2022-10-25 PIE WG Meeting Agenda/Minutes

Antitrust Statement

Professional Associations, such as HL7, which bring together competing entities are subject to strict 
scrutiny under applicable antitrust laws. HL7 recognizes that the antitrust laws were enacted to promote 
fairness in competition and, as such, supports laws against monopoly and restraints of trade and their 
enforcement. Each individual participating in HL7 meetings and conferences, regardless of venue, is 
responsible for knowing the contents of and adhering to the HL7 Antitrust Policy as stated in §05.01 of 
the Governance and Operations Manual (GOM).

New Proposals and PSS for review - PIE comments or interest

No new proposals or PSSs.  The PIE workgroup had previously commented on PSS-2122 that we wanted more information, so Brian Alper was on the call to explain the FHIR Representation of Eligibility Criteria for Clinical Trials PSS.   CQL and BRR workgroups. An eligibility profile with EvidenceVariable overlap with what payers currently do to identify clinical trial eligibility.  The PIE workgroup commented that we want updates as an interested party.  Peter asked if an auth was needed.  Brian stated that the PSS does not address workflow.

Jan 2023 Connectathon in Henderson NV Jan 14-15

Jan 2023 WGM in Henderson NV  - meeting dates and quarters (Jan 16-20)

PIE WGM Jan 2023 Draft Agenda

Add Da Vinci Community Roundtable Wednesday Oct 26 at 4:00.  See registration link below.

https://us02st1.zoom.us/web_client/8csbj6s/html/externalLinkPage.html?ref=https://register.gotowebinar.com/register/5638257570590461195

US Realm - Recently published updates to HL7 standards link

http://standups.hl7.org/

Mission and Charter Update

GOM US Realm Steering Committee - Remove US Realm Task Force sentence from the GOM, Austin bring to TSC

HL7 Governance and Operations Manual (GOM)

HL7 Essential Requirements (ER)

RC2209 Peer Review of Proposed Revisions

The following proposed revisions are attached for your review.  Please make your comment and, if any, suggested changes as specific as possible.

GCR 223 §10.09 Clarify who is responsible for tooling [GOM]

GCR 373 Revise criteria for TSC Implementer Representative [GOM]

GCR 375 TSC representation may be either Chair or Vice Chair [GOM]

GCR 377 Add hiatus before rejoining TSC [GOM]

GCR 380 Add accountability to process for WG review of standard lifetime [GOM/ER]

GCR 386 Define “Associate” as applied to SOU [GOM]

Reviewed all proposed revisions and had comments on GCR 377 and GCR386:

GCR 377

PIE Comment:  Correct reelection to “re-election”

GOC response: It should be noted that there are seven other occurrences of “reelection” in the GOM.  Research indicates that either form is acceptable.  No further action required.

GCR 386

PIE Question:  Who will this be sent to? Should the responsible Work Group decide to retire a published STU that is currently accepting feedback it shall conduct a 30-day Comment-only ballot soliciting feedback on the decision to retire the STU at least two ballot cycles prior to the anniversary date. 

GOC response: The Comment-only ballot will follow normal ballot process which includes Notice of Intent to Ballot (NIB) which is released to the general membership.  No further action required.

HL7 Email from 10/19 -

Good afternoon! It is Ticia Gerber. This is a request for your structured HL7-related responses on the CMS Request for Information (RFI) seeking public input on the concept of CMS creating a directory with information on health care providers and services or a “National Directory of Healthcare Providers and Services” (NDH).  

The Federal Register listing can be found at: 

https://www.federalregister.gov/documents/2022/10/07/2022-21904/request-for-information-national-directory-of-healthcare-providers-and-services 

Your responses on the CMS RFI are due to me at tgerber@hl7.org by November 18. Timely submission aids the response development and ensuring a full representation of the HL7’s community perspectives.  Attached here is a response template to make responding easier and streamlined. Some questions viewed as high priority for an HL7 response are highlighted in green, though please select the questions your Work Groups and Accelerators believe are important. 

