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Chair:  Jean Duteau

Scribe: Floyd Eisenberg  

NOTE - This call is rescheduled from July 23, 2020.  The originally scheduled call for August 6, 2020 is also rescheduled for Thursday, July 30, 2020.

Thus, the next two calls are Thursday July 16 from 1-2 PM ET and Thursday July 30 from 1-2 PM ET

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Health Data Incehaas@healthedatainc.comyes
Gay DolinNamaste Informaticsgdolin@namasteinformatics.comyes
Duteau due to TSC Retreat)
Iris Health
Wave One due to vacation) due to TSC Retreat)
Piper RanalloAmerican Academy of
MD due to TSC Retreat)


Minutes Approved as Presented 

This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."

Previous Meeting: 2020-07-09 Meeting Minutes/Agenda

Minutes Approved as Presented 

This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."

Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)


Minutes Approval

Reminder: Co-Chair Election open until July 31, 2020

Project Proposal - FAIRness for FHIR

FAIRness for FHIR Proposal:  PSS-1657 - FAIRness for FHIR IN REVIEW   

Work with the Research Data Alliance to provide guidance on supporting data FAIRness with HL7 FHIR. In particular describe how FHIR can help in supporting the FAIR (Findability, Accessibility, Interoperability and Reusability) principles ( and the proposed RDA recommendations on FAIR data maturity model indicators.

Follow up from July 9, 2020 discussion

Awaiting discussion of the project in FHIR-I and possibly SOA.
Marketplace Product Packaging Project

Status on Marketplace Product Packaging Project

Awaiting further feedback from Preston Lee regarding next steps, updates, and when specific group meetings will be held. Currently delayed due to Logica activities for COVID-19

Military History Project

Report from Military History Project team 

Confluence page: Military Service History and Status FHIR Profiles Project Page  Document

Plans to go to the September Connectathon for HL7 FHIR. Consider whether the API can be used for veteran status for DaVinci use cases.

US Core Methodology

FHIR Tracker Grouping: project = FHIR AND issue type in ("Change Request", Comment, Question, "Technical Correction") AND Specification = "US Core (FHIR) [FHIR-us-core]" AND status in (Triaged, Submitted, "Waiting for Input", Deferred) AND Grouping = USCore-errata-2020

Status of US Core Errata Package:


Deferred from prior calls:

  • J#27857 Add Reference to US Core Patient in Vitals Signs Profiles (Brett.Marquard) Persuasive
    • Deferred for clarification
  • J#27117 ICD-10-PCS: Note ownership and availability for Use. Include Codes. (saul_kravitz) Persuasive with Modification
    • Deferred - the copyright for the value set is owned by US Realm Steering Committee - request clarification from commenter.

Also deferred but reviewed in the US Realm Steering Committee and determined acceptable:

FHIR-27732 US Core MedicationRequest variance – encounter

FHIR-27731 US Core Patient variance – Patient.telecom

FHIR-27730 US Core Patient variance – Patient.communication.language

FHIR-27729 US Core Patient variance - us-core-birthsex

FHIR-27728 US Core Patient variance – us-core-ethnicity

FHIR-27727 US Core Patient variance – us-core-race

Briefly discussed on June 18 call and will require additional work:

FHIR-27770 - Need to work with Vocabulary and HTA since the current publication indicates reference to only one license year (2014) and CPT has a new license every year.  Need a reasonable way to manage the code system version. The version is based on the date of service. The OID, code and reference does not change but the version changes with every year of service.

Next Steps for US Core Errata

Details to follow.

Road to US Core Discussion

For consideration on the May 28, 2020: Additional US Core FHIR Trackers (Frank McKinney) regarding Real-Time Pharmacy Benefit Check (RTPBC) Implementation Guide - variance for profiles regarding Patient and MedicationRequest (see Tracker links bullet below). 

Current expectations: Expecting errata package for US Core toward the end of June 2020 for a 2-week comment period followed by a vote for approval and publication in early July 2020.

Jira Issue Summary (Reporter) Resolution

  1. J#27867 add reaction to allergies (ehaas) Persuasive
  2. J#27857 Add Reference to US Core Patient in Vitals Signs Profiles (Brett.Marquard) Persuasive
  3. J#27846 US Core Pulse Oximetry Profile: observation.value and component.value constraints are different (emmanurse) Persuasive with Modification
  4. J#27836 Expand Procedure Codes Value Set to include ICD-10 PCS codes (ekivemark) Persuasive
  5. J#27117 ICD-10-PCS: Note ownership and availability for Use. Include Codes. (saul_kravitz) Persuasive with Modification
  6. J#27116 Change Description of ICD-10-PCS Value Set (saul_kravitz) Persuasive
  7.  J#27876 - Remove Must Support References to non US Core Profiles (Brett.Marquard) Persuasive

Eric reviewed the Publication Request - Re: HL7 FHIR® US Core Implementation Guide STU3 Release 3.1.1. He also reviewed the changes showing the changes for this errata package.

The Co-Chair list serve received notification of the errata package on 15 July 2020 with indication that the comment period will ent on 29 July 2020.  Only 1 comment currently exists for resolution, related to a question about the smoking status issue arose on the Structured Documents call this morning. 

Jira tracker addresses the question:  FHIR-28079 - Getting issue details... STATUS  recommends:

  1. If possible, identify the additional codes that were needed that were not available and add them to the existing (prior) value set. This is not required but should be easy given the problem was there are codes that were not available.
  2. Use preferred binding strength for this improved value set.
  3. create a MAX minding to all of SCT. for the element.

FHIR-27082 is an existing tracker for the same issue.

The question is about the USCDI  requirements. For this current binding, the time to determine the appropriate codes would take considerable time.  The codes in the original set were considered insufficient but they now have been used for a number of years.  Adding more codes may miss something - consider making the binding preferred. And, should the profile be broader to address tobacco status. 

Group consensus agreed to a current resolution (16 July 2020) to roll back the binding to preferred with a Max binding in the current errata package. And to consider the appropriate set of codes going forward. As informational - the Max binding extension elementdefinition.maxValueSet - I.e., use the preferred set but requires SNOMED (the Max).  The tracker FHIR-28079 remains open looking for future development of appropriate codes for the value set. Therefore, the group did not vote directly on the resolution but no one voice disagreement with this resolution.

The comment period started 15 July 2020 and ends 29 July. The next call (30 July) will consider vote on publication request and errata letter to CTO.

Some discussion about timing of smoking status questioned use of issued Vs effectiveTime (dateTime) of the observation - will be discussed on CQI tomorrow (17 July 2020).

Eric will continue to work through QA issues.


Informational for CGP: The canonical url for NUCC Provider Terminology includes abstract code categories in the content loaded into the FHIR Terminology Server. These USCoreProviderSpecialityNucc value set abstract code categories may need to be removed but the value set does not need to change because it is all codes in the code system. The expansion is incorrect. This is a FHIR tooling issue and once fixed, the US Core reference to the value set will inherit the change. Related Zulip chat:

The meeting was adjourned at 1:54 PM EDT.  The next meeting of the CGP WG will occur off cycle - on 30 July 2020, one day after the US Core errata package comment period ends. At that time the CGP WG may be able to approve the errata package, publication request and CTO errata letter.

Supporting Documents

Outline Reference

Supporting Document

Minute Approval


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