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Attendees Present

Chair:  Lorraine Constable Q1; Paul Knapp Q2
Scribe: Anne Wizauer

Q1Q2Name
xx

Calvin Beebe

xxLorraine Constable
xx

Tony Julian

xxPaul Knapp


Ewout Kramer
xxAustin Kreisler


Wayne Kubick
xxThom Kuhn
xxRik Smithies
xxSandy Stuart
x
Grahame Grieve, guest
x
Rob McClure, guest
x
Finnie Flores, guest

Agenda

  1. Agenda review
  2. Discussion Topics
    1. Review Mission and Charter - 15 minutes
    2. Assignments needed:
      1. architecture/tooling risks that came out of TRAC - need an individual candidate to review issue
      2. Generalize FHIR Ballot Expectations - need an individual to work on this
      3. Educating cochairs on precepts
    3. Feedback from Product Management Council on Technical Alignments Between Product Families
      1. Datatypes, vocabulary, status codes, work flow, clinical value sets, structural value sets, negation, modeling, etc. What changes can be made? What are the priorities for consistency across product families?
    4. HTA:  Referencing external vocabulary and currency of value set content.
      1. Identify what, if any, precepts need to be created to support Referencing External Vocabulary
      2. Is Currency of Value Set Content within HTA's scope?
    5. Large group engagement for standards development

      1. risks/precepts

    6. Mapping coordination - mappings should be a component of cross-family projects. How to represent mapping in a standardized way? Need to establish a precept.
  3. Topics to carry forward:
    1. Ownership of content/precept on coordination with domain committees 
      1. Issue is around products crossing multiple product families - who owns those?
        1. Draft Precept: The family of the wire format is the responsible family, and the management group of that family would manage it.
    2. Management group vitality assessment precept
    3. Precepts We Need to Develop - prioritize/analyze risk
    4. Ballot vs. non-ballot feedback - value of membership and capacity


