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Attendance can be found Here

Co-Chair and Key Participant information can be found on the Agenda found Here

Discussion items

3:30Meeting startedJim Case

The attendance recording mechanism was explained

3:35Value Set Expansioin ProjectRob McClure

The group have been working to finish up comment reconcilliation of VSD ballot or FHIR ballot so there has not been a VSE meeting for several months.

Currently looking at FHIR process harmonisaiton and value set expansion and binding semantics concern that we have not been focusing on the right things.

Question: is the intetion of VSE to be on a local level or to be more 'standardised'. Yes, the content logical definition, where it is logically expandable that (with some caveates) the result would produce the same outcome.

FHIR Definition of expansions is a possible focus for a profile to clarify how VSE is required for best practice in FHIR expansion definitions.

FHIR has always wanted a lot of flexibilty in the kind of informaiton which is in an expansion and how closely that is aligned with the code system with which it is associated.

    • in your compose CLD you would draw upon designations from a code system supplement. And then that is recursive which achieves a hierarchy within the expansion. There are acknowledged problems (from a vocabulary perspective) to this process and we are seeking to put guidance to reduce bad practices (which are already occuring).

FHIR publishes the definition with the expansion and may or may not include relevant to codes/definitions etc. There are quesitons about when you have a definition in the expansion but there are different instance ids but the canonical id is the same are they the same?

Anything which is a value set will show up in an expansion.

In addition to the code, codesystem version, the definition of the concept could also be included

The meeting reviewed the FHIR Operation $expand on ValueSet issues:

When an intensional definition is used to generate an expansion, the message should include the intensional definition and the result of applying that process. However the lawyers will not support publicaton of intensional definitions of vendor property (this is not a problem in areas of the world but it is a real issue in the USA)

As there is an aknowledged need to change due to ambiguity and multiple interpretations of status. It was agreed that the status quo is not acceptable. Invariant 11 is not acceptable.

As we therefore need to go back to ballot we have two options:

  • rename the element (which could be a quick fix, but also could be a good long term solution)
  • by stating that the element is 'definition status' - the expansion remains stateless and it is clearer what information is being transmitted.

It was agreed that the suggested solution be discussed with FHIR management and further discussed tomorrow.

Robert Hausam to discuss with Grahame Grieve and report back to Vocabulary in Q3 on Tuesday

Action items

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