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  • Confirm May WGM GH schedule
  • Finalize Gender Identity minimum universal realm value set content so that it can be created - someplace

Approval of minutes

Approval | Meeting Link

Discussion items

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  •  Schedule
    • May 2 - FHIR Connectathon 
      • Yes, we will still meet.
      • Cooper will be available
      • Lisa, Riki will not be available
      • Perhaps work on Use Cases
    • May 9 Not meeting with normal weblink - May WGM - You must register to attend
      • Monday May 9 Q4 3:30-5p ET - Primary overview, timeline
      • Wednesday May 11 Q4 3:30-5p ET - All supporting work group attendee working session. Harmonization decisions, review of approach
    • May 16 - PLAN TO MEET even though this is Monday after WGM
      • Review WGM decisions
      • Other as determined at WGM
  • External updates?

Confirm May WGM agendas



  • WG meeting could be used to review IG and use cases to get input.
    • Resolve R5 sex and gender patient section
    • Understand other resources
  • A smaller group will meet before the WG meeting to determine some of the smaller needs/requirements for the WG.
  • The gender harmony ballot points to the R5 ballot. If the R5 ballot is postponed, the gender harmony ballot may have to be postponed until the next ballot cycle. This is theoretical at this point, but needs to be discussed.
  • Review of IG
    • IGs can have a design for the choice of an observation-based approach.
      • Can be placed between the Model and Terminology tabs.
      • Speaks to the SDOH approach.
      • The model diagram cardinality is difficult to read. 
    • The IG needs words that describe choices and links to places of implementation.
    • There was an outstanding question of vocabulary for V2. Will the vocabulary be listed or a table.
      • Clarity is needed for CDA expectations for null flavor. The concepts and the null flavor are grouped together for FHIR and ungrouped for CDA.
      • The union value set could also be used.
      • The value sets should be in THO and/or VSAC with THO being the source of truth.
10minPostpone to May 2 - Wrap up FHIR core R5 text describing use of SFCU extension at that level


Cooper Thompson - Not available 


All - Rob is unable to insert the OneDrive shared word doc from Cooper. I also realize that a google doc is a problem. SO the current material on this section is linked off the Implementation Guide landing page:

Updates to FHIR R5 Patient Resource Sex and Gender Section

Please review and comment on this page for discussion with Cooper.

50minGH Terminology, Finalize Gender Identity including decide on NULL vs DAR code system and work on others
  • Reminder that intent is use in Universal Realm so freely available. Realm-specific mapping expected to occur
  • Value sets will be Extensible MIN Binding (except SFCU to be Required)
  • We can create our own code system if needed.


  • Rob McClure met with SNOMED to discuss what this group is doing to move the promotion of male, female, and nonbinary concepts in May.
    • They can be referenced in the international release and will eventually be in the subset either later this year or next year.
    • USCDI points to male, female, but they need to know if a Canadian extension is used.
    • SNOMED also has older codes. They are going away and SNOMED said do not use them.
  • Null Flavors are in use for all other gender value sets. If unknown is used, there will be an issue.
    • There are issues with using unknown in SNOMED as qualifiers values would have to be used.
    • Unknown has to be used, but there are other unknown codes that could be used.
    • There was a discussion of when unknown versus not available are combined but there is a challenge in this project correcting the bigger issue.


Acceptance of the minimum value set of male, female, null flavor (UNK) by Robert Horn and Ulrike Merrick

12 approvals and one abstention (Kathy Walsh

Action items