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Chair:  Jean Duteau

Scribe: Floyd Eisenberg  

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Meeting ID: 915 0605 8769

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Meeting ID: 915 0605 8769

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NOTE: This attendance applies if you are present at the related meeting/call, regardless if you have signed a different attendance for your WG. 


Previous Meetings: 

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 (note - 09 July and 16 July minutes need approval)

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

Minutes of three past meetings approved as written - by consensus.
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 - 

SOA WG may be in principle the sponsor  of this proposal.

(In case, ArB may be interested in sponsorship or co-sponsorship)

See SOA All-hands TC 17Aug2020 

The project was reviewed with SOA on August 17 and will be reviewed with ARB.
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.

Working on preparations of the FHIR Connectathon 25:

2020-09 Social History: Verification of Military Service History and Status

US Core Methodology

Publication Request - Re: HL7 FHIR® US Core Implementation Guide STU3 Release 3.1.1. The changes for this errata package Awaiting final edits to submit to HL7 CTO and notify TSC.

Publication Request - Approved by CGP 30 July 2020

CTO Errata Letter - Approved by CGP 30 July 2020

Status update - Brett Marquard, Eric Haas


Deferred from prior calls (not errata-related):

  • 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

The errata, the publication request and the errata letter were all approved on July 30. by CGP. All QA has been updated and Wayne Kubick (CTO) has been notified for the errata release and some copyright updates.  Final publication is pending.

Discussion about a routine process for tracker item review and a release plans for US Core updates/versions. Consider a block vote for some of the existing outstanding trackers (especially the variances requested for Pharmacy listed in the description column to the left).

Process for review of trackers:

Once per month - first meeting of the month starting in October

US Core track in FHIR Connectathon - from Inferno team - Argonaut participating - shared track, title US Core. 

Consider how to handle variances:

  • Does each require approval from CGP/US Core?
  • If so, what is the enforcement?
  • Is enforcement a US Realm decision?

Consider the following US Core Variance Process:

  • A proposed variance should generate a tracker for US Core to determine if US Core should make the change. Justification There are good reasons for variances and US Core project should be aware of these reasons.
  • If US Core does not agree with the change, the variance must be reviewed for approval by US Realm. And US Realm will review the reason for "not persuasive" decision in CGP.
    • The US Realm decision should be part of a publication request (I.e., approval Vs lack of approval)
    • TSC should require that variances have been approved before publication approval
  • Example: Financial Management is added modifications "approval" to the publication check-list. The effort is manual but it represents an attempt to review variances.

  • Potential variances must be identified as the work progresses and not only immediately before publication.

Jean will create a draft process (confluence page) and include links to the work the must be done.

  • Can a tool allow review of where MUST SUPPORT is not followed consistently - would alleviate the human work effort needed to review the requests?

Public Health IG Recommendations for US Core (Craig Newman)

Public Health sponsored FHIR IGs (Birth and Fetal Death reporting and Birth Defect reporting) and noticed a good number of data elements in common; I.e., a potential to share a number of profiles including patient (probably), mother/father/relatedPerson and a number of observations about the pregnancy and delivery (plurality, number of previous live births, LMP, etc). Public Health is looking at making a “common public health” FHIR IG that defines these profiles and that their individual IGs can reference. Particularly for the observations, a lot of these concepts go beyond public health and could be used by a number of different systems. Public Health requests discussion with CGP to get a feel for whether or not CGP should be pursing adding profiles to US Core or some sort of IG that maybe has more visibility than a “public health” IG might get. (Craig Newman, John Loonsk, Cynthia Bush, Sarah Gaunt)

Request follow-up from Craig Newman

September Virtual WGM Agenda

September HL7 Virtual WGM schedule - Monday, September 21 noon ET through Friday, September 25 at 6:00 PM ET (2 hour slots on a 24 hour basis through the week).

Thursday, September 24 from 2:00 - 4:00 PM ET

Consider topics for this session.

Virtual WGM Agenda/Minutes 2020-09-2020 - Cross-Group Projects (CGP)

Reviewed and updated WGM agenda with topics.
ANSI Survey

ANSI Opens Survey: Standardization Empowering AI-enabled Systems in Health Care
The American National Standards Institute (ANSI) has released a survey on standardization empowering artificial intelligence (AI)-enabled systems in health care. ANSI seeks feedback from interested stakeholders on related standardization issues, solutions, efforts, and the role of standardization in the governance and regulation. Survey responses are requested by July 31, 2020 , and the results will be used to inform the discussion at a public-private virtual workshop hosted by ANSI on September 14, 2020. ANSI will provide details for the workshop in the near future. ANSI Survey - Standardization Empowering AI-Enabled Systems in Health Care


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:

Adjourned at 2:01 PM EDT.

Supporting Documents

Outline Reference

Supporting Document

Minute Approval


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