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Chair: Davera Gabriel 

Scribe: Reuben Daniels  


Monday, August 15, 1:00-2:30AM UTC

Monday, August 15,  9:00-10:30AM USA ET

Monday, August 15, 11:00-12:30AM (next day) AEST

Tuesday, August 16, 2:00-3:30AM NZDT   


Attendee type:

M - TSMG Member

O -Observer / Guest


P - present

A - Apologies

X - (Apologies with Proxy)



M (Co-Chair)X - proxy to ReubenClinical 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.
National Institute of Standards and Technology (NIST)
MX - proxy to ReubenHL7 New Zealand
MPPrecipius b.v.
HL7 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)
OPJohn 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
Martha JonesHL7 Intern
Riki MerrickVernetzt, LLC
Gaurav Vaidya
Emily PfaffUNC
Eric PrudhommeauxJaneiro Digital
Joe AmlungReginstrief Instutute
David BoothYosemite Project
Jim BalhoffUNC
Christian ReichOHDSI
OPHarold Solbrig

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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


  • TSMG appointments for 2023
    • Slate needs to be developed
      • Expiring members and willingness to stand again (y/n)
        • Davera - yes
        • Sylvia - no
        • Rob M - no
        • Peter - no
        • Michael - yes
        • Roel - yes
TSMG Standing Subcommittee Updates

