Subcommittee Lead: Jessica Bota 

Supporting TSMG Co-Chair: Reuben Daniels 


Wednesday 8:00-9:00PM UTC

Wednesday 4:00-5:00PM USA EDT

Thursday 7:00-8:00AM AEST

Thursday 10:00-11:00AM 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
OPGrahame GrieveHealth Intersections

Joan Harper

Canada Health Infoway

John Snyder

National Library of Medicine

Rob Hausam


Alex Kontur

Ravi KafleWashington State Department of Health
Abdullah RafiqiICF
Hope GrayUAB - Birmingham, HL7 Intern
Martha JonesGeorge Mason, HL7 Intern

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).

Agenda Topics

Meeting was recorded

Agenda Outline

Time allocationLead

Agenda Item

Welcome and scene setting5JB
  • Note that meetings are recorded
  • Welcome to TSMG members and observers
  • Rollcall
  • Today's objectives:
    • Continue to go through each element type where differences exist across duplicate resources
  • Goal is to get a list of resources we consider duplicates or easily categorizable fixes (only have non-consequential differences) and then a list of duplicate resources that need to be consolidated/resolved
  • From our last discussion
    1. Resolve code systems and value sets anchored in THO but only in the FHIR spec (Grahame)
      1. Noting that this includes Gender Harmony value sets
    2. Resolve code systems and value sets anchored in THO but exist in THO and FHIR core (Grahame)
      1. Modify build to warn the committees that own them via the build itself 
      2. Will list CS and VS that need reconciliation by WG here:
    3. Resolve code systems and value sets with differing anchors, but believed to be very close to the same content (THO/UTG Subcommittee)
      1. Michael will rerun his analysis based on the FHIR CI build NPM ci build NPM package:
      2. Resolution will be based on CLD vs metadata changes for value sets, and content changes for code systems
      3. THO subcommittee will look into these differences further
Handling THO anchored content in the FHIR spec
  • Handling THO anchored content in the FHIR spec FHIR-37440 - Many CodeSystems use urls when they should be TRIAGED  
    • Michael has completed an initial review 
      • Assumption is that resources will share <id> (we know this isn't a rule but we need something to link the resources)
      • There are 42 code systems anchored in THO that are only in the FHIR core specification
        • Need to do same analysis for value sets
        • Assume they need to be moved but would like to finish analysis
      • There are 72 code systems and 190 value sets that are potential duplicates across THO/FHIR
        • Continue to discuss how to address changes across the following code system elements:
          • meta.lastUpdated (all) - not consequential
          • date (all) - not consequential
          • url - once moved, should all be anchored in tho
          • experimental (19) - we assume that all code systems may have been set to false upon moving to THO but this requires verification (V2 and V3 initially set to false, but some FHIR content set to true initially), consequential
          • title (23) - need to improve titles, they should have spaces, consequential 
          • valueSet (70) - value set should be in the same place as the code system (for all codes value sets), this will get cleaned up with Grahame's cleanup and he will bring it back to us if something else needs to be done, non consequential
            • If value set is more specific (enumerate or have cld)
            • However, we are looking at CodeSystem.valueSet so this does not apply
          • meta.profile (62) - not consequential
          • description (22) - need to be reviewed, consequential
          • publisher (18) - not consequential
          • name (8) - consequential, involve WGs if needed
          • contact (18) - there were somethings done algorithmically, things in THO had a default value of Health Level 7, this should be made consistent as a bigger effort so non consequestial
            • Need to consider adding email, url, and other subelements
          • status (17) - things brought in from R4 and R4B were not changed, if updated as part of R5. Keep anything populated and if both are populated then the R5 value should be used, consequential
          • oid (25) - consequential and require cleanup, need to understand how this is happening from Grahame as there are duplicate OIDs across and within THO and FHIR (urn:oid:2.16.840.1.113883.4.642.1.0)
          • property (1) - this one change was added to THO so THO property needs to persist (in measure-type), but should remove the property definition header since we are using the standard, consequential
          • hierarchyMeaning (1) - if blank, it is considered is-a, non consequential
          • extensions
            • telecom - 
            • standards status - looks like lots of errors in R5 where 'cds' was incorrectly added, keep anything populated and if both are populated then the R5 value should be used, consequential
            • workgroup - use r5 value if present, consequential
            • fmm - looks like lots of errors in R5 where 'cds' was incorrectly added, keep anything populated and if both are populated then the R5 value should be used, anything with fmm 5 is likely an error that should be removed, FHIR value rules except for cds ones, consequential
          • concepts (18) - consequential, involve WGs if needed
        • Discuss how to address changes across the following value set system elements:
          • name (29) - consequential, involve WGs if needed
          • oid (5) - consequential and require cleanup
          • status (19)
          • standards-status (10)
          • title (63)
          • description (25)
          • normative-version (1)
          • experimental (159)
          • immutable (123) - everything is already set to true, non consequential
          • compose.include.system (19) - all should be fixed once urls are resolved, need to verify testscript-operation-codes (only this one is consequential)
          • date (180)
          • extensions 
            • fmm (25)

Will repurpose this call again next week!

Call adjourned at 5:01PM ET. 

Action items