Chair: Caroline Macumber 

Scribe: Davera Gabriel 


Monday, July 18, 1:00-2:30AM UTC

Monday, July 18,  9:00-10:30AM USA ET

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

Tuesday, July 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)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 to ReubenHL7 New Zealand
MPPrecipius b.v.
MPHL7 Germany
Health Intersections
OPCanada 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
Lloyd MackenzieAccenture
Ravi KafleWashington State Department of Health
Doug DeShazoLexisNexis
MaryKay McDanielFM/Markam
Corey SpearsMITRE
John SpinosaLantana
OPHope GrayHL7 Intern
Joe AmlungReginstrief
OPMartha JonesHL7 Intern
Riki MerrickVernetzt, LLC

PGaurav Vaidya

PEmily PfaffUNC

PEric PrudhommeauxJaneiro Digital

PJoe AmlungReginstrief Instutute

PDavid BoothYosemite Project

PJim BalhoffUNC

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Minutes Approved as Presented 


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Agenda Topics 

Meeting was recorded

Agenda Outline

Time allocationLead

Agenda Item

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


  • Announcements
    • January 2023 Ballot Cycle Deadlines
      • August 21st, 2022: TSC Approval of PSS
      • November 1st, 2022: NIB Deadline (6 weeks prior to ballot opening)
  • Contract work announcement for web-based terminology resource editor for FHIR
  • Working group meeting registration has started - please register
  • TSMG appointments for 2023 - eMail to Dan V on 23June22
    • AI:  Davera will follow-up with Dan V - done, no response
      • Response from Dan remains outstanding
      • Rob M will follow-up this week with inquiry
TSMG Standing Subcommittee Updates

  • September Connectathon 
  • Outreach / Education Topics
    • Weekly meetings over summer: request to add to conference call calendar 
    • Zulip Terminology Stream Analysis - in process preliminary results
      • Concept Count preliminary results here - additional topics, especially coding systems
      • Next-up
        • conversation length analyses
        • Individual persons - will group to HL7 role
        • Individuals would be reviewed and their roles assigned to better understand what kind of person asks certain kinds of questions
  • Co-chair terminology presentation: FAQs needed
  HL7 Terminology / Unified Terminology Governance (THO/UTG)10RD/JB
  • E-vote for review of terminology expectations for IG developers
    • Terminology Expectations for IG Developers (Working)
    • E-vote has been set up: 2022-07-11 TSMG e-Vote
    • RM / LM: was not aware of the notification to respond to the eVote
    • RM: requesting there are announcements to go to Zulip for eVoting
      • RD:  is this sufficient notification?  posting to Zulip?  Zulip + eMail (listserv) should be sufficient
      • CM: did not get notification via eMail. 
      • RD: suggestion that for the Listserv notification be  "TSMG eVote" at the front edge of the subject line to support noticing the eMail,  rules et al
    • RM: requesting an additional week for review - updated request - for next week 7/25 call 
      • Some additional discussion will ensue in the subgroup call tomorrow
  • THO release schedule
    • THO release schedule added to HL7 calendar: HL7 Calendars
      • Freeze dates and anticipated release dates for THO included
      • RM: please also announce this in Zulip:  in UTG Stream, also Implementers, Committers & Announcements streams
    • TSMG will send out reminders about upcoming ballot freezes and once publications are available to the co-chair list
    • R5 ballot:  may close the week before the WGM... out of cycle 
      • Jess AI: follow-up with Grahame re:  the timing of the R5 ballot close.  As there needs to be a THO release in the context of this 
    • David Booth (in chat): "According to Lloyd( in Zulip here): " (May 16-17 timeframe)1:23 PM Based on the feedback from across the work groups at the WGM, the FMG has voted to proceed with the 'late' Sept. 2022 cycle timeframe for the R5 ballot.  This means that the deadline for final content will be Aug. 21 and ballot will close mid-October.  We'll provide more details on specifics around QA process, etc. closer to that date. Discussion on #committers or #implementers "
  • Versioning policy for UTG/THO
    • Reuben sent out doodle poll last week for new task force to define versioning policies for:
      • External code system metadata records
      • Value sets
      • Naming systems
      • Concept maps
    • Poll is closed Meeting will happen on Wednesdays at 4pm EASTERN.  Reuben will create calendar entry and these will start next week.
  • Many CodeSystems use urls when they should be FHIR-37440 - Getting issue details... STATUS
    • Rob Hausam was able to determine that Grahame changed the uris back in July 2018
    • Should remove these from R5 prior to the FHIR content deadline
    • Note that THO code systems reference value sets anchored in as well as the value set in THO
      • This is due to those being published in R4/R4B
    • A comparison from this commit must be performed.  Per Rob H:  this is ~1600 files, thus this cannot be a manual process to inventory / check the possible changes.
    • Must be done before R5 - a high priority task
      • Can we escalate this other technical resources? 
      • This doesn't require a terminology SME.  A comparison need to be established: can be a scripted process
      • Rob H: Version differences, but there may not be content differences.  we have not established that.  Perhaps only duplicates.
      • Content that exists in both THO and R5 with the same canonical URL
        1. Exact match on content - remove resource from R5
          1. Grahame modified version so that it referenced THO or FHIR based on the version, not sure logic for validation though
          2. If minor version is 1, it was migrated as part of 4.0 cleanup and 4.1 prep. If 3, it was part of prep for R4B, Ted saw some with minor version a 6
          3. All have a major version of 0 in THO due to some build hack to pull out the right thing and not give duplicate resource errors
        2. Versions are different - look to see if the content is different & determine which content is correct - a manual review
        3. Content is different, do manual review to determine which is the most up to date - another manual process
      • Content anchored in THO that only exists in R5
        1. Move to THO and remove from R5
      • Determine handling of value sets that reference THO anchored code systems
  • FHIR-37402 - Getting issue details... STATUS
    • Per agreed upon policy and process, the URI, once declared and used, will not be changed. 
    • Agree, proposed resolution to change type to non-preferred and adding a new URI is not acceptable
    • RB, ST: this should be changed
    • John Snyder (in chat): May want to keep it because there is also so we could end up having "ICF-CY" International Classification of Functioning, Disability and Health for Children and Youth) - Synopsis
    • There may be some small number exception cases
  • The following in red were not reviewed for lack of time
  • Subcommittee work in progress
    • Deprecation Policy and Implementation
    • Filling slots for UTG OSG Voters
      • Management Groups for Product Family OSGs 
        • FMG: John Moerke (Bryn discussing final slots with FHIR-I today)
        • CMG: Lisa Nelson, Alexander Henket, Marc Duteau
        • V2: Michael Faughn, Frank Oemig, Rob Snelick
    • Vocab WG follow-up: Policy Requiring Identification of Stewards for HL7 (Internal) Code Systems
IRIs in FHIR & UTG contentup to 40 minsGaurav Vaidya

