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Date:

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2023-10-17
  

Facilitator:  Anthony Julian 

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Note Taker:

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Anthony Julian 
 

Attendees

Present
Name
Affiliation
XMayo Clinic
R

Nick Radov Co-chair

United Healthcare
R

Isaac Vetter Co-chair

Epic
X

Brian Frankl Co-chair

Surescripts
XVernetzt, LLC
X Altarum     
XLabcorp

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Agenda Outline
Agenda Item
Meeting Minutes from Discussion
ManagementQuorum Reached (co-chair + 2) Y/NY
Management Minute ApprovalDeferred
MethodologyBlock vote on ... a disposition for several V2.9.1 related ballot items , per Riki

Discussion was held RE: guidance for usage of the SOGI information  as referenced from the product brief for HL7 V2.9.1:  https://www.hl7.org/implement/standards/product_brief.cfm?product_id=516 


Motion from Craig Newman/Brian Frankl /2-0-1

Ulrike Merrick or Craig Newman  will update the Jira tickets.

For all of these the resolution is the same

  • Jira grouping tag: 2023-10-03
  • Proposed disposition:

o   Not persuasive

    • The scope of the original Observation-based guidance was for patient only. If other persons need similar data exchanged (Sexual Orientation, Gender Identity or Pronouns), then the new GS* segments should be used as described in the base standard.
    • The usage is found in the newly defined gender harmony guide for implementers https://build.fhir.org/ig/HL7/fhir-gender-harmony/branches/main/hl7v2genderharmony.html
    • The observation based guidance will be updated to
      • The default approach for any message type where the base standard message definition does not already include patient-level observations is to insert the PATIENT_OBSERVATION segment group defined below. Examples for several common order/results related message types are provided below.

        If a given domain (e.g. Immunization) already has an existing solution defined, the domain-specific approach may continue to be used in place of the default approach." as agreed upon on this call. 

  • For OO:
    • V2-25602 - Everywhere GSP, GSR, and GSC are added OBX needs to be added as well
    • V2-25605 - Add OBX where new Gender Harmony segments were added
    • V2-25618 - Add OBX where Gender Harmony Segments are added
    • V2-25625 - Add OBX where Gender Harmony Segments are added
    • V2-25626 - Add OBX where Gender Harmony Segments are added
    • V2-25627 - Add OBX where Gender Harmony Segments are added


  • For PA:
    • V2-25603 - Add OBX as an alternative to GSP and GSR
    • V2-25612 - Add OBX where Gender Harmony Segments are added
    • V2-25620 - Everywhere GSP, GSR, and GSC are added OBX needs to be added as well
    • V2-25622 - Add OBX where Gender Harmony Segments are added


  • For PC:
    • V2-25613 - Add OBX where Gender Harmony Segments are added
    • V2-25615 - Add OBX where Gender Harmony Segments are added


  • For FM:
    • V2-25610 – Add OBX where Gender Harmony Segments are added
    • V2-25624 – Add OBX where Gender Harmony Segments are added


  • For SD:
    • V2-25623 - Add OBX where Gender Harmony Segments are added


Related, but a different resolution:

  • For V2 Management:
    • V2-25564 - Update Existing Guidance To Remove "short-term"
      • proposed disposition:
      • Persuasive
      • This was an oversight and has been corrected as of 9/25/2023
    • V2-25596 - Update existing SOGI guidance to remove "Short Term" designation.
      • proposed disposition:
      • Persuasive
      • This was an oversight and has been corrected as of 9/25/2023
Methodology

LOI/LRI ACK Choreography Question

20231017 - will be moved to a future agenda when the SME's are available.

Background is written up here: 

This boils down to these questions:

#1 verify that message structure (and content validation is ONLY at application level) - besides figuring out if file is even HL7 and reviewing MSH

#2 If AA is sent in MSA, does that mean no ERR segments can be sent?

Methodology

2024 info ballots on maturity of MessageHeader, MessageDefinition


There will be three for-comment ballots in 2024 and WGs are asked to ballot each of their FHIR resources towards a goal of maturation for normative in R6. 

We need to decide when to ballot our resources. Alternatively, is deprecating MessageDefinition really an option?

20231017 - will be moved to a future agenda when the SME's are available.
Methodology

Determine next steps:

  • Extension review from Grahame's automated analysis


During the Sept WGM, FHIR-I or FMG? asked each WG to analyze and review extensions on their resources for unnecessary duplication. 

The auto-generated list is called stats2 and is here ....

20231017 - will be moved to a future agenda when the SME's are available.
MethodologyJiras (Time permitting)
Management Next agenda
 Adjournment
 Adjourned at

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