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Chair:    Reuben Daniels 

Scribe:  Davera Gabriel 


Tuesday, November 29, 8:30-10:00PM UTC

Tuesday, November 29,  3:30-5:00 PM USA ET

Wednesday, November 30, 7:30-9:00AM (next day) AEST

Wednesday, November 30, 9:30-11:00AM 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)
MD Partners, Inc.

X - Proxy to Reuben

MPApelon, Inc.
National 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
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
Joe AmlungReginstrief
Martha JonesHL7 Intern
Riki MerrickVernetzt, LLC
Gaurav Vaidya
Emily PfaffUNC
Eric PrudhommeauxJaneiro Digital
David BoothYosemite Project
Jim BalhoffUNC
Christian ReichOHDSI
OPJohn Carter
OPMarc Duteau

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. Note items in RED below are deferred due to lack of time

Agenda Outline

Time allocationLead

Agenda Item


  • Announcements
    • THO/UTG Subcommittee Calls will move to Thursdays at 3.30-5pm Eastern on alternative Thursdays (alternating with the Vocabulary WG Main Call).
  • Upcoming Meeting Schedule (Quorum is 6 attendees + 1 co-chair)
    • 12/6 - Davera and Reuben out
    • 12/13 - Carol and Reuben out
    • 12/20 - Canceled 
    • 12/27 - Canceled
    • 1/3 - Davera and Reuben out
    • 1/10 - Meet, final prep prior to WGM
    • 1/17 - WGM
  • TSMG Membership Slate for 2023
    • Proposed Membership Slate has been approved by TSC
      • Ioana Singureanu, US Department of Veterans Affairs – Standards implementation and conformance experience, along with HL7 product line expertise
      • John Carter, Te Whatu Ora Health New Zealand- International (NZ Affiliate) Representation - Terminology Services and Implementation expertise across the health care industry and at a national level in NZ. Current HL7 New Zealand board member.
      • Chantal Schiltmeijer, NICTIZ  - International (Netherlands Affiliate) Representation – Terminology Service implementation expertise in the Netherlands, representative of the Dutch National Release Centre at SNOMED International meetings. (requires re-confirmation from candidate, may require a substitute to be proposed to TSC)
    • Unless changes are made to TSMG membership rules, under current 2 and 4 year terms rules, propose that seats have alternating terms. Meaning, the new members take on two year terms (which were one year term seats prior). When current 2 year members cycle out (Carol, Reuben, Michael , those seats would become 1 year terms in their renewal, and so on).
      • Jan 2023-Dec 2024, current members who had 1 year term, now 2 year terms (3): Roel, Michael, Davera
      • Jan 2023-Dec 2025, new members filling a 2 year term seat (3): Ioana. John and Chantal
      • Through Dec 2023, current members with two year term (4): Carol, Reuben, Bryn, Lisa
        • DG Moves this renewal pattern be accepted. CM seconds.  Motion passes 7-0-0
PSS Needing External Review
TSMG Standing Subcommittee Updates

 HL7 Terminology / Unified Terminology Governance (THO/UTG)As neededJB/RM/CC
  • Terminology expectations for IG developers
    • Terminology Expectations for IG Developers (Simplified)
      • RD will be able to work on this in the upcoming week.  Includes a meeting with Grahame on this topic
    • JB and RM have attempted to simply the policy. Group reviewed the policy discussion summarized below
      • Policy applies to any HL7 Implementation Guide
      • Input from FMG and TSC has been included, CMG has not commented. Policy should be applicable across product lines.
        • For this to work, everything in THO will need to have an OID to support CDA
      • Open Action Items:
        • Validate that the first few steps are the same as those in Validating and Requesting Identifiers for External Code Systems and Identifier Systems
        • Review Reuben Daniels drafted list of the consolidated Tooling requirements for IG Publisher and duplicate URI handing that call
        • Update from CMG
          • Was added to their agenda last Wednesday
        • 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)
    • CM: would like for TSMG membership to weigh-in on any outstanding issues by this Friday (2Dec22).  Barring any additional comments to be resolved, this version of the policy will be sent to TSC for approval
    • (RM / ??) will request time on the TSC agenda to provide a walk-though of this policy
  HL7 Terminology / Unified Terminology Governance (THO/UTG)10RD/JB
  • Technical correction for THO
    • 5.0.0 release has corrupt R3 package, will be fixed in 5.0.1
    • TK: recommends not using the third # in the triplet because that is designated for incrementing the tickets in the update. Recommending 5.1.0 instead
    • MD:  can we just use the original number? TK: that would not provide the correct designation on a history page.  Need to create another number, thus should be, recommending: 5.1.0
    • JB Moves TSMG approve an ad hoc release of THO version 5.1.0 to fix corrupt R3 package and create a new up ticket to document the fix. DG seconds. Motion passes 9-0-0

Parking lot and work in progress

  • 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
    • This item is blocked without the expectations for IG developers policy being developed.
    • 8Nov22 TSMG meeting: deferred
  • 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
    • Progressing to finish HL7 Value Sets and moving to External Identifier System Metadata Records
  • 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 
    • Need a follow-up with Grahame Grieve. Will invite him to this week's THO/UTG Subcommittee call.

HL7 Terminology Authority (HTA)

    • Next meeting on Thursday 1December 3-4pm EASTERN US
Outreach & Education

  • Vulcan FHIR to OMOP project
    • Track in the January Connectathon
      • validation architecture based on CAMP FHIR
    • Vulcan 101 presentation section (14Dec22)
    • Environmental scan report - started
  • Alignment of Value Sets across product families - with Lisa Nelson
  • Develop standard curriculum requirements for 3 workshops:
    • Intro to FHIR Terminology
    • Advanced FHIR terminology
    • Terminology for IG Developers
  • Write-ups for dissemination (to be developed)
    • Accessing CDCREC Value Set
    • Using ICD-11 on FHIR
    • Terminology Expectations for IG Developers (component of workshop above)
Technical Steering Committee (TSC) matters10RM

TSC Membership - (deferred: RM not available today)

  • 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
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