RDF subgroup of the HL7 Implementable Technology Standards (ITS) working group presented a proposal on supporting concept IRIs in FHIR by incorporating IRI stems into the UTG repository to the HL7 Vocab WG last Thursday (item 4 on the agenda  Apart from some great feedback, the Vocab WG suggested that we present our proposal at the Monday TSMG meeting so that we could get feedback from a wider group of HL7 members, in particular the HL7 Terminology Authority and UTG/THO.

  • Vocab WG presentation sides are here (took about 20 minutes)
    • This generated 10-20 minutes of discussion and feedback, 
  • The full proposal as it currently stands is here
    • Group would like to get feedback from TSMG.
  • Proposal and questions from Vocab WG is in the slides / presentation:
    • Who gets to pick IRI stems and with what criteria?
    • How do we deal with versioning?
    • How do we deal with characters that aren’t ASCII?
    • Should FHIR ValueSets be changed to better support concept IRIs?
      • Per RM:  this entire proposal is  not a "should" as much is this is a "how" per the resource constraints
    • RM: HL7 doesn't need as much input re: developing stems
  • LM (in chat): Would we need to ask the same question for CodeSystems?  Should FHIR CodeSystems be changed to better support concept IRIs? and NamingSystems would need to be changed to better support IRI stems too, right?

 Technical Steering Committee (TSC) matters10RM
  • eVoting
  • Requirement for web-based authoring environment - will be a feature of editing tool out for contract
  • Leadership elections in process for TSC - please vote of you are able to
Terminology Server (Implementation Requirement)

  • Follow-up from WGM - next steps re: terminology server (service) requirements (1-page description)

Supporting Documents

Outline Reference

Supporting Document