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Chair: Caroline Macumber 

Scribe: Davera Gabriel 


Monday, May 23, 1:00-2:30PM UTC

Monday, May 24,  9:00-10:30AM USA ET

Monday, May 23, 11:00-12:30AM (next day) AEST

Tuesday, May 24, 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)X - Proxy to CMSaludax
HL7 International
M (TSMG Rep to the TSC)PMD Partners, Inc.

X - proxy to Carol, P

MPApelon, Inc.
MPNational Institute of Standards and Technology (NIST)
HL7 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)
OPJohn SnyderNational Library of Medicine (US)
Ted KleinTK Consulting
Lloyd Mackenzie
Ravi KafleWashington State Department of Health
Doug DeShazoLexisNexis
MaryKay McDanielFM/Markam
Corey Spears
John SpinosaLantana

Antitrust statement

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Minutes Approved as Presented 

05-12-22 - WGM session

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
  • September WGM survey: in person / remote
    • Next meeting - re-poll TSMG re: which quarter is the best when there is an in-person meeting
    • The quarter we used MAY have conflicts
  • Follow-up from WGM - next steps re: terminology server (service) requirements (1-page description)
    • Needs to clearly state why we do not have what is needed in the currently available services including THO or
    • Jess / Reuben / Rob Hausam
      • (add Zulip chatlink, ecosystem links...)
  • Lisa Nelson: Applying the remaining approved Jira tickets for R5 to ConceptMap2 is on my agenda to do this week.  Then, once that's done, the plan is to get Grahame to merge and apply the ConceptMap2 updates to ConceptMap, so that will become the new ConceptMap for R5 (and ConceptMap2 will be dropped - it was only intended to be a temporary placeholder for the changes until they were ready to be merged).
    • Need for Aligning all product families to FHIR (for CDA) 
      • "other participant" role : there are not sufficient roles in RIM to support the needs in CDA: Assembler & composer in role class associative value set. These are now available in THO
      • Need to create alignment in FHIR: modify RoleClassAssociative value set with the additional members
      • Ask of the TSMG to support alignment between V3 RIM and FHIR
      • Rob M: this is in the Vocabulary WG scope of responsibility.  Lisa M should bring owners of the V3RIM (M&M(?)), Austin and Vocab together to resolve
        • Is CDA bound to release of the RIM? Lisa: yes CDA is bound to v2.7 of the RIM
        • Need now is an improvement needed to meet the needs of C-CDA, which is outside the bounds of the designated release.
      • Rob H:  there are some structural differences between RoleClassAssociative and RoleCode - not sure that there is a class change needed, but a change to RoleCode may be the solution
    • Lisa: if this specific use case is solved, there is a more general use case that the CMG runs into with re: to V3RIM needs to apply changes to the Value Sets beyond those that are fixed in the V3 RIM.  
      • Rob M: suggesting there MAY be a way to use "other" to add value set members that CMG needs and not be bound to the RIM v2.7 constraints when there is a conflict between the bindings and the expansion that is needed
      • Lisa: CMG will need to be able to benefit from the improvements offers by expansions to the RIM ValueSets
PSS Review

  PSS-2088 - Getting issue details... STATUS

  PSS-1970 - Getting issue details... STATUS

TSMG Standing Subcommittee Updates


Connectathon Management

  • Follow-up from WGM session: generalized "Ask an Expert session"

