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Web Meeting Info:

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3:30PM EDT (UTC-4). Note that the calls are now two hours in duration.   Today we will end early and continue longer with the cochairs for planning for the WGM next week.


None received.

Agenda Topics and Notes

  1. Roll call and Agenda check (Chair)
    Call began at 3:35PM EDT with quorum reached.
    Add planning for next week's WGM.  Will be set up soon.
  2. Announcements (all)
    • Harsh Sharma is MIA although was elected cochair.  No one has hears anything about it.    Apparently Jean Duteau contacted him, and may have had a conversation.   We will hope to hear from Harsh.

  3. Action Items Check  (Chair)
    1. We acknowledge that we need to take care of the items on this list. Rob asks that co-chairs especially review their action items and resolve or update
    2. Attendees and especially chairs are again urged to finish and check off their action items.
    3. Reuben created the page for the Name&Shame list

  4. Next WGM Planning (Carol Macumber)
    Planned schedule for the WGM will be added soon.

  5. Review of new PSS involving Vocabulary (chairs)
    There is a Confluence page relative to this where we can see the new projects in review and started.  We should comment on these or at least review to make sure they are not something we need to get involved with.  Note that the items on this page are projects that are either looking for sponsors/cosponsors, interested parties, or related projects in HL7 that the listed proposed project should be made aware of.

  6. Co-chair Items
    1. Co-chair calls moved to 9AM ET every other Monday starting next Monday

  7. Vocabulary Policy Items Needing Decisions (Ted Klein)
    1. FHIR-I has agreed to move curatorship/stewardship of the NamingSystem resource to Vocabulary.  The WG must formally vote to accept this.  Rob Hausam moves that vocabulary WG takes such ownership of NamingSystem, Peter Jordan seconds.   Vote: 9/0/0; motion carries.   Reuben will bring this vote to the next FMG meeting to get this formally completed.
    2. Policy around 'breaking changes'.   Big questions currently on code system URIs and Naming System identifiers.   Chairs call is focussed on this topic exclusively right now until we have a policy to bring forward to the main call here for approval.   Table to 9/3 call; must be discussed on chairs call next Tuesday and ALL chairs MUST review the policy statement around this.
      1. talking points for the impleentaiotn of the policy under work by Ted, Rob H, and Reuben.   The working draft is here.
      2. No charges since last discussion we will defer discussion until progress has been made.
      3. We had quire a lot of action on this at last week's WGM, and Vocabulary WG is on the hook for adding clarity in the description to the policy statement.   Rob M recommends we create a task force to get this done.  
      4. The task force to move this forward will be comprised of Rob McClure, Reuben Daniels, Carmela Couderc.
      5. HTA will review the work done by the task force to get this done asap.   
      6. First meeting of this task force will be next week Monday 10/5 at 5:30PM ET using the regular vocab zoom.
    3. Guidance for IG developers for new CS/VS/codes for new IGs.   Includes the recommendations such as: Do in UTG?  Local to their IG?  Something else?
      1. UC1:  it is already in UTG
        1. Changes in UTG will go into the UTG ci build; sometime later (who knows when) they will be incorporated into a new UTG release but that may not work in the timeframe for development of the new IG.
        2. Unknown how the IG Publisher deals with version updates for HL7 vocabulary
        3. Can we have some way to access the UTG ci build for IGs when needed?   For particular artifacts if needed?   Discuss next week in the joint FHIR-I session
      2. Current initial draft of object is in but since it is NOT a normative ballot-bound item, there is desire to move it to UTG.   
      3. Current artifact are local to the IG and there is desire to move them to UTG
      4. Desire to cleanup up issues such as IP issues in the existing artifacts
      5. We should encourage iG developers to NOT create new artifacts solely within their IGs, but preferably in UTG.   Do we want this message or something different?
      6. We should socialize the Vocabulary WG policy that new CS/VS should preferentially be in UTG rather than local in their IG or in the FHIR ecosystem unless there is a compelling reason to keep it in FHIR or local in the IG.  
      7. Can we find a way to get the right folks together to run this to ground?   Right folks:   Ted, Rob Hausam, Mary Kay, Grahame, Frank McKinney.  
      8. We probably need another task force to discuss this as it is complex and must be decided in terms of what we think would be best approach for IG developers.  Task force members should include Ted, Rob Hausam, Mary Kary, Frank McKinney, Reuben, Peter, Carol M.   We will ask Carol Macumber to schedule the first call.

