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US Realm Steering Committee Call Agenda/Minutes 

Location: Exhibition 3.4

Date: 2020-02-04
Time: 2pm (Q3)
Co-ChairsSteve/BrettNote taker(s)Anne
Quorum: Chair +7

Attendees:

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Attendance Log

2020-02-04 US Realm Sydney WGM Attendance

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Attendance Log

2020-02-04 US Realm Sydney WGM Attendance

Agenda


Administrivia

  • Agenda review

Review items:

Discussion:

  • (20-30 mins) Question for Accelerators - Do you have examples where you built new profiles specified in US Core (e.g. Patient, Allergy, etc.) because you couldn’t use US Core?

  • (20 mins) Extension requests (approved in 2016!)
    • How do we implement?
    • Quarterly review?
  • (10 mins) Solicit any additional quick US Realm Quality checklist items:
    • Profiles build upon US Core
    • Terminologies align with US requirements
    • Extension have followed the US Realm Extension process.

Minutes

Administrivia

  • Agenda review

Review items:

  • Skin and Wound PSS
    • Susan Matney here to represent the project. 
    • Wayne asks why this is just coming to us now given that so much work has been done on it. We are trying to get things in circulation sooner. Susan states it was a lack of awareness of the process. 
    • Update target dates to reflect what is done and not done.
      • Side note: Discussion over the fact that there should be a process for updating US Realm things to be Universal whereby the US Realm communicates the project to the international community to solicit participation.
      • Invite FMG to a future meeting to discuss and perhaps TSC
    • MOTION to approve with the assumption that the dates will be updated: Wayne/Rob
    • VOTE: All in favor

Discussion:

  • (20-30 mins) Question for Accelerators - Do you have examples where you built new profiles specified in US Core (e.g. Patient, Allergy, etc.) because you couldn’t use US Core?
    • There are currently 5 or 6 accelerators. As we get more, the possibility that we have discordance with US Core profiling work increases. 
    • Viet states that since Da Vinci started two years ago, they've put out 14 IGs. They always try to start with US core. Some of it is readily reusable but US Core doesn't have enough detail to support workflow, so they end up coming up with additional profiles for that. Terminologies are also an issue and those issues are being addressed with HTA. They would like to be part of the USCDI to US Core process. From a technical standpoint they'd like to be able to look up all available profiles and their lineage more easily - they are working with Grahame on that.
    • Steve: Separating the US Core's evolution from certification is important - they are related but separate. 
    • Viet: The quality measure work that Bryn leads is picking up steam. The QI Core profiles are based on US Core. If we as a realm adopt more QI Core, those would be good candidates.
    • Need to keep feedback loop open so that any new profiles that are created get pushed into updates to US Core.
    • Discussion over DocumentReference. 
    • Viet: The data exchange between payers and providers - the payers don't have the richness needed to send back to providers because it's claims based. It will improve over time as more clinical data is introduced.
    • Chuck: One challenge is bringing in like-minded or comprehensively equal european or asian groups who want to participate in an accelerator project. We need to be more clear to external parties on how they become an accelerator.
  • (20 mins) Extension requests (approved in 2016!)
    • How do we implement?
    • Quarterly review?
      • Reviewed document. Do we think it's still important to have this process, and if so, where do we implement it?
      • Steve notes that there is work being done on a registry that the US is funding, in addition to significant other government investments into FHIR. These projects are leading into more profile and extension development and increases the risk for duplication. Having these things represented in the registry would allow greater consistency and less duplication. 
      • Wayne notes there are multiple paths into the extension review process. Currently are only registering at the IG level; need to register at lower levels.
      • Hans: We need to have guidance that is consistent so we don't have tension between what is truly a US extension and what is a global extension.
      • Brett: The registry would have to be functional before we could implement this process.
      • John: Could be given as a best practice and use it as you do the review of the publication.
      • We could review all the extensions added to the registry on a quarterly basis. If we have conflicting extensions, how to we address that?
      • Viet: Does USCDI manifest itself in FHIR as US Core? A: USCDI is a subset of US Core. 
      • Ed: You have to recognize that everyone that is creating extensions don't understand HL7. It's a lot easier to do it yourself than to see if someone else has already done it. If everyone creates their own extensions, we're in trouble. Need to refocus on exactly what the US Core is.
  • (10 mins) Solicit any additional quick US Realm Quality checklist items:
    • Profiles build upon US Core
    • Terminologies align with US requirements
    • Extension Extensions have followed the US Realm Extension process.
    • Others?
      • Where is the right checkpoint to avoid duplication of extensions? Bryn suggests a warning when you try to publish an IG if one already exists. The IG Publisher is used all throughout development, not just at the end. Bryn will add a tracker with this idea.
      • Brett: We have a clear set of US terminology requirements - could we do a validation on those in IGs? Rob: There could be a profile that we would want to apply in IG publisher when you're going to be US Core compliant.

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      • Discussion over potential strain on IG publisher. Could perhaps use a simpler search function.
  • Adjourned at 3:30 pm