Attendance can be found here

Co-Chair and Key Participant information can be found on the Agenda found here

Discussion items

10:30Value Set MangagementTed
  • The FHIR API will be used to bring value sets into Trifolia.
  • Topics that require further discussion
    • VSAC efforts to clean up content have been undertaken and the question was asked when these will be available.
    • there is a need to clarify static binding
      • Rob McClure indicated that all statically bound value sets can change - especially regarding changes in versions of code systems - the US advanced directive is an example of this problem. Ted explained that implementation guides uses the binding terms to indicate where the statement of binding is held with static it is held within the implementation guide (dynamically bound - so that they can be modified and updated in the implementation guide). Static may be concepts which are specified outside th eimplementation guide. There are model structures where the value set or underlying code system can't be modified outside changes to the balloted model structure. All dynamic content is maintained outside the balloting cycle. There is a problem that many items are defined as static which should not have been defined that way.
      • Is this comment suffuicent for an STU comment saying that all static bindings should be removed as an errata.
        • Either remove all binding indications (indicate strength) or change all to dynamic? Implementation guides should not lock things down too tight. The expansion information needs to be more flexible. Put effort into maintenance informaiton to implementers to explain the requirements for expansions over time.
    Moved: that structured documents file an errata against consolidated CDA and possibly other implemetnation guides to change all static bindings to dynamic bindings.
    Moved by: Ric Gymeer, Kaye Dollen seconded.
    • discussion: that this be limmited to CDA at this point - this is a clarification.
    • VOTE: opposed 0, abstentions 0, approved 40

    • expansions of a value set definintion for a new code system and use of maps.
 Value Set DefinitionRob McClure

When a VSD is expanded against a new version of the code system, inactive codes drop out unless you ejxplicitely indicate that they should be retained as a legacy code.

The expansion project wants to show what a good expansion looks like but also how to create such a quality object. There is a very active project working on the issues raised.

There is a need to understand the changes affected by the use of a new VSD content. Implementers need a way and would like to be able to focus on the differences between versino A and version B - access to a Delta set to see the differences in expansions would be really helpful. A picture or artefact to understand these changes was called for.


A request for support for development of content for the UTG was made. UTG has a proposal for a new vocabulary object is being created - this will hopefully be a domain expert activity and UTG should have a sub process around creation of the draft proposal. the current process is all on the higher level governance processes, but this is a good request that is beyond the current scope deliverables but will be further considered in the future.

A request to harmonise value sets across th eproduct lines. It was reported by Vocab that this work is already underway and UTG will provide further guidance to facilitate this effort. OO is already undertaking this activity.

A project to unify content would be welcome within Structured Docs. Stewards of value set definitions need to be established for relevant content artefacts.

There are resourcing problems, for patient care in particular, but it is also a skill set which requires specilised tools and knowledge. Vocabulary has the core knowledge pool and we need to support the other domain oriented groups and work out how to do this. Help was requested - Vocab indicated that they have devleoped tutorials to support this need but if there is seen to be a need we will seek to run this again or consider the development of webinar material.

Also consider adding facilitator competency to the quality metrix.

Action items