Date: 5/8/2019

Quarter: Q4


Minutes Approved as Presented 


  • Welcome and introductions 
  • VR DAM continuous maintenance- AMS
  • HAI LTC update- David DeRoode
  • FHIR IG for CDS ballot recon - Nathan Bunker

Discussion items


5 min

Welcom and agenda review

45 min

VR DAM continuous maintenance

AbdulMalik Shakir
    • Please see VR DAM Continuous Maintenance.pptx
    • Reviewed existing specifications for vital records birth, death, fetal death and birth defects and then created a harmonized view of the data associated with them. Maintained traceability of elements, identified overlaps and differences. Because we know that some of the specifications have been updated, the DAM needs to be updated. What is the process to update? Continuous Maintenance. It will need to be reaffirmed every 5 years. This is similar to how the RIM was maintained.
    • Objective- to ensure the VR DAM reflects the content of published vital records related to the HL7 specifications
    • Intent- assist in surfacing and reconciling unintended gaps and inconsistencies
    • All modifications to the VR DAM are driven by content provided in the VR specifications going to ballot.
    • AMS has mapped out the process- see slide 3
    • Step 1- Prepare the specification; prepare the a list of VR specification elements
    • Step 2- Take current published version of the DAM and map the elements from that specification to the DAM.
    • Step 3- Identify specification to DAM mapping gaps and inconsistencies
    • Step 4- Reconcile VR specification to VR DAM gaps and inconsistencies
    • Step 5- Finalize required changes to the VR DAM
      • Who does this work? The person who develops the specification? Yes, they would take these findings and handle them as they would ballot comments.
      • How do these comments get submitted and by whom? Would be findings made during ballot and during reconciliation prior to publishing. Could get in the habit of including a generic ballot comment requesting the specification be harmonized with the DAM.
      • The DAM would only change when something goes to ballot and only after reconciliation.
    • Step 6- Finalize VR Specification to the VR DAM mappings
    • Step 7- Update DAM
    • Step 8- Ballot VR DAM as an STU and the DAM mapping specification as informative
    • Step 9- publish new VR DAM and new mappings to the HL7 VR consumers
    • Requested PHWG Actions:
      • To formally adopt the VR DAM maintenance process as a PHWG process.
      • To upgrade the VR DAM from an informative specification to a STU specification upon completion of the first application of the continuous maintenance process.
      • To include update of the VR DAM as a milestone activity in the PSS and on the notifications of intent to ballot for all vital records related specification develop or maintenance projects.
    • Intent would be to create a Continuous Maintenance process PSS that would not have a project end date. The PSS’s to update the specifications would be separate; these would have project end dates.
    • Currently there are 3 main contractors who support the NCHS work. IS it the expectation that these people would need to accommodate this work? This will affect contracts. Though it doesn’t necessarily mean that this person has to be both, but there would need to a person identified to both. A resource will need to be identified to update the DAM in parallel.
    • Birth Defects is planning to create their own birth defects DAM. Will this need to harmonized with the VR DAM? Is a VR specification limited to what is reported to NCHS? When the birth defects DAM project comes will need to determine whether or not this should be considered in scope.
15 min

HAI LTC update

David DeRoode
    • Long term Care HIA reporting project (CDA and FHIR)
    • NIBs have been approved, need to be submitted (one for CDA and one for FHIR) Final approved version is already in confluence (4-4) just needs to be submitted to HQ
    • IG is coming along. The Content is mostly done. The sample files are about half done.
    • Will be touching base with NSHN in a few weeks for review and review with stakeholders; before ballot.
    • Will be building out transforms between CDA and FHIR; will be made available during publication but not expected to be included in the ballot.
    • Erin will submit the NIBs
30 minFHIR IG for CDS ballot reconNathan Bunker
    • Would like to do a block vote. These were circulated the week prior to the workgroup meeting for review.
    • FHIR IG for the immunization forecasting operation
    • Balloted under R3. Plan to ballot next round in R4.
    • Goal is to not change objects, to take what PH has already created and package into an operation.
    • See URL for discussion notes Ballot #1 Discussion
    • 14933- don’t create a new domain-specific resource to define CDA recommendation for specific domains- would like to defer for future consideration.
    • Terminology related- 14940, 14923, 14922, 14920, 14909, 14901- Persuasive or persuasive with-mod; 14921- not persuasive
    • Structure use of resources and profiles of resources- 14942 (NP), 14941 (CfFU), 14938 & 14937 (PwM), 14936 (PwM), 14934 (PwM), 14931 (CfFU), 14930 (NP), 14929 (PwM), 14924 (Future consideration)
      • For these that are not persuasive will need reasons- these are documented in gForge
    • Technical Fixes to the IG presentation/format, additional examples, etc.- all are (Persuasive), 14914 (PwM)
    • Motion- Nathan moves to approve these comments as dispositioned and make these edits as documented.
    • Second- Laura
    • 8,0,1

Action items