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  • R4B and R5

Discussion items


Co-chair webinar schedule


Co-chair webinars collide with main WG call once a month. Do we want to try and change the day/time. Ted asked Sadhana about this schedule. She has not yet answered. 

Possibly swap with co-chair or UTG call. 

Rob M. suggests that we have a main Vocab call every week. Not everyone agrees. 

We decided when the co-chair webinar collides, will change the call to start the main WG call 30 minutes earlier, and schedule a 1 hour meeting (rather than the usual 2 hours). RM suggests that the main WG call continue when necessary, people can decide whether it is necessary to join the co-chair call.  RH suggested listening to the recording of the co-chair call.  Ted will add on-time, 30 minute calls to the schedule when this occurs. 

R4B ticket status


Rob H

R4B Tickets (as discussed on the 2/11/2021 FHIR tracker call. Must be applied and QA'ed by March 3.  Vocab goal is Feb 22.

R4B Criteria:

Note here:  it mentions that datatypes can be added to R4B 

29945  (Naming System maturity level),

29960 (Concept Map Dragon) and 

29113 (Naming System ownership)

Rob H talked with Marc D today, Marc will be making the changes and applying them to the R4B branch. Rob M will communicate to Marc that yes, we would like the 3 tickets listed above to be applied to the build by EOD. Marc will let Rob M. know when they are done, and Rob M. will let the other co-chairs know. 

VSD and GH JIRA processRob M.Every specification that is balloted on, and may be commented on, should now be in JIRA. Marc is working on the process to surface VSD and Gender Harmony to the JIRA project.  We need to remember that if there is a new specification, we need to go through this process. 

Process to request formal THO releaseTed 

The TSC approved publishing the next release of THO. Deadlines for anything going through the UTG process and in the CI build - snapshot will be taken Wednesday am (EST). (THO 2.1.0 for R4B) Feb 24.  Who is notifying the community? No notifications of publication requests. The new governance group will create a process. 

There is a listserv for all the co-chairs. A message could be sent there. Rob M will send info to Ted so he can send out an email to all co-chairs. 

R5 From LM email 
  • Priority criteria for a draft ballot in May 2021
    • have existing normative content they expect to update in R5
    • STU content moving to normative in R5
    • STU or net new content where they are seeking review to answer targeted questions to allow finalization of design in advance of the R5 ballots
  • Criteria for R5 have not been communicated (in terms of differences from any release)

FMG requesting exactly what content fits one of these criteria. Must be clean and ready for QA by March 30

Vocab has a lot of tickets to consider. Need to determine how tickets are prioritized.

How to prioritize 

  1. ones that look easy
  2. ones that are more involved (e.g. extensible)
  3. ones that are somewhere in-between

Please make sure you update tickets when you have a comment, or an idea about how to approach a ticket. Link to background information, or link to a Zulip chat. The ticket should be the main place to go to find info. 

DesignationUse code system/value set.  Not critical for R4B, but must be in R5 draft.  UP-107 must be applied for R5 draft. Rob H and Ted will work off-line to resolve this issue. 

OID related tickets 

project = fhir and "Work Group" = "Vocabulary [vocab]" and grouping = OIDs   

Must the OIDs be created via the OID registry, is there a technical requirement that the OIDs for a value set be in the OID registry.

TK: there is no V3 requirement that there is an OID in the OID registry for a value set. There is no OID registry API. 

RM: Is the OID registry the source of truth for all HL7 terminology - we can state that the OID registry is not the source of truth for OIDs for all HL7 terminology.

TK: at one time the OID registry was declared to be the source of truth (history - back to when V3 didn't participate in harmonization.....) 

RM: The OID registry as it exists does not contain every important OID, we shouldn't add OIDs to the registry simply because we have them. Personal opinion - we should create/generate OIDs for every terminology artifact. They don't have to be in the OID registry. The source of truth should be in THO (if appropriate) or in TOOLING UPDATE REQUIRED (possibly when the CodeSystem and/or ValueSet is created in UTG) (generate the OID, make it visible) HSCR project.  Category label = UTG  Vocab needs to define a policy 

RM: suggests adding this text to the tickets: Thank you for identifying these issues. Not all OIDs are in the OID registry. Vocab has identified that there is a deficiency in communication about OID assignments. It has been added to the list of items Vocab must address.  Please continue to bring these to our attention.  (Carmela will do this and prepare a block vote)  Some do not have OIDs, some do. 

TK: does this impact revenue? This is a complex issue that requires a systems level solution. 

Older policy: External CodeSystem OIDs must be registered in the OID registry - and there is a cost to this. Does HTA enforce this? This is not a policy that is enforced, known, etc. Its not clear that there was a formal policy, and if there is, this must change. 