  • September Connectathon / WGM 
    • Terminology Service Track proposal
    • "Ask an Expert" volunteers:
      • Peter Jordan
    • Breakout session / Hot Topics:
      • ICD11 over view / discussion: Q1 Tuesday
      • THO content copyright - TDB WGM
      • Gender Harmony Ballot instructions
    • TSMG session in WGM needs to be nailed down
      • Need to get Dan V is available for this meeting
      • Topic for that session:  Copyright for THO content established
      • JB: added Dan to the agenda
  • Outreach / Education Topics
    • Weekly outreach subgroup meetings Tuesdays 3pm EASTERN - cancelled this week
    • Zulip Terminology Stream Analysis - preliminary results: 22Aug22
  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
    • eVote to be completed by next week?
      • RM: issue re: THO-based URLs putting in a base URL that is not a part of an IG is not addressed, technical requirements for this is not represented in this document
      • JB:  the task force decided that using a temporary THO-based URL is not permissible
      • RD: there was discussion re: an IG reaching a certain level of maturity before assigning a permanent URL, RH: agrees
      • Publisher validation for terminology has an order in which it's looking for terminology validation: THO, then tx,fhir,org, then in to IG itself.  This means there needs to be a redirect to temporary URL declaration
      • RM: is willing to have a focused session to work through the workflow - its the process flow more than the URLs themselves that need to be worked out.  JB: agrees, more in agreement than not in agreement
      • Read & comment needs to happen.  The discussion / objection that RM is surfacing is based on review of the page / policy.  Everyone on TSMG needs to have completed this process.  Please complete reviews.
  • Many CodeSystems use urls when they should be FHIR-37440 - Getting issue details... STATUS
    • Michael Faughn extracted code systems and value sets based on url (resources matched by id) from the THO/FHIR NPM packages
    • There are 72 Code Systems that have been identified as potential duplicates across FHIR and THO, 18 of which have a different url anchor ( vs. and 16 were identified to have differences with concepts.
    • Changes across the following elements were identified, and it needs to be determined which of these is deemed significant. Note that a change is counted if the element is absent in one resource but present in another.
      • meta.lastUpdated, date, expermimental, title, valueSet, meta.profile, description, publisher, name, contact, status, oid, property, hierarchyMeaning, and many extension values including fmm, workgroup, status and telecom
      • RD: this clean-up needs to happen before the R5 content deadline (5Sept22)
      • JB: Should there be a publish of THO before the ballot? if THO publication doesn't happen then there will be many broken links.
      • RM: completing the clean-up cannot happen until after the ballot closes.  GH will need a publication of THO sometime after the ballot closes
      • Further discussion will happen on tomorrow's subcommitee call
  • Versioning policy for UTG/THO
    • Reuben to provide update on first meeting - weekly Wednesdays 4p EASTERN 
    • This week's discussion topic: HL7 terminology systems in THO
  • Standard copyright for HL7 content
    • Raising suggestion to have a standard copyright statement for content maintained and published by HL7
    • Currently no way to enforce this but could be in guidelines
    • The HL7 Copyright policy is here 
    • RD: the Australian policy is: Copyright ©️ 2018 Australian Digital Health Agency - All rights reserved. Except for the material identified below, this content is licensed under a Creative Commons Attribution 4.0 International License. See This resource includes material that is based on Australian Institute of Health and Welfare material. All copies of this resource must include this copyright statement and all information contained in this statement.
    • Gaurav V (in chat): The 4.0 is the version number of the CC-BY license. I think CC-BY-ND says you can share this content but can't share a modified version of this content:
    • Carol all CC licenses can be found here:
    • Connectathon topic: copyright issues for terminology content.  Also engage HQ (Karen V / Dan V...) re: HL7 guidance re: Terminology content.  (i.e.: new THO content & FHIR content on THO)
   HL7 Terminology Authority (HTA)10RD/DG
  • TSMG ratification votes from 28 July 2022 meeting
    • VA — National Drug File — Reference Terminology (NDF-RT)
    • FDA — Unique Ingredient Identifiers (UNII)
    • ISO — ISO 3166 Country Codes
      • HTA Confluence page requires URI and OID updates to align with core FHIR spec; and new THO Code System Metadata and Code System Identifier Records should be created and older ones removed.
      • Remove ISO 3166 COUNTRY CODES HTA page and add the following three new pages as follows:
        • Codes for the representation of names of countries and their subdivisions Part 1, Country code (ISO 3166-1)
          • OID: TBD
          • URI: urn:iso:std:iso:3166
        • Codes for the representation of names of countries and their subdivisions Part 2, Country subdivision code (ISO 3166-2)
          • OID: TBD
          • URI: urn:iso:std:iso:3166:-2
        • Codes for the representation of names of countries and their subdivisions Part 3, Code for formerly used names of countries (ISO 3166-3)
          • OID: TBD
          • URI: urn:iso:std:iso:3166:-3
      • Retire the following existing Code System Metadata and Code System Identifier records in THO
        • Iso31661edition2
        • Iso31661edition2alpha2
        • Iso31661edition2alpha3
        • Iso3166_2
      • Create 3 pairs of Code System Metadata and Code System Identifier records corresponding to the above three HTA pages.
    • ISO — ISO/IEEE 11073-10101:2020 Health informatics — Device interoperability — Part 10101: Point-of-care medical device communication — Nomenclature (MDC)
      • Update ISO/IEEE 11073 Nomenclature for Personal Medical Device Communication HTA page as follows
      • DG: Motion to update corresponding Code System Metadata and Code System Identifier records in THO to align with other metadata fields in the updated HTA pages. RB: Seconds the motion.  Motion passes 9-0-0.
      • RM: these changes would be occurring when?  after ballot closes... do we issue a JIRA ticket? The ballot requires stable content in THO, when the ballot opens, things in THO cannot change.
      • JB (in chat): They also have a status of retired
      • RD: we would like to fix the broken links.  RM: the state of content when the ballot opens needs to persist, broken links or not
Technical Steering Committee (TSC) matters10RM
  • Discussion on Management Group reforms
    • From RM's Zulip update:
    • Term limits: Of the 4 MGs - 2 against, 2 for.
    • TSC has asked us to consider opening up the MGs so that there are no appointed members and instead it works just like a WG. Perhaps appointed co-chairs (or elected - which approach was not discussed) but anyone can attend, participate, and vote.
      • RM needs feedback on that approach. I for one voiced concerns that doing that would have an unintended negative impact by allowing people to reduce the commitment to participate and attend.
    • Please comment on if this proposal is something you would like to see adopted.
    • RM also mentioned the idea of official appointed alternate members that only voted when quorum was not met. As a way to get people involved but at a lower intensity so that cycling folks on/off might be easier. There was concern that added too much co-chair burden.
      • Commentary required from TSMG members on this too.
  • Proposal: TSC Product Management Council
  • RM: would like to take an alternative proposal to the TSC.  
  • RD:  please state the problem(s) as perceived by the TSC
    • RM: adding new membership, but also want to address the issue of having members that persist forever (for a very long time)
  • RM: Suggesting there would be 2 alternative members that would be available to vote as proxies or when others are not available, sufficient to establish quorum.
  • RM: re: term lengths - suggesting alternatives like 2 or 4 year terms then cycle off for a year. 
    • RD: if there is the caveat for alternative members then this address the occasional difficulty of establishing quorum.  
  • RM will take to the TSC: 4 year terms, then one year off and establishing 2 alternate members as outlined above 
FHIR core tickets assigned to TSMG10RD
  • 21 unresolved tickets.
  • 11 relate to the OID registry
  • Suggestions for resolving these
    • Allocate time in Main call
    • Block votes
    • Subcommittee which must have a TSMG quorum
  • DG: Moves to take the Block vote approach.  JB: Seconds.  Motion passes 8-0-0
  • RM comment: surprised that tickets can be assigned to a management group:  RD: yes... FMG has many. 
Parking Lot 


Supporting Documents

Outline Reference

Supporting Document