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HL7 CDAMG Minutes

Location: online!

Date:

Time: 4:00 PM Eastern

FacilitatorLisaNote Taker(s)Linda


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Meeting ID: 935 3262 7375
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Meeting ID: 935 3262 7375

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Attendance:

PresentName
  •   
Lisa R. Nelson, MaxMD
  •   
Linda Michaelsen,  Optum
  •   

Brett Marquard, Wave One Associates

  •   

Jean Duteau, Duteau Design Inc

  •   

Rick Geimer, Lantana Consulting Group

Regrets

  •   

Giorgio Cangioli, HL7 Italy

  •   
Emma Jones, Allscripts
  •   

Andrew Statler, Cerner Corporation (regrets) 

  •   

Yan Heras, Optimum eHealth LLC

  •   

Raychelle Fernandez, Dynamic Health IT

Quorum: Co-Chair +3

Guest(s):  

Didi Davis

Matt Rahn

Ken Lord

Dave Hamill

Sajjad Husain

Wayne Kubick

Natasha Kreisle

Craig Newman



Agenda (with Integrated Minutes)

STANDING BUSINESS

  • Quorum
    •  Attained
  • Attendance Review
  • Approve Minutes of 2020-09-21
    •  Minutes approved by consensus 
  • Approval Request(s):
  • Administrative Updates:
    • CDA Stylesheet Issue

      • Vulnerability discovered in how pdf's are rendered in iframe's in an Unstructured Document.  The base stylesheet had to be updated.  New beta of stylesheet has been released
      • Do existing publications have the stylesheet embedded.  These need an errata release that will just reference the stylesheet in Github repo. 
      • Stylesheet should NOT be embedded in Download package going forward
      • There will be new rules about what should and should not be in Download packages
    • CDA IAT – brief update
      • Approved 7 topics to be presented on October 21st
      • CCDA Zulip chat has more
      • Registration is open, $99
      • Invites will go out to speakers for a dry run from Dave Hamill to familiarize with Zoom
      • Topic leaders should still register as speaker
  • Group Discussion - Goal: prepare for the 11/7 meeting with Wayne (CTO), Austin (TSC), and Walter(BOD)
    • What does Maintenance Mode for CDA mean to us?
      • Commitment will be to "Maintain" the CDA
        • Increased focus on FHIR 
        • Applies to CDA base specification
        • Will transition to FHIR documents over time, next few years
          • Move towards CDA on FHIR
        • Will produce a web standard version of CDA (R 2.2?)
        • IG's based on CCDA and templates will continue until FHIR ready, >1 year
        • CCDA hoped to be a web spec in 12 to 18 months
        • Need tooling for maintaining standard
      • What does CDA MG think this means?
    • What specific questions would we want to have addressed? For Nov 4th meeting
      • Does ONC plan for the maintenance of CCDA for USCDI going forward?  Matt said they plan to go forward if funding is present
      • What about CDA documents like eCR, Cancer Registry, QRDA, etc? Can be continued/under CDA R2.0
  • What is the V2 Product Family doing to create mappings between V2 and FHIR

FUTURE BUSINESS

  • Update from CTO/HL7 regarding Vision Re-Imagining and "Maintenance" categorization for CDA - on November 4th
  • CDA Web IG Publishing PSS - review of draft PSS
  • Summarize Review of Mission and Charter (2020.09.21 Update Comments), and Decision Making Principles (2020.09.21 Update Commentswaiting until after Nov 4 call
    • Comments and questions have been escalated to SBG and CTO
  • CDA IG Quality Criteria – request summary of next steps - waiting until after Nov 4 call

    • Google Drive Live Link
      urlhttps://docs.google.com/presentation/d/1--yI0lEZVl7dEulhzHZ_4aGdrLE1wZSt_yI36n5fGVo/edit#s
  • CDA Quality Plan – brief update -waiting until after Nov 4 call
  • CDA Roadmap – brief update -waiting until after Nov 4 call

    • Google Drive Live Link
      urlhttps://docs.google.com/document/d/11d8Ntj-I3qKBYj12WpuMJkMs3-V2r-dx/edit
  • Discuss Value Set and Release Errata page(s) to CMG agenda 
  • CDA R2.1 errata coming soon???
  • No Meeting on Wednesday October 21 (due to C-CDA IAT)
  • Next Meeting:  Wednesday November 4,  1 - 2 pm ET