  8. Documentation Page for MED-RT (Jessica Bota/Carol/Rob Hausam)

    The page of information for using MED-RT in FHIR was updated and HTA and the updaters want a quick review on today's call.   It can be found at: 
    Following review, Rob H or Jess (as VA rep) will post an announcement and call for comment on the Zulip implemented and Terminology channels.    This page represents the resolution of the FHIR ticket for Med-RT.  

    1. Last call it was determined that more information about MED-RT would be needed since only portions can be represented by FHIR. Suggested addition:

      “The MED-RT Code System includes relationships between MED-RT concepts and concepts in external Code Systems, as well as relationships between concepts only in the external Code Systems. The external Code Systems that MED-RT references include RxNorm, MeSH, and SNOMED CT US Edition. 

      The contents of this page are intended to represent concepts defined as existing solely in MED-RT and does not include relationships that reference concepts in the external Code Systems. For more information on MED-RT, see”

      Robust discussion of the wording of this second sentence, with much disagreement.  We made substantial progress at last week's WGM.   We came to agreement, there is a ticket FHIR-28553, and Rob H is on the hook draft the wording and get the final changes done.   We will remove this item once the material is in the ci build so we can keep nagging (smile)

  9. UTG Update (Carol/Jess/Ted)
    1. Status
      1. After discussion with CTO and TSC chair, the full membership rollout and go-live will be delayed until release 2.0.0 is done
        1. Hope to be done within 1-2 weeks at the most
      2. All information is posted on the  UTG confluence pages and immediate priorities are on UTG Project Tasks broken down by milestone (i.e. publish Release 1 of content)
      3. Release v2.0.0 of UTG content schedule plan (content is published and essentially live, but not yet doing Jira workflow process for approved semi-automatic processing)
        1. Latest build has 2 errors and 1636 warnings with IG Publisher v1.1.27; Grahame working on infrastructure issues
          1. See 'Open Content Issues' section below for remaining items
        2. Grahame has moved v2, v3 content from the FHIR pages, pointed to UTG instead
      4. Continued to work on Submitter Educational Sessions
        1. First THREE webinars are complete: Community Intro, HL7 Members, UTG Reviewers/Voters.
          1. Latest session for reviewers available here:
        2. Work continues on the final series of three sessions for Submitters of change proposals that focus on overall process of submitting a proposal, the content, and using the custom tooling
      5. Continued to work on Documentation updates and organization
        1. Feedback was received throughout the WGM that UTG information was difficult to find. The following pages have been updated/revised with the hope that they will be more easily accessible and create a 'web' of links that get people where they need to be
          1. (current build Documentation tab)
          2. Vocabulary Maintenance at HL7 (also linked from main Vocab Confluence page)
          3. HL7 Tools and Processes (main HL7 page for tools and processes)
        2. Rob H also suggested bumping the UTG documentation topic on zulip in the implementers stream every couple weeks 
        3. Jess working with Melva tomorrow 10/2 to go over documentation ease-of-access, organization, etc. 
        4. Any other suggestions????
      6. Open Content Issues
        1. Due to a timing issue, the FHIR resources for the R5 preview site were updated with their versions after the R4.0.1 versions were imported
          1. We still do not have a documented plan for this one; Grahame recommends we just assert a new version for all FHIR UTG content and don't worry about it but this violates Vocab WG versioning policy
        2. The V3 coremif being generated by the UTG build pages is not valid