Regarding an RFI overview: 

The agency is seeking comment on how a CMS-led directory could reduce directory maintenance burden on providers and payers by creating a single, centralized system, promoting real-time accuracy for patients. Using modern interoperable technology would allow payers to update their own directories seamlessly from a single directory through an Application Programming Interface (API). It could also make data available in a format that would ease health data exchange between providers and improve public health reporting, a need highlighted by the COVID-19 pandemic. Finally, a CMS-led directory could directly support network interoperability through the Trusted Exchange Framework and Common Agreement (TEFCA). 

Importantly, the RFI also notes: 

• To align with national standards for interoperability, an NDH could be built on the standards established by the Office of the National Coordinator for Health Information Technology (ONC) at 45 CFR part 170, subpart B. Specifically, an NDH could use HL7® Fast Healthcare Interoperability Resources (FHIR®) APIs, the latest standard for which is codified at 45 CFR 170.215(a)(1), to enable data exchange.   

• Using a FHIR API, stakeholders could access and use NDH data to support a variety of use cases. Industry would be able to transform the data for purposes beyond what a public-facing CMS portal would be able to provide, and present it in a customized format for consumers, commercial, or operational use. A patient or consumer could use an NDH directly, or through an app of their choosing that connects to an NDH via a FHIR API, to locate a provider. 
• The Validated Healthcare Directory or VHDir FHIR IG is highlighted as describing the technical design considerations for collecting, validating, verifying, and exchanging data from a central source of provider data using FHIR standards and as central to defining the underlying architecture for a proposed national directory of validated healthcare data and to provide technical specifications for the exchange of such information. Also cited are the National Directory Endpoint Query IG, the National Directory Exchange IG, and the National Directory Attestation and Validation IG in relation to developing and maintaining new FHIR IGs to further describe data attestation and verification processes.  

Lastly, CMS states in the RFI that, “given these existing efforts to establish FHIR-based standards for healthcare directory information exchange, CMS could leverage this work to serve as the technical foundation on which to develop a FHIR API-enabled NDH. Additionally, using FHIR standards would help align an NDH with the technical standards at 45 CFR 170.215 finalized by ONC in the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program final rule (85 FR 25642).” 

There is obviously a lot of critical HL7-related content and query in this RFI. We thank you in advance for your effort and input to comment on it at this busy time! We look forward to your comment submissions before or on November 18. 

HL7 email 10/19: 

Co-chairs,

The TSC has received a request for the merger of the Modeling and Methodology work group with the FHIR-I work group. As part of this work group merger process, the Modeling and Methodology work group is being dissolved. Per the HL7 Governance and Operations Manual, a vote of all work groups must be held to move forward with the dissolution of a work group. We have established a Confluence page where you can document your work groups decision (agree or disagree) on this matter. This page includes information on how to cast your work groups vote along with a copy of the dissolution request form.

https://confluence.hl7.org/pages/viewpage.action?pageId=139668469

This vote will remain open until the end of day, Sunday November 6th unless the vote has not achieved quorum (60% of all work groups voting) at that point, in which case the vote will be extend until it reaches quorum.

Regards, Austin Kreisler

TSC Chair

• FM supports the comments of O&O below. FM is not opposed to making FHIR-I the FHIR methodology group with limited additional domain content responsibility. The co-chairs of FHIR-I should not include members with concurrent HL7 management or governance responsibilities. FM does not support the transfer of the remaining MnM responsibilities to TSC as this would violate the separation of concerns regarding management, methodology and governance and is not populated with the skill sets to support this work. Suggest dispersing the work amongst other committees such as INM, ITS, SOA etc. For example, to combine within existing committees the abstract and concrete specification activity.
• Motion to support the above comments. Disagree with the merger. Jeff Brown/Chris Cioffi. 12-0-0

This will rollover to next week for the PIE workgroup to take a vote.

• Monthly Reminders to Co-Chairs:
  • Standards approaching expiration: 
    • https://confluence.hl7.org/display/HL7/ANSI+Standards+approaching+expiration
  • STUs Expiring in the Next 6 Months
    • https://confluence.hl7.org/display/HL7/STUs+Expiring+in+Next+6+Months
• Upcoming PSS and NIB Deadline Dates for Future Ballot Cycles
  • All deadline dates can be seen on the new Balloting, Content Submission, Voting, and Working Group Meeting Schedules on Confluence at:
  • https://confluence.hl7.org/display/HL7/HL7+Calendars

CDex PIE Jira tickets review Weds CDex call

CDex mapping continued