Adjourned: 

PROJECT REPORT OUTS: 


Scheduled Reviews:

DateProjectWhoResources for Review

Use of Structure Definition

Rick

Jean

Lisa


NEXT STEPS:

Working to transform C-CDA R2.1 into new Web IG Publishing (QA of some templates delivered so far)

OPEN ISSUES:


NOTES:




CDA

Product Line

Update Releases


Brett

Lisa

NEXT STEPS:


OPEN ISSUES:


NOTES:

Depends on new CDA IG Web Publishing capability



 CDA

Errata Releases

Brett

Lisa

NEXT STEPS:

Review the current Errata Release Checklist.

OPEN ISSUES:

Can official Errata Releases be prepared by SDWG in the mean time? - discuss at Sept WG meeting


NOTES:




CDA Quality Plan

Lisa

Brett

NEXT STEPS:

OPEN ISSUES:

NOTES:

Backed up behind ballot for Quality Criteria.  Plan is coming along. (and Roadmap updates)



CDA Announcements & NotificationsLisa

NEXT STEPS:

OPEN ISSUES:

NOTES:


CDA R2 C-CDA 2.1 Implementation-A-Thon

Lisa

Linda

Raychelle

NEXT STEPS:

  • Call for presenters for October 21, 2020 C-CDA IAT (closes September 15, 2020)

OPEN ISSUES:

  • Plan for 2020 needs to be solidified with Dave Hamill - Discuss at Sept WG meeting
  • Follow-up on Actions from July 2020 IAT


GroupingItemResponsible personStatus 
Life and Death in C-CDA

Add rubric for to check that a patient's name is not changed (using any scheme) to indicate a patient is deceased

John D'AmoreBrett will working with John through Examples Task Force.
Life and Death in C-CDA

Create gold-standard example of problem list containing pregnancy information

John D'Amore

Completed

http://hl7-c-cda-examples.herokuapp.com/examples/view/Problems/Pregnancy%20with%20Week%20Gestation

Payer Section in C-CDA DocumentsConvey support for the new identifier extensionLisa NelsonCompleted.
Extending CDA to add more useful identifiers

Update the Companion Guide to add guidance on using the new extension. 

Lisa NelsonLisa is working with a team to implement to CDA R2.0 Extension
Payer Section in C-CDA Documents

Determine where payer identifiers should go in the document and represent with gold-standard example

Linda MichaelsenLinda is working to create an example of using this new extension to represent the payer identifier. Linda would like to provide an example for review at the October 2020 IAT.
Extending CDA to add more useful identifiers

Determine real-world use cases and develop gold-standard examples - e.g. payer identifiers

Lisa Nelson

Jean Duteau

Should  Lisa do this in working with SDWG?

Implementation Considerations

When Generating C-CDA Encounter

Summary and Patient Summary Documents

Develop guidance for the Companion Guide around when summary documents are exchanged.

Joe LamyJoe is doing a topic on this at the October 2020 IAT
Implementing Clinical NotesWork with Regenstrief on LOINC Codes for Laboratory Reports and Pathology ReportsLisa

Regenstrief has issue several proposals to address the confusion around the Clinical Notes USCDI V1 data class.

Proposed comments related to USCDI on behalf of the LOINC Document Ontology Subcommittee.

https://loinc.org/files/meetings/document-ontology/20201005%20DRAFT%20USCDI%20Clinical%20Notes%20comments%20and%20new%20data%20element%20proposals.pdf?utm_source=Workgroups&utm_campaign=eb7d080c2f-EMAIL_CAMPAIGN_2020_10_05_08_06&utm_medium=email&utm_term=0_d6fe8d9574-eb7d080c2f-450653981

USCDI ONDEC Submission Form - Clinical Notes Data Elements

https://loinc.org/files/meetings/document-ontology/20201005%20DRAFT%20USCDI-ONDEC-Submission-Form-Prep-Sheet_ClinicalNotes%20data%20elements.pdf?utm_source=Workgroups&utm_campaign=eb7d080c2f-EMAIL_CAMPAIGN_2020_10_05_08_06&utm_medium=email&utm_term=0_d6fe8d9574-eb7d080c2f-450653981