Type 6 OID - are for external code systems if an external code system doesn't have their own OID. The owner can still be listed as the external organization.  

Bulk loading of OIDs would be helpful. 

Using Codes / Selecting a Code System Identifier Text Review

Co-chair review of this text:

Updated text for Using Codes / Selecting a Code System Identifier

Confirm so ticket can be applied. 

Decided to talk about this at the 6 pm meeting. 

Code System Identifier Deprecation 

Discussion from 2/08

  1. Code System Identifier Deprecation  
    1. See notes here: 2021-01-18 Vocab Chair Agenda/Minutes
    2. See notes here where the group was reaching consensus:  Jan 2021 - HL7 WGM - Thursday Q3 Minutes
    3. FHIR-30319 - Getting issue details... STATUS  voted to move out of R4B to R5, define a policy related to deprecated 
    4. FHIR-31028 - Getting issue details... STATUS   create a new concept in Publication Status value set = Deprecated  
      2. Add a new concept to the CodeSystem, change the existing definition to be the existing enumerated list. Make a new ValueSet that is enumerated list + deprecated 
  2. Deprecation applies to
    1. CodeSystem Identifier
    2. CodeSystem resource
    3. ValueSet identifier
    4. ValueSet resource
    5. Concept Map resource
    6. Status:
      1. V3 and V2 ValueSets support deprecation in the work flow, FHIR does not as a status
      2. V3 and V2 ValueSets do not support Draft, whereas FHIR does 
        1.  Candidate for unification/harmonization
    7. FHIR inconsistently defines workflow status (e.g. review, approve) - sometimes in the Resource, other times depending on Provenance

Action item from 2/1: compare/merge material from WGM Policy for terminology in FHIR IGs and the Vocab material during the Task Force call today.  Done. 

2/15/2021 Update: Vocab needs to define a deprecated identifier policy - the addition of a new publication status code is great, but doesn't solve everything. There is an immediate need to document how to work with the R4 definition before we get to R5. Based on last discussions, implementations can't distinguish between inactive and deprecated by looking at the effective period. TK will update the ticket with his thoughts on this issue. Unfortunately we are time limited. This was pushed to R5.  

FHIR-30319 - Getting issue details... STATUS

Discussion 2/22/2021:

Governance: (still need a policy)

Deprecated status takes precedence over the validity period.

How to detect deprecated identifiers 

  1. Deprecated = true
  2. Validity period end = past date

Chance for mis-interpretation? Adding deprecated to the status value set does not help the NamingSystem identifier deprecated issue. 

Ran out of time. 

External code systems - Canada

Extensible definition

Did not discuss on this call.

Rob M.

Discussion from 2/15:

Rob H: get the proposed text integrated into the FHIR specification (in the CI build), and review in context. 

We reviewed FHIR-29968  and did not get to the point where we have a text block to propose for the R5 build.

Rob M:

  • Example value set expansion: Red, Blue, Green, Yellow
    • Someone wants to communicate Magenta. Is this a type of Red, or is it something different? In SNOMED, magenta would be a sub-type of red.
    • Extensible is intended to be guidance for implementers for what to support.
      • It is allowed to send a code that is in a more recent expansion/version of the bound value set.
      • See #4 in the comment of the JIRA.  This is problematic. 
      • It is acceptable to have a new value set version or a new value set that is claiming conformance to the original extensibly bound value, where an expansion has a concept that is a descendant of the original extensibly bound value set expansion
        • Want to explicitly add magenta to the expansion - either a new version of the original value set or a new value set and claim conformance. 
        • #4 as written doesn't allow this.
    • An implementer might decide to add magenta to their value set because their use case needs it. Conceptually, there is a new IG that has a new ValueSet.  
      • This is really obvious when a different CodeSystem is in play
  • Ted: Extensible could be viewed as ideally you would make the value set required, but you know there are use cases that you can't possibly know about, and want to allow implementers to send something not in the value set when necessary. 

.   FHIR-29968 - Getting issue details... STATUS

Policy on the use of extensible value set bindings

This was discussed at length during Q5 Tuesday during the WGM. Jan 2021 - HL7 WGM - Tuesday Q5 Minutes

See discussion notes from previous co-chair call: 2021-01-18 Vocab Chair Agenda/Minutes

Should we also review the definition of preferred binding strength? 

How to distinguish between extensible and preferred?

CPT4 Syntax

Did not get to this topic

Supporting C-CDA FHIR IG

Did not get to this topic

From WGM. How does C-CDA address terminology quality now that Term Info cannot be referenced?  

Action items

  •  Carmela A. CoudercPrepare block vote for OID registry issues entered by John Snyder
  •  Carmela A. CoudercEnter HSRC ticket for tooling request to create OIDs for CodeSystems and ValueSets