          1. Lloyd hopes to get the coremif stuff working this week
          2. Dave T completed the fixes for the formal naming property inherited default values missing from original import; Lloyd is testing
          3. Kathleen reported issues with some V3 content but has not provided the information required to address them - we will remove her problem items to address
        3. In progress of fixing remaining value sets with NUCC bad enumerated codes in the HIPAA value sets (Ted/Rob M)
          1. Bad codes have been fixed but some issues with NUCC Value Sets remain
          2. Working with Rob M to address remaining NUCC issues
        4. NamingSystem.title URI corrections for remaining systems
        5. Warnings for bad markup in descriptions
      7. Workflow Tasks
        1. We need a checkbox for folks who make changes to Code Systems to affirm that they checked for the impact (if any) on value sets build on those code systems
        2. Josh is working to setup a different Jira project for reporting bugs and issues with the UTG Tooling and Process or Publication unrelated to content
        3. The process for implementing approved proposals in master source of truth seems to be working well, but will require additional testing as proposals are implemented
        4. Need to finish documentation for the process
    2. Pilot update
      1. With the decision to go live, all Pilot tickets not yet approved will remain in the queue and be handled normally
      2. In general, we need more folks to go to Jira and look at it and comment on the proposals and/or vote on those in Consensus Review.
      3. Feedback and issues from the Pilot are logged on Participating in UTG Pilot Testing
        1. The majority of issues reported in the Pilot (and all major issues) have been addressed and have their own section in the UTG Project Tasks page
    3. Discussion/Decision items 
      1. A standing agenda item was added to the UTG call to review open tickets
      2. It was agreed at the September WGM that will be the single repository for external Code Systems at HL7. 
        1. A plan is being created and will involve a separate governance process for external code systems
      3. Per WGM, Reuben is creating and publishing a list of CodeSystems to be removed from UTG, including a deadline for community review
        1. The communication will include the action to be taken with the CodeSystems in question and the criteria by which they were placed on the list
      4. During a long discussion at the FHIR connectathon, it was decided that we will use NamingSystem for identifier management broadly.  
        1. This means immediately that we will have a NamingSystem resource instance for every UTG code system.   In addition, we are looking into adding something to the CodeSystem resource to indicate that it is a 'stub' i.e. an empty resource that exists solely to house informative metadata, but contains no content or technical information about the code system (e.g. hierarchy meanings, properties, case sensitivity, etc.)
      5. Need to define precise process to work through non-HL7 content in UTG
        1. Ongoing calls/meetings with Reuben, Ted, and Rob H to flesh this all out completely and bring to HTA and Vocab.   Working page of notes is here.
    4. Immediate Priorities
      1. Fix content issues (see Open Content Issues section above) and Publish Release 2.0.0 of the UTG content
      2. Continue to test the final process for implementing vocabulary changes
      3. Work on resolution of the new errors introduced by version 1.1.2 of the Publisher
      4. Finish educational materials for Submitters

  10. FHIR Tracker Items (Rob Hausam/Carmela).  Tabled to 9/17 call; request to prep for the session!
    1.  All folks are requested to join the every other Thursday calls on this topic because without attendees no decisions can be made.  The calls alternative with these main Vocab calls.

