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HL7 TSC FMG Meeting Minutes 

Location: (voice and screen)

Date: 2020-05-20
Time: 4:00 PM U.S. Eastern
Chair: LloydNote taker(s): Anne W.
Quorum = chair + 4yes/no
Co chairsxDavid HayxLloyd McKenzie
Wayne Kubick, CTO
xHans BuitendijkxBrian PostlethwaitexPaul KnappxAnne W., scribe
xJosh MandelxJohn MoehrkexBrian PechxLynn Laakso
xGrahame Grieve

xBob Dolin

xRick Geimer

xMelva Peters

xBrian Phinney

xScott Robertson

xCraig Newman

xPatty Craig

xNandini Ganguly

xSandy Vance

xDavid Sundaram-Stukel 

xJuzer Khorakiwalla

xPeter Muir

xDonna Campbell



  • Roll Call
    • Numerous guests here representing projects, as observers, or for the open mike session
  • Agenda Check
    • No additions
  • Minutes from 2020-05-06 FMG Agenda/Minutes
    • MOTION to approve: John/Hans
    • VOTE: David abstains. Remaining in favor.
  • Action items
    • Reviewed
  • Connectathon report
    • Sandy reports things went really well and surveys are out. Paul asks what the final numbers were? Sandy reports 662. John states it went far better than he expected. Highest attendance yet. Lloyd provided some feedback but overall it was awesome. Lots of engagement and participation. Recorded around 30 track overviews that are now available on education on demand. John reports that the SANER project raised over $600 for 4 animal shelters. 
  • Review Items
    • Outcome Criteria Framework Implementation Guide PSS
      • Bob describes the project and recent updates to the PSS. Further description here: Outcome Criteria Framework
      • Lloyd asks why the first ballot will be comment only? Bob replies that the rationale was that the work is novel and to take a softer approach.
      • Lloyd: This is recommendations for how IGs should document expectations but not something that would be implemented directly? Bob confirms. There may be some constraints or conformance criteria.  Lloyd: Who would be required to change the code that they write as a result of this. Bob: It would be a test to see if their core definitions adhered to the implementation guide. 
      • Lloyd asks for others' opinions on ballot track. Paul states it should be STU to Normative. Lloyd: It's conformance language on specifiers, so it's a slightly weird beast to be a normative IG. Bob: CQI originally approved it as informative. Lloyd states the experimentation stage can be done at the connectathon as opposed to comment ballot. Lloyd states he's comfortable authorizing it for STU and then examining the content at a later date to determine if that's actually appropriate or if it should be informative. Paul agrees. 
      • Lloyd states the normative timeline is aggressive; the guidelines are two STUs before normative. 
        • MOTION to approve: Paul/Brian Pech
        • VOTE: All in favor
    • C-CDA on FHIR Publication Request

      • Rick Geimer here to present the request. Is an unballoted STU update. Warnings appearing are because the value sets are housed in VSAC and another due to issues with composition profiles causing a time out. Lloyd suggests suppressing them. Build should be clean with no warning messages. Rick will reach out if he can't get the suppression to work.
        • MOTION to approve: Hans/Paul
        • VOTE: All in favor
    • Pharmacist Care Plan Publication Request
      • Rick here to present the request. This was an STU ballot based on R4. Lloyd notes there are a number of unmatched slices and VSAC value sets that should be put in the suppressed file with reasons. 
      • Need to define a page for downloads. There are two TOCs. Lloyd is concerned about the format of numerous pages with few paragraphs. Not seeing anything that points to the profiles and says what you're supposed to do with them. No capability statements. Nothing stating what it would mean to conform with this IG. Need the text of the spec of who is sharing it, what they're sharing, what each system should implement. Rick states there is a CDA version of this as well and they tried to keep the language in sync. This is a FHIR Care Plan document for the pharmacist use case. Rick will add documentation explaining that. Lloyd: Should also have an example of the whole document as opposed to just individual resources. Paul: Are the profiles built on US core? Rick confirms. 
      • Update the main menu to be IG home. TOC is fine, but shouldn't be there twice. Should have an artifact index and downloads. Should be some statement that a conforming actor conforms to the bundle - a capability statement. Lloyd reviews the C-CDA on FHIR version and states the same types of updates should be completed there as well. Paul: Get the profiles examined by the domain committees.
        • Rick will make updates and bring back
  • Discussion Topics
    • WG Responses to Request Email/Open Mike
      • Email responses received from Pharmacy, Public Health, BR&R
        • Reviewed Pharmacy responses. They struggle to understand what has been implemented and the scope of what has been implemented. And what if most of the implementation is on an old version? Lloyd: Old versions count unless the resource has been significantly restructured. Don't necessarily require it be implemented in every one of its use cases. A business expert for that case could do a review and determine that the criteria has been met for implementations.  If you think there are implementations you're not hearing about, we can send out a formal solicitation. Melva: Unless somebody comes to pharmacy and tells us, we don't know what's out there. The implementers have stopped participating in pharmacy and it's getting harder and harder to review FHIR issues. Lloyd: If submitters are not responsive, then you could close things off after a warning that you'll do so. Craig notes Public Health is having similar participation issues. 
        • Medication, MedicationRequest, and MedicationStatement/Usage will try for normative. 
        • Lloyd suggests making sure that there is a Pharmacy track in the next Connectathon and see if you can get some more engagement that way.
        • Craig states they have a need for knowledge of Immunization resources and Consent. Perhaps there could be a larger ask regarding implementation data. Need to draft a survey on implementation and perhaps awareness for lower FMM items. Answers could include implementation in production, in progress, aware, not interested.
          • David Hay will draft a survey on implementations and awareness
        • Craig states they have a good set of immunization experts but we lack experts on the technical side.
    • When is it appropriate to create a Jira entry for an IG? Should we wait until there's an approved IG proposal?
      • In JIRA, in order to get a specification and its artifacts to show up, people need to submit a pull request that contains an XML file. Lloyd recently got one for a proposal that hasn't been approved yet. Do we want to have a policy that IG proposals should be approved prior to being able to use JIRA to solicit feedback? John asks what the harm is. Lloyd states the trackers will be there forever, and they could end up being there for something that never comes into existence. Josh: That would be unfair to people who have project management needs. The alternative is using email or Github issues. Melva: The same question may exist around resources. She has seen resources being added before a proposal exists. Lloyd notes that resources have appeared in ballots before a proposal is received, so there is precedent for that. Paul: Perhaps there should at least be a PSS. Lloyd will make sure there is a PSS underway and suggest they should get an IG proposal underway when he comes across these.
  • Reports
    • Connectathon management (David/Brian)
      • Already covered
    • SGB –
      • Have been working on UTG principles/approach
    • MnM –
      • Nothing new. There was a question about where committees put profiles and extensions such that we don't end up with redundancy across IGs which is under continued discussion.
    • FMG Liaisons –
      • No report
  • Adjourned at 5:30 pm Eastern