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Subcommittee Lead: Jessica Bota 

Supporting TSMG Co-Chair: Reuben Daniels 


Tuesday 8:00-9:00PM UTC

Tuesday 4:00-5:00PM USA EDT

Wednesday 6:00-7:00AM AEST

Wednesday 9:00-10:00AM NZDT 

See for meeting details.


Attendee type:

M - TSMG Member

O -Observer / Guest


P - present

A - Apologies

X - (Apologies with Proxy)



M (Co-Chair)


Reuben DanielsSaludax


Jess Bota

Apelon, Inc.

Lisa Nelson


Michael Faughn

National Institute of Standards and Technology (NIST)
Davera GabrielJohns Hopkins University Institute for Clinical and Translational Research

Dan Vreeman

HL7 International

Ted Klein

Klein Consulting

Marc Duteau 

HL7 International

Joan Harper

Canada Health Infoway

John Snyder

National Library of Medicine

Rob Hausam


Alex Kontur

OPRavi KafleWashington State Department of Health
Abdullah RafiqiICF

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Minutes Approved as Presented 


This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."

Agenda Topics

Meeting was recorded

Agenda Outline

Time Allocation


Agenda Item
  • Rollcall & Proxies
  • Note that meetings are recorded
  • Approval of meeting minutes
  • Agenda check
  • Need to document requirements for a web-based terminology editor tool
  • Continuing to work with Lawrence Gerstley on Jira automation for submitters
    • Working on adding ability to perform automatic validation using the IG Publisher upon submission of proposed changes
  • Ted adding release labels to previously implemented UTG tickets
New Business30 
  • Follow up on Terminology Expectations presented on Co-Chair Webinar on 4/7
    • This is related to the section on "Workflow process for use of internal code system identifiers in FHIR and beyond" below
    • For CodeSystems:
      • Use external codes (LOINC, SNOMED, THO, etc.) whenever they fit the use-case
        • Clarify what Lloyd means by THO for external codes
      • If you believe that the concept is IG-specific and that no other IG and no other technology will ever need the code, you can apply to the TSMG for permission to keep the CodeSystem as IG-specific forever.  If they grant that permission, then you can keep the CodeSystem within the IG with a URL of your choice
        • Need a documented process for IG developers to follow
      • If nothing appropriate exists and you must create your own and TSMG doesn't approve it as IG-specific, initially define them within your IG with a CodeSystem.url that includes "temporary" as part of the URL string - to make clear that it will likely change.  This gives you carte blanche to make breaking changes as you see fit.  You can drop codes, add codes, redefine codes, change hierarchy, etc. and don't have to abide by "good terminology practices".
        • Unsure why temporary MUST be in the name
      • Once you have more implementation experience and you're confident in the definition and hierarchy of the code, then propose a change to LOINC, SNOMED, THO or wherever is appropriate.  This step must happen before any referencing artifacts can progress to FMM3+
        • IPS breaks this rule
    • For ValueSets:
      • In most cases, valuesets can (and should) be IG-specific.  The only exceptions are:
        • There is a high probability of the value set being used elsewhere
        • The definition of the value set is either immutable (e.g. "all codes from code system X"), or is clearly defineable such that decisions about changes can be made by an independent body and everyone impacted by those changes will be comfortable with those changes
          • There are DaVinci IGs where several will use the same value set, but no one outside of DaVinci will likely use it
        • Even then, putting value sets into THO should generally only happen once the definition has matured (FMM3+) so that there's no concern about making breaking changes.
        • Should clarify when to put in VSAC or THO or if that is up to implementer
        • Need OIDs for CDA so MUST have an OID generated for any content to be added to THO
        • Would be important to see content related to specific IGs (filter or search)
          • CCDA web publishing is asking for a similar functionality (filtering of manifests)
  • Determine what to set Release Label to with Withdrawn UTG tickets
    • Group agrees to leave as "None"
  • Tickets in Consensus Review
Subcommittee Work in Progress15JB
  • THO cleanup
    • These tickets have approval from TSMG to proceed in UTG
      • Fix the "All HL7 Code Systems" tab to exclude external content
      • Add tabs for deprecated content (based on deprecation task force)
      • Add default value of 'true' for all code systems without a <caseSensitive> element (mainly external code systems) unless otherwise specified to resolve warnings in THO
    • Need to start discussions (with FMG?) about having ability to render extensions in THO
  • Task force recommendation review and implementation (voting, quorums, WG health, etc.): UTG Task Force Recommendations to TSC 
    • Tracked by HSCR-155 - Getting issue details... STATUS and its subtasks
    • Continuing to fill OSG voter slots
      • FMG: John Moerke
        • Bryn asked to follow up 
      • CMG: Lisa Nelson, Alexander Henket
        • Lisa following up 
      • V2: Michael Faughn, Frank Oemig, Rob Snelick
    • Will continue to follow-up on filling Realm-based and Vocab OSGs
  • THO release schedule
    • Need input from TSC/HQ and they have requested some information from TSMG on documentation and level of effort 
      • Info sent to Rob and Bryn who will follow up with TSC
  • Vocab suggests that TSMG require all code systems to have a Steward
    • UTG submitters would need to get WG approval from the Steward to propose changes to the code system
    • Discussed on main TSMG call but no one wanted to make a motion to make this a policy
    • Steward definition
      • The WG responsible for the maintenance and upkeep of the code system (not to be confused with Publisher who makes the content available)
        • This implies that the WG has the domain expertise/knowledge related to the code system
      • The primary point of contact for questions or issues with the code system
    • FYI: Vocab added an extension for steward, there is a proposal to update the definition of publisher (which was intended to represent steward) and remove the extension
    • Might be a good idea to get a count of how many code systems in THO do not have a steward value
    • Michael Faughn performed analysis on the number of code systems without a Steward value
      • Out of 797 code systems, 236 do not have a Steward value
      • Code systems broken out by product family:
        • 38 V2, 147 V3, 47 FHIR, 3 unified
      • Current TSMG solution is to make corresponding Management Group responsible (by either having them assign the WG responsible or by assigning them to the MG itself)
        • In the FHIR space, it could be the resource owner
        • V2 - make the V2 management group responsible
        • V3 - will be a multi-management group exercise.  CMG will take a look at the V3 sets first.  FMG will take a look at the list next to determine which is the appropriate responsible party. 
          • Austin is reviewed the list and found 3 code systems appropriate to assign to Structured Docs
          • Should consider having other WGs look over the list (MnM, OO)
      • Vocab WG to run a query for each code system across FHIR core to identify the resources and their responsible WG(s) for each listed code system.
        1. Rob Hausam will check with Lloyd and whether and how we can do this.
        2. Will bring this back for the Vocab call in 2 weeks.
   Adjournment0 JBCall adjourned at 5:00PM EDT. Next call in one week at 4:00PM EDT May 5, 2022.

Supporting Documents

Outline Reference

Supporting Document

Minute Approval2022-04-19 UTG/THO Subcommittee Agenda and Minutes

Action items