Minutes 

  1. Agenda review
  2. Grahame Grieve here to discuss a couple of issues.
    1. FHIR Community process is underway. We'll be inviting our partners to participate. Discussions with participants here rose the issue that some participants are starting to use our publication tooling, but are nervous about it because there is no governance over the tooling. In principle, FMG has the authority to make decisions but there are no formal channels. Grahame is going to set up a change control process over how IGs are rendered and a notification channel/discussion so community process participants are part of the process of deciding how IGs are best presented.
      1. Lorraine: You might want slightly different style guides for IGs that are fully balloted. Grahame: They'll be different in terms of branding, but that's baked into the agreement. Calvin: What revenue streams are coming from this community to make these changes, or is it all being borne by the HL7 organization? Is the tooling currently open source? Grahame: Yes. The community can suggest changes but don't have authority.
      2. Discussion over coordination with Publishing and Tooling. Calvin: Has Wayne been involved in some of the discussion here? He is trying to coordinate the funding streams. We've got an open source product utilized here and in other places; how do we maintain it? Wayne will need to be a party to this discussion. Grahame: Austin, Wayne, and I have weekly coordination calls. Calvin: Funding won't last forever, so we need a footing under this. Grahame: The best opportunity was when we set up the accelerator program. The nexus between accelerators and business side of publishing support should be part of an exec wing of the TSC task force around accelerator programs.
      3. Grahame reports he currently spends 4 days of publication cycles supporting the accelerators. There are real costs. DIscussion on how to engage Wayne. Perhaps we need a budget line supporting operation. We don't have an overarching plan. The accelerator world and the nature of building relationships raises a nexus between governance, business, and strategy  that doesn't quite land anywhere solid in the organization currently. SGB should be looking at the governance aspects. The WGs are being caught flat-footed by the change in orientation. Lorraine: ARB is grappling with what we need to be looking for when we review the external content. 
      4. TSC task force should address orientation as well as scale. 
      5. Grahame notes that we'll be getting closer to IHE through the Gemini program - this will raise governance issues. Gemini is looking to do some cooperative work that may challenge our current policies. 
      6. FHIR has a maturity model which is tied to a set of activities HL7 undertakes. People are now bringing projects where they are re-expressing mature content in a new form. The existing maturity process regards everything starting de novo. We need a representation of this issue in the maturity model. CIMI is bringing stuff into a FHIR representation that has been socialized in a different community. If people come to FMG arguing that they have mature stuff, should it go to ARB for review? ARB normally catches stuff at the PSS level. Calvin: Historically we've had a challenge with external profiles from anywhere asking for a stamp to get published. Grahame  notes they still have to ballot and connectathon. Paul: Would suggest that we either check that it's been through ARB or punt it to ARB to be the arbiter that determines that it's mature content. Calvin: FMG should make a recommendation to SGB on the rule change or precept they would like to see around maturity assessment and we can endorse it. Grahame: The issue is when people come in and ask for an accelerated maturity process because of external experience with solutions. Discussion over where the PSS fits in with this process. This is a mid-level jump that may miss the PSS. Discussion over the challenge of value sets in this material. 
      7. Lorraine: The requirement that it go through HL7 processes and be worked on under the regular WG DMP process is causing issues. CARIN Blue Button project has confusion around this. They believed it wasn't an issue since it was developed under an open process, but it wasn't an HL7 process. 
      8. FMG discussed guidance on technical corrections around breaking changes. That should probably be reviewed here and generalized. We still need to finish the original work on technical correction. Need to get the base definition settled.
    2. Rob McClure here to discuss issue regarding harmonization proposal around media type. There's a CDA-based IG for advance directives that wants to refer to video elements. The CDA-based representation of that pointed to  what we use in Vocabulary in V3 content as convenience copies, previously referred to as an external/internal code system. There are subsets that are official and subsets that are unofficial. On the unofficial list is wmv. The convenience copy created for V3 had a very small subset focused on particular needs at that point. That code system had only a few codes and then it grew to 47; only a few were associated with a value set used in CDA. There is also datatype alignment that uses this; it was using a small value set but was defined as all codes. It points to an obsoleted RFC. The intent was probably that it should have pointed to BCP13. The way the world treats this is that it is BCP13 - anything that is a valid mime type should be able to be put in there. Because of this, it looks like the things that CDA could use are only the small set; when you look at the larger set, the ones they needed weren't there. The proposal was to put them in to the set. Adding these codes should be fine, but we hadn't asked the right people.
    3. Rob would like SGB to agree that the proposal is okay and can go through the next cycle. Decision that no SGB action is required at this time. 
    4. Rob would like to figure out a way to avoid binding to a code system and bind to a validator instead. That would be an SGB decision. Austin states that's actually a methodology issue. If there was a rule to be created stating that all product families need to do something the same way, that would be an SGB issue. 
  3. Discussion Topics
    1. Review Mission and Charter - 15 minutes
      • Anne Wizauer to add mission and charter review to 2019-10-02 call
    2. Assignments needed:
      1. architecture/tooling risks that came out of TRAC - need an individual candidate to review issue
      2. Generalize FHIR Ballot Expectations - need an individual to work on this
      3. Educating cochairs on precepts
    3. Grahame notes that they are developing a group of people who can do pre-ballot review and have created a checklist. Lorraine notes that ARB is looking at using the checklist in their review process. Similar process could be used by committees and product families.
    4. Paul notes we need more oversight on what groups are able to put up on HL7 sites. EST set policy on this for the wiki and staff applied the process. Need to extend this process to Confluence. This situation involved a spreadsheet which would have been difficult to catch. May have to start implementing moderators for the accelerators. 
    5. Lorraine notes that TSC gave an extension to Blue Button through the end of the WGM. Austin notes that no one at TSC was willing to put forward a motion to extend it further. As of today they are off side of the deadline. It will be on the 9/30 agenda. The sponsoring WG was also unaware of the request. Austin has sent a communication to Ken to communicate the absence of action on the request and that it will be discussed on 9/30. 
    6. Discussion over when to meet in Sydney since our Friday is gone. Decision to do a joint with ARB on their Friday meeting.

