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ANSI Anti-Trust Policy:  Professional Associations, such as HL7, which bring together competing entities are subject to strict scrutiny under applicable antitrust laws. HL7 recognizes that the antitrust laws were enacted to promote fairness in competition and, as such, supports laws against monopoly and restraints of trade and their enforcement. Each individual participating in HL7 meetings and conferences, regardless of venue, is responsible for knowing the contents of and adhering to the HL7 Antitrust Policy as stated in §05.01 of the Governance and Operations Manual (GOM).

OO Main - Meeting Information

Meeting Details

Date: June 1, 2023

Time: 1 - 2PM ET


Meeting Status

Chair:  JD Nolen

Scribe: Riki Merrick

  •  Quorum (Co-Chair + 4) Met 

OO Events 


OO Calls Next 7 Days (check if happening)

  •  Clinical Order Workflow in FHIR
  •  Catalog
  •  LAB


  •  FHIR Orders Exchange (DME/Acute/Admin)
  •  v2-to-FHIR
  •  Specimen
  •  HCP
  •  OO on FHIR

  •  Cancer Pathology Reporting
  •  IHE SDC/eCC on FHIR (hiatus)
  •  Nutrition (next 4th Wed June)

  •  v2-to-FHIR (on hiatus)
  •  Main Call
  •  LIVD (proposed June 15 next call)

Upcoming Topics/Due Dates



June 25, 2023

NIB Deadline
FHIR IG Proposal
July 7, 2023FHIR Content Freeze
July 11, 2023FHIR Connectathon Proposals Due
July 18 - 27, 2023WG Approves Ballot Content for FHIR IG Content
July 27 - 30, 2023Ballot Content QA Period
July 30, 2023Final Ballot Content Deadline
August 4, 2023September 2023 Ballot Opens
September 9 - 15, 2023September 2023 Phoenix Working 


(Names of people present are BOLDED)



Ralf HerzogRoche
Rob HausamHausam Consulting
JD Nolen
Hans BuitendijkOracle
Riki MerrickVernetzt, LLC / APHL
Yanick GaudetStar Global
Sarah GauntLantana
Andrea PitkusUW
Marti VelezisSonrisa / FDA
Jackie Hemenway
Dan RutzEpic
Jose Costa Teixeira
Olga Volk
Bob DieterleEnable Care
Kathy WalshLabcorp
Lorraine ConstableConstable Consulting
Elliot SilverResMed
David Barwin
Dave Hill
Alex Goel
Nancy SpectorAMA
Donna Pertel

Agenda and Notes:


Approve Minutes

OO Project Proposal Triage

  • Jira
    • Motion: OO would like to be an interested party with updates before to going to ballot or publication.
    • Riki Merrick / Lorraine Constable : 12-0-0
    • Comment posted 
  • Jira
    • The scope will include lab-related content
    • OO would like to be a co-sponsor of this work; Given the scope  of the work, should this be led in the cross project endeavor?
    • Comment posted
  • Other (Project Approvals, NIBs, etc.)

    • No additional administrative items today
  • Topics for Today:

    • OO ONC NPRM Response Draft

      • Action for today: Need to finalize comments and send them to HL7 PAC
      • Discussed the comments
        • RE: The utility and maturity of existing HL7 v2 and C-CDA standards supporting laboratory interoperability and the impact of moving to FHIR-based laboratory data exchange.
          • In the summary statement – Riki had a comment to reword as the workflow is not completely covered in FHIR US Core
          • Riki Merrick to Everyone (Jun 1, 2023, 1:35 PM)
            • FHIR US Core examples are not mature enough to handle lab results
            • FHIR and CDA are not implemented in the labspace
            • CDA is used for data sharing between providers
            • FHIR US Core is not mature enough to consider in certification
          • Andrea Pitkus to Everyone (Jun 1, 2023, 1:37 PM)
            • While FHIR elements needed for laboratory orders and reporting are generally available, profiles, implementation guides, US Core, and other needs to implement and support laboratory data exchange in accord with CLIA are not yet mature.
          • Riki - add revisions here
          • Will discuss on the COW call

    • ADI/ServiceRequest vs. Consent Discussion - NOT DISCUSSED - email sent to Maria and Dave/ADI Project team

      • Need to find a time to discuss with the PACIO/ADI Team.

        • Motion to post: Riki Merrick / Lorraine Constable : 11 - 0 - 0 

-------------Adjourned at 2:02PM EDT

E-Signature Update

  •  Yes
  •  No
  • Check back in June for progress


  •  Yes
  •  No

UP-44 -no value set content defined for v2 table 963 value set 

  • Leaving UP-44 open for now – so that the new tickets and this one can be linked

V2-Jira Review (time permitting) 

  •  Yes
  •  No

Projects/Feedback (Updates in BOLD)

  •  Yes
  •  No

ProjectTopicsProject Information
  • Topics:
    • Need to add current topics
  • Project Page Link: 
  • Meetings
    • Every other Friday, 9-10am ET starting 10/1
  • Topics:

    • Need to add current topics

  • Project Page Link: 
  • Meetings:

    • Mondays 1 - 2 PM ET
    • Thursdays 11 - 12 AM EDT

Discussion Topics: 


  •  Yes
  •  No

Block Vote of old Jira trackers set for next main call - see:

