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  • Review policy page

Discussion items



Ballot open. 

What to review

  1. 3 Vocab tickets
  2. Add a page to list what people are going to review for ballot? 

VSD-P progress
Carmela, Marc, Jess and Carol completed their QA based on rows in the Resource Grid. All changes were reviewed on March 9. Marc will be making the changes. 

Monday Code System Identifier & UTG series ending


Code System Identifier Monday 6 PM EDT series ending today. CC to continue the series.  Will start from workflow diagram, and use that to develop the following materials. 

  1. Best practices
  2. QA checklist
  3. Tooling opportunities
  4. Policy
  5. Edge case list

NCPDP Code System Issue 

Check on action item below: Any other steps to take?  DONE/Resolved. IG authors agreed to change the url.


Did anyone enter a ticket into UTG for the issue with value set v2-0895? Not in THO, Present on Admission. Minutes from last week below:

No ticket has been entered. This is for Rob M. who will follow through. 

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

RM: somehow through NamingSystem document this convoluted scenario. 

Policy Page

Vocabulary Work Group Policy Statements

We reviewed and confirmed existing policies.

Review and define plan

  1. Approved: CWE/CNE item in the Approved Policy section might be something that is pre-Confluence, or not needed anymore. V2 and V3 use the same abbreviation but they have slightly different meanings. 
    1. Action item: Rob H and Ted will discuss - important for V2 to FHIR project
  2. CodeSystem Identifiers
    1. Reorganized this section and moved some line items to be sub-bullets
    2. Proposed Vocabulary WG Policy on Creation of Canonical URLs for UTG Code Systems  
      1. Name of page is misleading, 
      2. Action item: Should be added to an HTA agenda. Ted Kleinwill summarize and recommend a triage path
      3. CodeSystem stubs, etc. 
      4. Provides advisory background information 
      5. This will most likely be folded into the Policy on Maintenance of Code System Identifiers (URIs) and some content may  migrate to HTA
  3. Created a "Lower Priority" section
    1. Vocabulary WG Policy on content changes to old HL7 systems  

New JIRA project 

(did not get to this topic)

Rob M.Clarify how to set up the JIRA project for existing standards

 FSH for NamingSystem & CodeSystem

Carmela     NamingSystem template     CodeSystem template


There is no documentation to help someone attach to a UTG ticket to establish a NamingSystem. How can we help people do this quickly. To move forward, we cannot wait for a perfect tool.  We quickly looked at ontoserver UI to create CodeSystems.

R5 Priorities

Did not discuss

From LM email 

R5 draft deadline is in 16 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. The FHIR tracker call on 3/11/2021 focused on ConceptMap as will the one on 3/25.     Consolidated information from Michael Lawley   Vocab dashboard (CC confirmed tickets in Michael's document are on dashboard)

  1. ConceptMap
  2. NamingSystem
  3. CodeSystem
  4. ValueSet (addressed via VSD-P project, and incorporating 3 CPG profiles)
  5. Changes to FHIR spec to address THO  
    1. Remove FHIR pages that reference CodeSystems and ValueSets that are in THO, direct to THO
  6. Difficult topics
    1. Extensible
    2. Policy clarification

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 3/15

Discussion from 2/08.  3/15 note: this is now a "to do" item on the policy page

  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: Note from 3/15 - this is now on the policy page as a "to do" 

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 3/15

This is encapsulated in one of the policy statements yet to be defined - in the lower priority section.

Vocabulary Work Group Policy Statements

Supporting C-CDA FHIR IG

Did not discuss on 3/15

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

Action items