    7. Feedback from Product Management Council on Technical Alignments Between Product Families
      1. Datatypes, vocabulary, status codes, work flow, clinical value sets, structural value sets, negation, modeling, etc. What changes can be made? What are the priorities for consistency across product families?
        1. The most pressing issue brought up was publication alignment and cross-product guidance and consistency.
        2. Lots of conversation this week around information modeling around FHIR. 
        3. Discussion over quality checklists for non product family groups. CIMI has two major streams of work - work to build the base model and reference model that the generate their archetypes off of. Balloted the reference model several times but didn't publish it. Then they've got all of these archetypes. Right now they're working through the lab side.  They intend to build a universal spec but are basing it on US core. At what level does it make sense to be generating profiles? Does it make sense to have a profile for every LOINC code? There should be a more intermediate level.
        4. Calvin: What happens with the AMA coming in could be pivotal for the organization. They are thinking of adopting their previous work on clinical use cases into FHIR. Lorraine; The initial one is referral management and there's another one on self monitored blood pressure. They do have external content. Encouraged them to restructure the project so they're taking their workflow process and putting it in context of what has already been defined. Calvin: This could help us establish HL7 as the technical arm of a major physician community to make their use cases work for them. There is another AMA group working on a referral project but it is in early stages. 
        5. Discussion over announcement regarding CAQH CORE work. Seems to overlap with Da Vinci work. Seem focused on workflows. What does HL7's cooperation with them mean? The implications and ramifications to the WGs is unclear at this point. Thom notes that another huge project will be coming in from CMS. 
        6. Calvin: The biggest challenge is our biggest success, which is the accelerator program. Lorraine: it is also our biggest risk. Austin: Success in selling it is only one measure of success. How do we get ahead of it? Discussion over the TSC task force. We now have TSC members, board representation, and one cochair (Josh Mandel). Paul: We've got an explosion of profiles and extensions, and an explosion of both value sets and missing value sets. There is no place to point to structurally. Lorraine; OO wants to define a standard extension in R5 and is looking how to publish that. 
        7. Discussion over potential precepts in this area. 
        8. At TSC we could develop a checklist for the accelerators
        9. Calvin: Should a representative from each accelerator sit on the TSC? Or act as liaisons? Austin is opposed to membership but there should be a liaison. This relates to our agenda item about large group engagement. Thom: When an accelerator is signed there should be a list.
    8. HTA:  Referencing external vocabulary and currency of value set content.
      1. Identify what, if any, precepts need to be created to support Referencing External Vocabulary
      2. Is Currency of Value Set Content within HTA's scope?
        1. Carry forward
    9. Large group engagement for standards development

      1. risks/precepts

        1. Carry forward
    10. Mapping coordination - mappings should be a component of cross-family projects. How to represent mapping in a standardized way? Need to establish a precept.
      1. Need to look at the space, understand what is going on there, and recommend if we need a precept.
      2. Some want a requirement on CDA IGs that they all have FHIR mappings. That's one of the precepts we could put forward if we believe that's important. Is it part of the product that's being produced, or is it a separate product? Mappings also require maintenance over time.
      3. The management group for a family could determine what the contents are for IGs. Is that an overreach? 
        1. Carry Forward
    11. Precepts on stable identifiers for value sets, concept maps, and code systems
      1. Discussion over whether this precept is needed.
    12. Reviewed Policy on use of Retired or Legacy HL7 Code Systems
      1. Any Vocabulary policy meant to be implemented outside of the group should be vetted by SGB
      2. If we decide we're happy with a policy, does it go to TSC or does it just go out? Austin notes some of this that is described as policy may actually be methodology. Vocab has not been formalized as a product family. Where is the dividing line between methodology and governance policy?
        1. MOTION that SGB indicate agreement and approval of this policy with requested clarifications on the first sentence on HL7 code systems since the table lists others; clarification on the third bullet under "HL7 will...", and to remove the sentence before the table. Once that has been accomplished, SGB will recommend to the TSC that this policy be disseminated to the WGs for adoption: Lorraine/Austin
        2. VOTE: Calvin abstains. Motion passes 6-0-1
  4. Next call: 10/2


OPEN ACTION ITEMS:


DescriptionDue dateAssigneeTask appears on
  • Paul Knapp to send documentation to the cochairs of HTA and Vocabulary noting that we've drafted precepts on external terminologies and highlight questions on their currency document.
Paul Knapp2019-11-06 SGB Agenda/Minutes
Paul Knapp2019-09-20 SGB WGM Agenda/Minutes
Paul Knapp2019-09-20 SGB WGM Agenda/Minutes
Austin Kreisler2019-09-20 SGB WGM Agenda/Minutes
Lorraine Constable2019-09-20 SGB WGM Agenda/Minutes
  • ACTION: Paul Knappto ask for the most current version of Currency of Value Set Content
Paul Knapp2019-08-07 SGB Agenda/Minutes
  • ACTION: Paul Knapp will work on a grid with types of change/degree of review
Paul Knapp2019-05-22 SGB Agenda/Minutes
  • ACTION: Need to create precepts on stable identifiers for value sets, concept maps, and code systems
2019-01-18 SGB WGM
  • ACTION: Review proposed updates to the GOM, then determine how/where to represent SGB
2019-01-18 SGB WGM
  • Add Calvin's document on continuous maintenance and the decision to the SGB site.

2018-11-14 SGB Agenda/Minutes