JIRA Status



JIRA Issue Backlog
  • Should the extension be removed?
    • 4/27 NOTES:
    • Side-bar: There are also several extensions on other resources, for example for nutrition that we are not sure where the extensions came from
    • Related Jira referenced in comments = FHIR-29273
      • This jira mentions these artifacts
        • Blood Pressure Panel
        • Body Length
        • Body Weight
        • Head Occipital-Frontal Circumference by Tape Measure
      •  came from Rita Pyle
    • A component is different from a qualifier
      • It is not in the definition for component, but mentioned in text in we say “or may provide qualifying information to observation.code”
        • Can we find out how this text got added? – It is in R4, but not R3, so maybe we can find it
      • Is the bodyposition an observation that is part of the bloodpressure measurement procedure?
        • Diastolic pressure
        • Systolic pressure
        • Body position – this would have to apply to both of those measurement
      • The old jira came from Rita Pyle – let’s ask her to supply the list of qualifiers that are modeled differently – add comment to this Jira tagging her
      • Add Overall comment? We see a difference between qualifiers and components of an observation – let’s do some more research first
  • Total FHIR = 246 Tickets in Submitted, Triaged, Waiting For Input

    • FHIRCore = 219
    • FHIRCast=1
    • FHIRPath=11
    • FHIR IGs = 8

  • Add the ability to reference QuestionnaireResponse from DiagnosticReport
  • Pulled from Block for further Discussion by Dan Rutz 
    • Needs "a better evaluation of real examples of which workflow, procedures, and data structure truly invoke a DiagnosticReport which involves an embedded QuestionnaireResponse as part of the .result element.  It may be valid, but needs to be well-substantiated."

  • At-home Test - Deferred tickets that have been reopened.
  • This group is not meeting – how or when do these tickets get resolved?

  • Grouping the tickets with Observation.category changes
  • Need to determine where to have this discussion – at least to propose dispositions for a block
  • Discussed at WGM – need to determine outstanding JIRAs

Catalog JIRAs
  • Made progress on QA of IG Changes
  • Ballot Reconciliation Spreadsheet is ready to go

Block Vote Pulled JIRA




Elliot Silver pulled FHIR-33042

Hans pulled FHIR-32154, FHIR-25552 

From May 25, 2023

JIRAs to Be Applied (FHIR Core)

JIRAs to Be Applied (IGs)

  • Status of tickets


Total To be Applied:
  • 41 FHIRCore
  • 115 IG related
JIRAS to be marked Published


Note - these are in the published R5 on

Modules - Updates on progress

  •  Yes
  •  No

The following are draft pages to organize and author content for each of our health care product resources: 

OO Resource Coverage

  • Need to discuss developmental roadmap for each of the OO resources for R6
  • Added R6 planning to WGM agenda
  • Need to discuss what needs to be done prior to WGM to prep for discussions
  • Add Resource reorg comments to module pages


  • Marti revised related resource for each topic area to where the resources align to current modules
  • Definitional resources were in workflow (pattern is still there) but those are now in administrative – Marti and Jose to take off-line

Projects/Feedback (Updates in BOLD)

  •  Yes
  •  No

ProjectTopicsProject Information
FHIR Orders Exchange (DME/AcuteOrders) (Administrative)
  • Topics:
    • Referrals/PriorAuths/Orders/Claims
    • Focus on exchanges between Ordering Provider and Performing Provider
    • Overlaps with FHIR in the Lab/Workflow - establishing boundaries for each project
  • Project Page Link: 
  • Meetings:
    • Every Monday 12 - 1 PM ET
  • Topics:

    • Need to add current topics

  • Project Page Link: 
  • Meetings:

    • Every Monday 2 - 3 PM ET
  • Topics
    • Device Associations
    • Intake/Administration/Procedure Consistencies
    • Device Structure
    • otherwise Jira tickets for Device(Definition), BDP, Nutrition
  • Topics
    • Treatment Orders discussion - see OO-on-FHIR Meeting minutes from 11/15
      • To standardize Portable Medical Orders/Advance Directives, etc.
      • Patient Care will evaluate ServiceRequest, Consent, CarePlan and follow-up with OO 
    • Looking at PC involvement so we can track down related people on observations – boundary between observation.subject and observation.relatedPerson - familyMemberHistory profile review, FM has similar conversations around subject and beneficiary
    • also should review Gravity work around sexual orientation
    • VisionPrescription resource ownership - need to update ownership
    • Jira tickets work
Cancer Pathology Reporting
  • Topics
    • IG has been reviewed and approved by FMG with the caveat that it not be published until the MedMorph Reference Architecture IG is published (checking on ETA)
  • Topics
    • Pending IG updates and Publication Request

  • Project page: 
  • Meetings
    • Every Wednesday 2 -4 PM ET
    • Note that the call is listed on call calendar only as 1 hour call, since conference center won't let calls overlap
  • Topics

    • Pending resources
    • Working on R5 ballot comments

  • Project page link: 
  • Meetings

    • 4th  Wednesday ONLY 2-3 ET
(FHIR in the Lab) Order Workflow project


  • Workflow 
Order Service Catalog
  • Topics
    • Supply chain and Inventory
    • WHO - Product/Trade Item
  • Topics
    • LIVD IG - Ballot Reconciliation 
    • LRI/LOI
    • Lab related topics