    2. There are a few issues currently marked 'ready to vote'; please look these over as we hope to vote on them on the call next. (same time slot as this call next week). The JIRA query for this is: The JIRA query is named Vocab: ReadyForVote.  There are a number of items in this ReadyForVote state.   We will work through some on the 9/17 call if they are ready and listed here.
      1. FHIR-26549 - ValueSet.identifier definition review requested as part of VSDP   voted on Vocab Main call, see ticket for vote.
      2. FHIR-28116 - ValueSet.compose.include.valueSet Extension - Title TRIAGED
      3. FHIR-28119 - ValueSet extension valueset-systemName - update description to include VSD alignment TRIAGED

        FHIR-28172 - discussed and will keep on the vocab list

        FHIR-27851 - should be discussed at the FHIR-I session. This code system should be moved.   (Ted added this ticket to the agenda, as an example of a general issue)

        FHIR-12655?? - defining expressions for codes in a code system, moved priority to low - this is a "nice to have"

        FHIR-27762 - CodeSystem constraint is incorrect - this is an example of where a mistake made its way into a normative resource. The constraint in question is csd-1. If this is truly a mistake, we might need to make a technical correction to R4.  (Ted added this ticket to the agenda as an example of a general issue) 

  11. Gender Harmony Project Update (Carol/Rob M)  
    Project is progressing.   Next project meeting is Monday October 5.  Preliminary work is complete albeit with some loose ends.  Plan is to begin the process to define the document which is planned to go to January ballot with a NIB deadline of November 1 and text document for ballot to Lynn by mid-November.  EBM project and the related Covid project have put out documents about creation of code systems; work with JBI has been referenced and is part of all of this.     This material is likely to be both useful and of interest to HL7 and its projects, and guidance for UTG and the Vocabulary WG.  An early draft can be found here.

  12. Liaison Reports     
    1. ISO (Ted) - Fall 2020 TC215 meeting is virtual only, scheduled for November 12-17.

    2. LOINC (Ted/Rob H) - New LOINC release: LOINC 2.68 and RELMA 7.1 are now available for download from the website.   LOINC has now been accepted as a member of the JIC.  Sarah at Rengenstrief has taken a new position, a number of open positions have been posted for LOINC.   New copyright statements that LOINC is mandating be used have been received.   We need to put in some effort to get the notices placed in al the mandated spots in UTG.  Dates for the LOINC Fall meeting Combined Lab / Clinical meeting 10/13 - 9:45am-10:45am EST and the Clinical Businss Meeting 10/16 - 11:00am-2pm EST confirmed; registration is open.  Other days and times that week will be the Lab meeting and various tutorials and presentations   Discussions with LOINC and HTA continue around the legal statements for LOINC content.

    3. HTA (Carol/Reuben) -  HTA call yesterday approved the DICOM change, and LOINC presented a change of ownership/stewardship of UCUM as well as URI change, copyright information around LOINC discussed.   Extensive work at last week's WGM.   The decision to have a single repository for all external stuff at and will be brought to TSC.  Work on some of the external material for Mary Kay has begun.   Carol and Reuben are on HTA, Rob M is liaison.

    4. SNOMED (Rob H/Reuben/Peter) - The next meeting is confirmed to be virtual and no charge.   It will be held October 8-9.   Registration at Work still moving ahead with SNOMED on FHIR and to bring an IG forward.   Work moving ahead with the Sushi and related tooling. Question on how we should represent a standalone extension in FHIR and UTG.   Recommend using a Fragment.   It is noted that a fragment cannot add new concepts or other structures, but a 'release' of core plus a national extension is considered a complete code system and not a fragment.  There is a new release of the Global Patient reference set and is now also available as an RF2 reference set.  Continued work on post-coordination.

  13. New Business
    1. EBMonFHIR are creating code systems for FHIR core.  There will be a lot of Concept Maps.  We should as this project (ie Brian) to give us occasional updates.

    2. A notification has been given that the FHIR release 4B is going forward.  See the zulip thread for details.  Impact wrt Vocabulary WG will be discussed on the next cochair call.

  14. Next call items
    1. See items remaining in RED above.

The call was ended and adjourned at 5:37PM EDT.  Next call scheduled for Thursday October 15, 2020 at 3:30PM Eastern US Time for two full hours, which would be two weeks from today.  We can consider moving the week for it if there is strong feeling that we should do so, otherwise the suggestion is to continue on the same cycle.  

Action Items

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