List of code systems without steward is here
      • Vocab WG to run a query for each code system across FHIR core to identify the resources and their responsible WG(s) for each listed code system.
        1. Robert Hausam will check with Lloyd and whether and how we can do this.
        2. Will bring this back for the Vocab call in 2 weeks.
    • Continued working through materials related to Workflow process for use of internal code system identifiers in FHIR and beyond
      • Need to ensure that this aligns with expectations laid out by FMG via Lloyd at the co-chair webinar
      • Vocab co-chairs to set up joint with Lloyd at May WGM for clarification
  • UTG Development status updates
    • Meeting weekly with Lawrence to review automation progress
      • GitLab is configured
      • Working on automatic verification using IG Publisher upon submission of proposed changes
 Technical Steering Committee (TSC) matters10RM
  • Decision Making Practices
    • Default Decision making practices are here, select portions of this document are available to be modified by WGs

    • comparing defining quorum section - changed subcommittee and electronic voting section(s) 

    • also changes to the manner of making routine decisions, whether there is a requirement for voting or not
    • Reuben:  an outstanding unknown issue has to do with how subcommittees make decisions - do they vote or not?
      • Lisa:  CMG doesn't have voting in their sub-groups, Structured Docs also does not vote in their subgroups
    • Sub-commitee eVoting: added section "quorum for the TSMG requires that a co-chair and at least 50% of the current members be present... Any sub commitee meeting... "  this section should be reviewed by the TSMG membership and approved in an upcoming meeting brofre going to the TSC

Supporting Documents

Outline Reference

Supporting Document

Minute Approval2022-04-04 TSMG Agenda and Minutes