Skip to end of metadata
Go to start of metadata

Web Meeting Info:

Join Zoom Meeting - | Meeting ID: 718 380 6281  P: 370553 

+1 646 558 8656 US (New York) | Find your local number:





  • Confirm R4B changes
  • R5 ticket approach - prioritize 
  • Address Zoom bombing

Discussion items



THO 2.1.0 release published 

Feel confident next release will be easier. 

Main WG call & UTG series ending


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

UTG call series ends tomorrow. Ted will check into this and re-establish.

There is a rule documented nowhere,

that this is an invalid CodeSystem url, because THO is using the FHIR IG publication process, and that process doesn't allow a url such as this.  would be accepted by all the publication software 

CARIN IG was published successfully with multiple instances of CodeSystem urls in a format like this. Ted reports that LM and GG claim this is not allowed. RH surmises that at the time of CARIN publication, this was allowed, and times have changed and it is not longer allowed. 

Were warnings suppressed? 

The CARIN IG (and any other IG that did this) has to change their urls as something like this is invalid:

CodeSystems from UP-130 have been added to THO, all with

This is technically an external code system, but the url is 

There is no documentation to prevent this url pattern from being used in a CodeSystem url. 

Next steps:  

This might be limited to NCPDP code systems added from UP-130.

  1. Discuss with FHIR-I (address the lack of documentation issue)   (what follows CodeSystem/ in the url must match what is in the resource in the id element unless there is a special parameter in the IG)
    1. Ask FHIR-I to confirm the policy that for everything rooted in THO or in that the string after CodeSystem/ must be the same value as the id for the resource
      1. Confirm that the warnings should not be suppressed with the special parameter when publishing for ballot
      2. If both = Yes, then the tooling should faithfully enforce this with the appropriate warnings/errors - Prevent this in the future
      3. Rob H volunteers to bring this forward to FHIR-I
    2. Inventory and comment where appropriate
  2. Leave the urls as is, or change (the CARIN IG has been published - STU1)
    1. Someone has to contact Mary Kay that the NCPDP urls will need to be changed in STU2 

There is a value set v2-0895, that declares a CodeSystem version. 

The CodeSystem content for  doesn't seem to be in THO.  Only the most recent version of a CodeSystem is in the build.

The ValueSet CLD references the previous version of the CodeSystem. To make thinks interesting, the CodeSystem name also changed. A ValueSet that used the previous version of the CodeSystem wasn't updated. PresentOnAdmission

The name also somehow references NCPDP which is not correct. 

RM: somehow through NamingSystem document this convoluted scenario. 

Someone has to enter a ticket into UTG. 

Policy Page

Did not get to this.

Vocabulary Work Group Policy Statements

Requires updates

Review and define plan

R4B ticket status

Discussed - please QA



R4B Tickets Must be applied and QA'ed by March 3.  Vocab goal is Feb 22.

Ticket QA?  Please take a quick look and make sure everything was applied correctly. 

29945  (Naming System maturity level),

29960 (Concept Map Dragon) and  *******Note: it was voted during the main WG call to reopen, update to remove inclusion of Structure Map . Rob H. to create new ticket to include Structure Map in R5.

29113 (Naming System ownership)

 FSH for NamingSystem & CodeSystem

Did not discuss

Carmela     NamingSystem template     CodeSystem template


did not discuss

From LM email 

R5 draft deadline is in 29 days. Vocab needs to think about how to prioritize the work to be done. 

Must be clean and ready for QA by March 30.

ConceptMap is priority #1. 

This will be the main topic on the next FHIR Tracker call.     Consolidated information from Michael Lawley   Vocab dashboard (CC confirmed tickets in Michael's document are on dashboard)

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

did not discuss 

Steps to resolve issue?

CC triaged the tickets. During main WG call, Ted agreed to add these to the UTG agenda for review. Hopefully soon as a policy will need to be crafted. Note there is an OID policy for SNOMED extensions here:  Vocabulary WG Policy on OIDs for SNOMED CT Extensions  

  1. Remove FHIR pages that reference CodeSystems and ValueSets that are in THO, direct to THO
  2. More?


did not discuss

What pages should be removed or changed now that THO is live? 

Using Codes / Selecting a Code System Identifier Text Review

did not discuss

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. 

3/1/2021 update: The identifier meeting attendees clarified the target audience for the materials we are creating. 

Decided to focus first on getting the diagram up to date - which is for an IG author audience.  

  1. implementers
    1. implementers should just use what is in the spec
    2. Rob H. contends that the FHIR spec should only have information for implementers
    3. If thats the case, then any information about how to obtain a code system URL might not belong in the spec
  2. IG authors
    1. responsible for making sure the spec has the right code system and value set identifiers

Note: the Monday 6 pm ET discussions have been specific to the URL - for use in FHIR. There are other identifiers for the other HL7 product families. This should be managed through UTG. Not only identifiers, but different metadata across the product families. Example? 

Once the HTA material is in HTA, the problem will be less.  TOOLING REQUIREMENTS - create OIDs for every FHIR terminology 

Code System Identifier Deprecation 

Did not discuss on 3/8

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 3/8

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 discuss on 3/8

Supporting C-CDA FHIR IG

Did not discuss on 3/8

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

Action items

  •  Robert HausamConfirm with FHIR-I that a CodeSystem url rooted in either or has limitations beyond the last slash - e.g. no other slashes and no special characters. Confirm that this is documented somewhere, and if not, request that it be documented. Confirm that this is enforced in tooling, and if not, request a tooling update to enforce the rule.