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Chair:  Caroline Macumber 

Scribe: Davera Gabriel 


Monday, October 24, 1:00-2:30AM UTC

Monday, October 24,  9:00-10:30AM USA ET

Monday, October 24, 11:00-12:30AM (next day) AEST

Tuesday, October 25, 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)AMD Partners, Inc.

MX-ReubenApelon, Inc.
MPNational Institute of Standards and Technology (NIST)
MX - ReubenHL7 New Zealand
MX- Reuben (if steps out)Precipius b.v.
MPHL7 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)
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
Harold SolbrigMayo
OPJoe AmlungReginstrief
Martha JonesHL7 Intern
Riki MerrickVernetzt, LLC
Gaurav Vaidya
Emily PfaffUNC
Eric PrudhommeauxJaneiro Digital
David BoothYosemite Project
Jim BalhoffUNC
Christian ReichOHDSI
OPHarold Solbrig

Antitrust statement

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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


  • Announcements
  • New time for this meeting
    • Finalize next month...
      • Daylight saving changes
      • Fonteva upgrade
  • 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
  • JB: Next THO freeze is planned for October 23
    • Announcements went to Zulip, co-chair list.

Code System:

Map to SNOMED:

The request from the IPS project for the TSMG is:

  1. Obtain approval (hopefully) from TSMG to publish the IPS STU 1.1 update with the current "Absent and Unknown Data - IPS" code system using the present '' canonical url.
  2. For the IPS STU 1.1 publication, the "Absent and Unknown Data - IPS" code system content will remain in the IPS IG (and will not - yet - be moved to THO).
  3. We will initiate discussions again with SNOMED Int. about the possibility of moving the "Absent and Unknown Data - IPS" concepts to SNOMED CT (International Edition and IPS Free Set/Terminology), in preparation for the IPS FHIR IG STU 2.0 ballot and ultimate publication.
  4. If, in further discussion, no agreement is able to be reached with SNOMED Int. and the "Absent and Unknown Data - IPS" concepts are not incorporated into SNOMED CT, then we will consider and most likely would plan for moving this code system and its content to THO for the official IPS STU 2.0 publication.

DG:  discomfort with conflating "none pertinent for this section of the record" with "none known" concept. RH: this can be brought up in another ballot

LN: is this an acceptable use case for "null Flavor?"  Does this value set has the granularity to express the required expressions?  RH:  this is a different approach. 

CM: due to the maturity level of the IG and if the process for the THO were in place, then this request would fail.  RH / JD:  its between maturity level 2 & 3. 

RH: urgency on this matter is due to the high demand for this content internationally

RD:  are there any breaking changes  JD:  yes there is one errata in the document that could be considered a breaking change. RH: utilization in Canada impactful.  The ask is to get these concepts in SNOMED CT, or of failing that into THO, but unsure which way this may go.  As such, want to be sure there is a source for this Value Set.  In prior correspondence: SNOMED CT do not want to include "no information" codes. 

RD Motion Seconded: LN: TSMG approve IPS publishing the Code System using the canonical url under the condition that the IG remain under FMM 2 Motion passes 6-1-0

TSMG Standing Subcommittee Updates

 HL7 Terminology / Unified Terminology Governance (THO/UTG)As neededJB/RM/CC
  • Decide on a version value for the next THO release.
    1. Here are the tickets planned for the release:
    2. JB (via email) I think the major consideration here is the inclusion of the THO licensing agreement
    3. Must decide on this call because it will hold up the release
    4. RD:  Moves to version 5.0.0 DG: Seconds  Motion passes 7-0-0
      1. LN: when was it frozen  CM: yesterday... RD:  should be published by the end for the first week in November (also the last release this year)
  • Terminology expectations for IG developers
    • Terminology Expectations for IG Developers (Simplified)
    • JB and RM have attempted to simply the policy. Group reviewed the policy discussion summarized below
    • JB (via email)Main discussion point probably should be how to prevent duplicate urls while recommending that IG authors anchor their content in THO regardless of any plans for it to be added later
    • CMG will add this item to their agenda on Wednesday
    • CM:  is there an implication that there would need to be tooling in place in order to enforce this policy?
      • RM  could employ ticketing to allow tracking / interaction with the community that could be used immediately without having to wait for tooling to enact this process.  
      • re: tooling - need to have a discussion with Grahame re: tooling to do lookup of a dB of URIs (confirming no duplicates)
    • If recommendation is that this should be a JIRA-based process then there would need to be a ticket-type of TSMG added.  Review of these tickets would then be a standing agenda item on the TSMG main calls (this one)
    • Reviewed open question in this call.  Next week: goal is to finalize verbiage. 
      • RD will draft list of the consolidated Tooling requirements for IG Publisher and duplicate URI handing that call

