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Scribe: Lorraine Constable

Joint with Hosting HCD

Summary of Health Care Product


Motion to accept the examples, with the proviso that Brian will fix the UDI DI value, for inclusion in the build.  Lorraine Constable / John Rhoads Against 0 Abstain 0 In favour 25


Chair: Hans Buitendijk

Scribe: Lorraine Constable

Hosting BR&R


Should we add to Observation or just DiagnosticReport? That gives just one place, drives consistency. Other argument is when the blob/image is the actual result.

Comment – these are slightly different use cases

Kathy – use case is where there is a “result bucket” and the document is the actual result that may have been scanned and is the actual result. Implemented R2 where this exists, but in r4 does not exist

  • Observation.valueAttachment?
    • Options
      • Observation.derivedFrom => Use case would not have Observation.value
      • Observation.valueAttachment => was in DSTU 2 and it is an actual result value.
      • DiagnosticReport.presentedFrom => Inconsistent placement of an observation.
      • Observation.extension-valueAttachment =>
    • Motion to propose in Q4:
      • Define Observation.extension-valueAttachment so it can be used with FHIR R4.
        • Requires determining where to post it. 
      • Include Observation.valueAttachment into FHIR R5 build as an STU item.
      • Document clearly when to use Observation.valueAttachment vs. Observation.derivedFrom vs. DiagnosticReport.presentedForm in
        • Observation introduction
        • Element definitions
      • Kathy Pickering, John Moehrke
        • Against: 0
        • Abstain: 1
        • In Favor: 10


Substance Definition – Substance

Reviewed the proposed Substance Definition entry; matched to Substance. Discussion of where Substance.code matches in SubstanceDefinition, which would go in SubstanceDefinition.code.code

Should we add a reference to SubstanceDefinition.

Action Create a gforge tracker to change code to definition which is a choice of Code|SubstanceDefinition. Also look at Device / DeviceDefinition to see if the pattern holds there.

Request to obtain the list of elements FDA thinks needs to be added to substance, so we can review and determine which resource it should go in, or both. Jean Duteau / Katherine <I missed her last name> To provide 

Follow up with Rik on Healthcare Product calls.

Nutrition Connectahon Update

  • Unfortunately partners did not show, but will be in Sydney
  • Worked primarily on documentation and examples.


Chair:  Robert Hausam

Scribe:  David Burgess