Page tree
Skip to end of metadata
Go to start of metadata

Chair: Caroline Macumber 

Scribe: Davera Gabriel 


Monday, August 1, 1:00-2:30AM UTC

Monday, August 1,  9:00-10:30AM USA ET

Monday, August 1, 11:00-12:30AM (next day) AEST

Tuesday, August 2, 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
Precipius b.v.
HL7 Germany
Health Intersections
Canada Health Infoway
OPNational 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 MackenzieAccenture
Ravi KafleWashington State Department of Health
Doug DeShazoLexisNexis
MaryKay McDanielFM/Markam
Corey SpearsMITRE
John SpinosaLantana
Hope GrayHL7 Intern
OPJoe AmlungReginstrief
OPMartha JonesHL7 Intern
Riki MerrickVernetzt, LLC
Gaurav Vaidya
Emily PfaffUNC
Eric PrudhommeauxJaneiro Digital
Joe AmlungReginstrief Instutute
David BoothYosemite Project
Jim BalhoffUNC
OPChristian ReichOHDSI

Antitrust statement

Professional Associations, such as HL7, which bring together competing entities are subject to strict scrutiny under applicable antitrust laws. HL7 recognizes that the antitrust laws were enacted to promote fairness in competition and, as such, supports laws against monopoly and restraints of trade and their enforcement. Each individual participating in HL7 meetings and conferences, regardless of venue, is responsible for knowing the contents of and adhering to the HL7 Antitrust Policy as stated in §05.01 of the Governance and Operations Manual (GOM).

Minutes Approved as Presented 


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


  • 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
    • Slate needs to be developed
      • Expiring members and willingness to stand again (y/n)
        • Davera - yes
        • Sylvia - ?
        • Rob M - no
        • Peter - no
        • Michael - yes
        • Roel - yes
    • Term feedback from TSC
      • Proposed that terms are limited to a maximum of two (2) two year terms or a total of four(4) years. 
      • Applies to current members?
      • What happens if a slate cannot be filled, would current members be provided an exception if they're willing to stand for appointment
      • RD as a caveat to acceptance. the policy for filling the empty seats should members fulfill their terms per policy be forced off and there are no prospective new members to fill the seats needs to be established.  
        • If no candidates come forward to fill empty seats, then there needs to be a policy in place to proactively deal with this situation 
      • LM: the issue in CMG was not having folks roll off, but encouraging new membership is a better focus.  The CMG policy is to ensure there are invitations to two new members.  There is a plan to seeking and inviting new members as a proactive process.  CMG has struggled with attrition.  The focus of the policy therefore is how to sustain the management group rather than limit the terms. 
      • RM:  alternate member slots could fill vacant member slots.
      • CM: next steps are to "clean up the notes" so that RM can take back some feedback re: this discussion
OHDSI & SNOMED CT 5-year cooperative agreement
Christian Reich, Suzy Roy

Agreement Announcements


Review terms of agreement

  • SR: Agreement enables utilization of SNOMED CT in OHDSI work products for research purposes without license
    • restricts use of SCT extracted for work 
    • provides a way for OHDSI users to utilize SCT and ensure appropriate IP for SCT 
    • CR is providing modeling feedback pertinent to research / OHDSI community as a component of this cooperative agreement
  • CR: OHDSI business focus is for research (populations) as opposed to focus on patient care for other SCT use cases 

Implications for HL7 standards and Terminology management practices

  • RM: anything that is not SNOMED in OHDSI, how will HL7 represent that?
    • Also will SNOMED be directly represented in OHDSI?  for HL7 how will we represent those concepts that are coming from OMOP, are these still SNOMED?
  • CR:  these are SNOMED concepts, we give them a different identifier, but it is still SNOMED. the identifier doesn't impact the identifiers.
    • If you create messages, then this is a different use case than is asserted in the OHDSI / SNOMED agreement requiring a different license
  • RM:  would like to focus on representational model
    • OHDSI sending an SCT concept:  then HL7 will need to figure out what 
    • CM: a supplement with OHDSI identifiers for SNOMED may be one possible solution
  • CR: If you convert OHDSI to FHIR, then you can use this conversion to interpret the meaning of the SNOMED code
  • RD: SNOMED to OMOP use cases is this the full international edition of SNOMED.  SR:  the version as accepted by the OHDSI team.  whatever that team uses.
    • what about affiliate editions of SNOMED CT.  SR:  this agreement doesn't apply to member editions, only the international edition of SNOMED CT
  • RM:  are the SCT identifiers exactly the same within the OMOP namespace, and these never change?  CR:  that is correct. 
  • CR: access to the terminologies in the OMOP Vocabulary is dependent on whether the accessing entity has licenses to the source (before OHDSI) content
  • RM: need to make arrangements to host / access OMOP vocabulary content within HL7 for purposes of representing OMOP within the HL7 
  • CM: requirement for an HTA record for OMOP Vocabulary
    • how / whether to obtain content from OMOP available within the THO is a decision for the Vocab WG
  • RM:  need to also be thinking about creating an IRI for the OMOP vocabulary (in addition to the code system identifier)
    • The OMOP code system obtains information form a variety of other terminologies (with its transformation)
    • When that information from HL7 goes to another system (OMOP to HL7 to CMS system) will require additional information about the source coding to support exchange
    • Issue of concepts having more than on identifier presents a problem, and in this case perhaps this also adds more than one code system in addition of the identifier
    • There needs to be a conversation about how to accomplish these "rules"
  • RM: question to Suzy... this is a second example where SNOMED has a second identifier (OMOP & LOINC)
    • SR: more than one concept identifier, SNOMED prefers the use of a single identifier.  We are allowing this with the agreement with OHDSI.  This is being negotiated with the Regenstrief for LOINC at this time.  Not allowing the generation of new SCT identifiers inside of LOINC
    • RM: traditional SCT identifier... can we send an SCT identifier but identify that as an OHDSI concept?
    • CR:  no we will loop back to the original SNOMED.
    • RM:  for any HL7 exchange the sender will have the requirement to indicate this is SNOMED, and revert this back to a SNOMED identifier
      • CR: for  FHIR message, you should issue the terminology and the original concept ID
TSMG Standing Subcommittee Updates

  HL7 Terminology / Unified Terminology Governance (THO/UTG)10RD/JB
  • Many CodeSystems use urls when they should be FHIR-37440 - Getting issue details... STATUS
    • 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
    • JB: Info about THO release schedule (starting for Jan 2023 ballot cycle): HL7 Terminology (THO) Publication Schedule
    • If there is terminology content (not just metadata) in the R5 ballot, then there is an outstanding issue about how to get that content into THO.  JB:  there are tickets (HTA) updates but these are metadata and not content
  • E-vote for review of terminology expectations for IG developers
  • 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
    • Postponed this week - will start next week
  • Subcommittee work in progress
    • Deprecation Policy and Implementation
    • Filling slots for UTG OSG Voters
      • Management Groups for Product Family OSGs 
        • FMG: John Moerke, Bryn Rhodes, Rob Hausam? 
        • 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 content10RD, CMTSMG vote required re: HTA recommendations
Technical Steering Committee (TSC) matters10RM
Terminology Server (Implementation Requirement)

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

Supporting Documents

Outline Reference

Supporting Document