Discussion ended here no further agenda items were discussed

  HL7 Terminology / Unified Terminology Governance (THO/UTG)10RD/JB
  • Standard copyright for HL7 content
  • Workflow for THO releases (moving content approved in ballot to THO AND how to handle missed THO deadline)
    • Requires discussion - priority item to resolve
    • This is a key component of the IG Developer tutorial
  • Versioning policy for UTG/THO
    • Finished proposal for HL7 Code System elements
    • There are a few higher level considerations before moving over to Value Sets
  • Many CodeSystems use urls when they should be FHIR-37440 - Getting issue details... STATUS
    • UTG/THO subcommittee working through differences across elements for duplicates to determine what is consequential 
  • Tutorial to FHIR-I at WGM - terminology expectations / UTG process
    • JB will share slides:  good starter content for IG developer tutorial
  • OHDSI Symposium follow-up
    • OMOP + FHIR track: high attendance
    • Upcoming proposal for Vocab WG re: OMOP Vocab / External Terminologies
      • FMG / FHIR - I proposal in the wings
    • SSSOM workshop to be repeated virtually
  • Vulcan FHIR-to-OMOP project
    • New participants: SMILE Digital Health
  • Proposal: developing a core UCUM Value Set (Upcoming)
      • CMG / V2 / OHDSI communities expressing interest
      • FHIR / CMG vale sets not currently aligned
HL7 Terminology Authority (HTA)

    • ICHOM folks came to HTA call this week, provided guidance on use of external terminologies vs local content development
    • American Type Culture Collection (ATCC) erroneously was imported at the time THO was first populated with an incorrect URL (which is the correct URL for WHO's Anatomical Therapeutic Chemical (ATC). HTA agreed to delete the existing ATCC record as it was 1) included in the code system records that were retired due to no exiting work group or management group claiming use and 2) it was completely wrong from it's existence
    • UICC TNM was approved to be added with the 8th edition information (OID and URI)
Technical Steering Committee (TSC) matters10RM

Product Management Council

    • Met Friday 21-10-2022
    • CDA MG will present at November PMC Webinar. TSMG likely next webinar thereafter.

TSC Membership - (deferred: RM not available at 10:12)

  • RM will take to the TSC: 4 year terms, then one year off and establishing 2 alternate members as outlined above 
  •   RM: update re: proposal from TSMG?
    • in TSC meeting: other management groups had not yet discussed this topic.  This will be reviewed in today's (this week's) TSS meeting. Update next week
    • Bryn will bring back this update if RM is not available

  • Deprecation Policy and Implementation
    • Tabs created
    • Deprecation Policy Framework
    • Issue logged to render identifier.period:
      • Lloyd disagrees with rendering identifier.period. Would rather hold deprecated identifiers in naming systems but enhance tooling to link code systems to their identifier systems based on url
    • RD:  this is the intended purpose for the CodeSystem / ValueSet can be linked to corresponding naming system established by the code system: url value is equivalent to the preferred url in the name - so they should
    • RD:  is Lloyd going to provide a link to the naming system?
      • JB: need to establish this as policy before he should go do this
    • RD:  will discuss this with Grahame to understand what his position is
Parking Lot 

  • Terminology Server (Implementation Requirement)
    • Follow-up from WGM - next steps re: terminology server (service) requirements (1-page description)
  • UTG / THO Subcommittee work in progress
    • Vocab WG follow-up: Policy Requiring Identification of Stewards for HL7 (Internal) Code Systems

Supporting Documents

Outline Reference

Supporting Document