USCDI ONDEC Submission Form - Imaging Data Element

https://loinc.org/files/meetings/document-ontology/20201005%20DRAFT%20USCDI-ONDEC-Submission-Form-Prep-Sheet_Imaging%20data%20element.pdf?utm_source=Workgroups&utm_campaign=eb7d080c2f-EMAIL_CAMPAIGN_2020_10_05_08_06&utm_medium=email&utm_term=0_d6fe8d9574-eb7d080c2f-450653981

Implementing Clinical Notes

Develop gold-standard examples for each supported USCDI note type (e.g. Consultation Note, Discharge Summary Note, etc.)

Emma JonesEmma can you drive this in Examples Task Force?
Implementing Clinical Notes

Seek clarification from the ONC to update Companion Guide to include more concise guidance on use of Clinical Notes


Emma JonesEmma - can you write up a request of specific questions that need to be addressed/answered?

Mapping Author Participation Information to 

FHIR US CDI Resources Derived from C-CDA Documents

Engage with SDWG and Patient Care to clarify how this work can move forward.

Perhaps initially focusing on smaller problems to solve

David Riddle

Follow-up was done with PC WG and this topic was discussed at the HL7 WG meeting in September 2020. This is a bigger issue than can be solved at this level.  

Alignment and mapping work between CDA and FHIR will need to handle this on a more global level.

NOTES:



CDA Base Standard

Lisa

Brett


NEXT STEPS:

  • Working with Calvin to draft an educational webinar that provides an overview of "what's new in CDA R2.1"
  • Will review progress at the 2020 Sept WG meeting

OPEN ISSUES:


NOTES:





CDA Maturity Model

Brett

Rick

Artifact created:

NEXT STEPS:

  • Implementing this after cutting over to use the FHIR IG publishing mechanisms.

OPEN ISSUES:

Agreed this should be utilized after going to Structured Definition.  SDWG would need to apply the Criteria. Could we get feedback at the IAT to apply the rating? Do we need a checklist to help the decision makers to assign the maturity model.

Would need to work with SDWG as the owner of C-CDA templates, to apply it to their templates.  

NOTES:



Jira Implementation

Andrew

Linda

Raychelle

NEXT STEPS:

OPEN ISSUES:

  • Revisit after February Meeting

NOTES:

Andrew is advancing this sending Wayne what he needs. HL7 supporting this conversion. This is a go via orders from Wayne.




PSS & Product RegistryLisa

NEXT STEPS:

  • Working on a list and process to gather accurate information - real-time recording

OPEN ISSUES:


NOTES:



Cross Workgroup Templates Pilot

Lisa

Giorgio

Linda

NEXT STEPS:

  • Lisa is comparing IPS to C-CDA for Problem Concern and Allergy Concern - update provided
    • Some progress comparing to IPS - reported to PC WG, any possibility for harmonized templates
  • Linda is working with FM: Progress stalled due to FM's need to focus on FHIR IGs under ballot
  • Medication Templates. - No action due to no resourcing

OPEN ISSUES:

NOTES




Value Set Process and UTG support

Lisa

Brett

NEXT STEPS:


OPEN ISSUES:


NOTES:

Sean has reported additional missing CDA R2.0 Value Sets.



CDA to FHIR mappingNew focus 

NEXT STEPS:


OPEN ISSUES:


NOTES:


ADDITIONAL TOPICS 

  • KEY GOALS BEFORE September WG
    • JIRA Migration Plan communication of roll-out
    • Quality Plan Creation and Communication of Roll-Out
    • Roadmap update
  • CMG Membership and interest in participation - update CMG objectives and Home Page content
  • Annual items:
    • Term voting, Co-chair confirmations  - July
    • Current member term renewal pattern
      • Even Years: Brett, Jean, Raychelle, Yan, Emma, Giorgio 
      • Odd Years: Lisa, Linda, Rick, 

Meeting Outcomes

Summary of Votes/Key Decisions

Next Meeting/Preliminary Agenda Items

Action items






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