Summer Intern - Vocab intro / white papers / FAQa

  HL7 Terminology Authority10


Policy & Process documentation

  • ready for a document to go to TSC, possibly for 6/6 (pending conformation)
  • Request from RobM: Please add on TSMG page an obvious link to "how to request an external code system identification" link
  • Jess:  there should be a review of the FHIR specification to be sure the changes in the External code systems process document are correctly represented in the FHIR specification 
  HL7 Terminology / Unified Terminology Governance (THO/UTG)10RD/JB
  • Subcommittee alternating topic every other week
  • Reviewed Terminology Expectations from Lloyd and documented questions/clarifications for joint with FHIR-I
    • Terminology expectations shared by Lloyd on April’s co-chair webinar did not fully align with the guidance from the Vocab Internal Identifier Task Force
    • Areas that needed alignment:
      • Statement that TSMG is responsible for approving IG-specific codes
      • Statement that unless TSMG approves, before FMM3 system must have ‘temporary’ in the url
      • Statement that Value Sets will rarely be in THO, and criteria for inclusion
    • Restatement of what was agreed on during Q5
      • Restatement of what was agreed on during Q5
        • For code systems
          • Users should use existing codes/CodeSystems if possible (external or THO)
            • If working with HTA to determine external code system url, you may use ‘temporary’ in your placeholder url
          • If using internal code system, follow 2 step process for code system definition in UTG/THO
            • First add naming system (to claim name and identifier) with the url anchored in using lightweight process

            • Code system with content (concepts) can be added later and implementers can work on the content within their IG until ready to move to THO
          • If internal code system is believed to be IG-specific for all time, must get approval from TSMG because the intent is that at FMM 3, the terminology artifacts are in THO
            • Determine if guidance should be to always anchor a code system url in so in case it moves in the future, the url doesn’t have to change
          • Validation checks proposed by FMG (need refinement, this was just captured from the call)
            • Check to see if code system is recognized (i.e., a CodeSystem instance in THO,, or NamingSystem in THO)
              • Need confirmation of alert level for things not found in THO/
            • Throw warning if url is in THO but not the content (FMM3+)
            • Throw error if ‘temporary’ in url if FMM3+ (only applies to external code systems)
          • For value sets
            • Vocab need to provide guidance on when value sets should be added to THO and ensure that we encourage sharing
              • Q; Lisa was there any discussion re utilization of the "unified" tab for the cross standard (V2/CDA/FHIR) Value Sets?  there is a need for a best practice for adding value Sets to the THO and the cross-product family value sets should show up under the unified tab, additionally a best practice would be that these value sets had a OID assignment
              • likely headed in a direction that would support search, which may obviate the need to develop navigation support provided by an "other" tab.
              • Rob M:  there are shared value sets among the standard families (more than zero) 
                • there should not be barriers for organizations to add value sets to THO, example: Gender Harmony will have value sets that will be used across the product families.  So there will always be some need for value sets to be hosted in THO
          • Next steps after agreement has been achieved with FMG
            • Ted will develop the lightweight process for IG developers to add placeholder on Pending tab of THO through a Pro Forma process that requires only the submission of field elements

            • Update

            • Vocab to document guidance and best practices for using terminology in IGs (for anything that doesn’t belong in link above)

            • FMG to document IG validation process

  • Subcommittee work in progress
    • Filling slots for UTG OSG Voters
      • Management Groups for Product Family OSGs 
        • FMG: John Moerke (Bryn filling final slots)
        • CMG: Lisa Nelson, Alexander Henket (Lisa filling final slot)
        • V2: Michael Faughn, Frank Oemig, Rob Snelick
    • Vocab WG follow-up: Policy Requiring Identification of Stewards for HL7 (Internal) 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
          • 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.
        • 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.
          • Austin Kreisler reviewed list of V3 code systems and assigned 3 to Structured Docs
      • List of code systems without steward is here
    • Report on Deprecation Policy and Implementation
      • No progress this week. Jess to work with Ted to make progress on performing inventory of deprecated artifacts in THO, create tabs with documentation, and ensure elements needed to communicate deprecation are rendered in THO
      • Deprecation Policy Framework
 Technical Steering Committee (TSC) matters10RM
  • Decision Making Practices
    • Not approved by TSC, what changes do we need to make before sending it back?

    • In meeting discussed comments from TSC.  Made small changes to confluence DMP document here in TSMG meeting in anticipation of upcoming TSC meeting / discussion later today.
    • Motion to approve the DMP document as changed:  DG / seconded RM. Motion passes 8-0-0

Supporting Documents

Outline Reference

Supporting Document

Minute Approval2022-05-12 TSMG Agenda and Minutes from May WGM