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This is the Confluence page to describe the UTG (Unified Terminology Governance) process and operations at HL7.  On this page you will be able to sign up to watch different areas for proposals for changes in vocabulary related to those areas in order to be able to review the proposals, comment on them, and vote on them. These pages will be improved based on community feedback throughout 2020 as we move towards being able to go live with this new approach to vocabulary maintenance at HL7.  Please go to the Documentation pages for full information on participating.


HL7 maintains multiple terminologies - v2, v3, CDA value sets and FHIR. However, ongoing maintenance of these terminologies proved to be resource intensive and quite opaque to much of the community and thus a need for a  uniform vocabulary governance process or strategy across all the HL7 product lines was identified. As FHIR and associated implementation guides became more popular and as HL7 continued to grow, this was identified as an increasing issue.  There is a need to maintain the terminologies that support all of HL7’s products (v2, v3, FHIR, CDA, etc.) in a way that is responsive and improves quality while reducing the resources that both HL7 and its volunteers must put into the process.  As well, there’s a need for the process to align with the community’s expectations for a more modern, continuous peer-feedback related process. The UTG process intends to solve these issues - see below.

Change Proposals - Maintenance of the HL7 Terminology

This section provides a high-level overview of the workflow process for submitting a proposal and participating in consensus review. People in the community submit a proposal for changes that contain all technical details to the vocabulary, and after validation it is released to the community for Consensus Review (to be voted yes or no). Proposals that are approved by a majority voting yes are implemented into the current build of the terminology. 

*** Documentation and Education Materials ***

The general architecture of the UTG process is best described by the diagram here.

The sections below provide a high-level overview of each process: Participating in Consensus Review, and submitting a Vocabulary change proposal

Consensus Review

Anyone wishing to participate in the Consensus Review of proposals in flight is welcome to participate. No tooling is required to participate - if you want to be a reviewer/voter on vocabulary change proposals and you are not one already, click this link below: 

Request Reviewer Permissions

All change proposals are validated and formatted for a consensus review, where folks may comment and vote on (up or down) any proposal.  Votes are weighted and there are several requirements (i.e. votes from specific users and groups) that must be met for the content to be approved or rejected.

The basic steps to to the review/voting process are:

  1. Get access to HL7 Jira by requesting an account on
  2. Request reviewer/voter permissions by filling out the following form: 

    Request Reviewer Permissions

    1. If you are NOT an HL7 member, please add a comment in the 'Note' field explaining why you want to become a reviewer and describe your relationship to HL7 and/or UTG
    2. If your Work Group has appointed you as an Oversight Voter (someone required to represent the WG by voting on UTG proposals in your area then please explain this in the 'Note' field and add a link to the Meeting Minutes and decision where the Work Group decided that
  3. Open issues can be viewed in the UP project on the UTG Jira Project
  4. Review details of proposal and view rendered version of proposed content via link on ticket
  5. Use comments to discuss the proposal if necessary.
  6. Vote Affirmative or Negative

If approved, the proposal enters the UPSM project workflow to be integrated with the source of truth and published.

Change Proposal Submission

The steps below describe the process for submitting a proposal. More detailed information on the process is documented at UTG Tooling and Proposal Documentation (this area is not yet complete).  At the current time, if you wish to submit a change proposal, please contact a member of the UTG Project team or send an email to the HL7 Vocabulary WorkGroup mailing list.  Don't know if you have permissions to be a Submitter of Vocabulary Change Proposals?  When you create a proposal and it goes into the Environment Setup state, if you see a button on the top "Draft A Proposal" then you ARE a Submitter!   If you don't see that button, you can become a Submitter by: 

Request to become UTG Submitter

The basic steps to submit a change proposal are:

  1. Get access to HL7 Jira by requesting an account on
  2. Request Submitter permissions by filling out the following form: 

    Request to become UTG Submitter

    1. If you are NOT an HL7 member, please add a comment in the 'Note' field explaining why you want to become a submitter and describe your relationship to HL7 and/or UTG
  3. Contact the UTG team for current status of tooling, process, sign-up, and permissions settings to be able to draft and submit a change proposal.

  4. Install required tooling (Vocabulary Server, UTG Editor, and Sourcetree)
  5. Draft the proposal (written information) on the UTG Jira Project
  6. Create and download a branch to edit content using Sourcetree
  7. Use Vocabulary Server and Editor to create content change(s) for the proposal - changes to the UTG resources
  8. Commit new or changes resources to branch using Sourcetree and Push the changes to BitBucket
  9. Submit proposal in Jira

Unified Terminology Governance Project (UTG)

The UTG process decreases the burden on HL7 resources by having the proposal submitter create and submit the content that they needed added, modified, or deleted in their own development branch (via BitBucket directly through Jira). Proposals are submitted using a Jira-based workflow that is open to the community (both submitting and voting). Automated checks and validations ensure that the content meets proposal requirements. The proposal goes through a consensus workflow to come to a resolution. If approved, the use of the Bitbucket branching allows simplified integration into the master repository.

The UTG project is scheduled to replace existing vocabulary maintenance processes (including harmonization) for HL7 internationally published normative standards in mid 2020. Additional information about project details, requirements, project management, and documentation can be accessed at the Unified Terminology Governance Project (UTG) Page

The second UTG session geared towards the HL7 community can be found below:

HL7 Education on Demand (free access):

HL7 YouTube:

UTG Content

Please see for the UTG landing page. 

The UTG resources are browsable at This page contains the current versions of UTG content. Resource history is also be maintained on this page.

All of the Code Systems and Value Sets for the Code Systems that are not ballot-bound are maintained through this UTG process as of Q2/Q3 2020. For a list of ballot-bound Code Systems and Value Sets, click here (NEED TO fill out).

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