Date: Sept 18 2019

Quarter: Q2

Chair- Joginder

Scribe- Erin

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."

Discussion items



AbdulMalik Shakir

Please see:VRDR Implementers' Community Meeting.pptx

Status: All ballot comments for both specifications have been addressed by the PH WG. Ballot content has been uploaded to GForge and are eligible to be uploaded to ballot site and then notify negative voters. AMS will notify the co-chairs when uploaded and ready to request withdraw.


  • 2 comments are awaiting resolution pending review with commenter. This is expected to happen while at the WGM.
  • Used column AI (substantive change) to indicate changes to the resources/profiles, vs change to narrative, typos. A summary of the profiles affected will be documented.
  • BIG changes:
    • Some comments suggested that the bundle within a bundle was too complicated
    • Some suggested that Task was introduced to help maintain state
    • Made a change to address both using a bundle, with a message using the Task resource.
    • Condition Resource is now being used, using a SLICE of evidence (observation) to indicate the support for this referral type. This replaces the bundle that was in the larger bundle
    • Will be producing samples
    • Harmonization of state machines- 360x IG standard was compared to our needs and came up with the states in common. Task resource has 2 statuses, Task and Business with bound value sets. The new state machine will replace what was originally provided.
  • There is a need to be able to send referrals through intermediaries and figure out how to structure this in FHIR, using messaging or RESTful Submit. In a RESTful Submit there is an expectation to not go through an intermediary. The community isn’t resolved on a single path so it’s felt that both should be supported at this time. Early adopters of FHIR hadn’t planned on using intermediaries or using messaging paradigm, though that is starting to change within some use case needs.
  • The AMA is potentially interested in advancing more specificity in doing referrals in FHIR (like specialty referrals in FHIR). Is considering putting forth a project proposal but has gotten push back in other workgroups similar to the push back we originally got. Would PH be supportive and be interested in participating as an interested party if for nothing more to then ensure that there is harmonization.
  • Publication request prep later this monthVRDR-
  • Also used column AI (substantive change) to indicate changes to the resources/profiles, vs change to narrative, typos. A summary of the profiles affected has been documented.
  • Scope limited to the communications between the jurisdiction and NCHS bi-directional communications.
  • The process was to transform the data collection form in a set of profile definitions.
  • The profiles are grouped into 4 categories:
    • Decedent demographics
    • Death investigation
    • Death certification
    • Decedent disposition
  • Can send profile groups independently if necessary
  • Made use of extensions, though very little. Took extensions from USCore Patient (demographics and address)
  • Included vocabulary bindings
  • Profiles are visualized in a UML diagram. Will be doing the same for BSeR
  • Were able to trace between our profiles and the similar set that the MITR group came up with.
  • Based the guide off of the DAM
  • Plan to submit publication request around early/mid-November.
  • Change proposals will be expected to logged in gForge, and then eventually Jira
  • Finalize changes to trial use specification by January 2021 to make may ballot cycle
  • Expected to go normative second half of 2021

STU releases-

  • We currently have 6 programs, would like to have a path forward to add other programs. How does the change effect existing trading partners? Would this just be additive? Is this considered substantive? We could consider this not substantive and therefore may not require reballoting.
  • The decision on how or what the release strategy should reside within the workgroup owning the project. But have to work that within the larger FHIR STU management.
  • R5 is expected to be published in 2020. This IG was initially balloted at R3, but will be migrating to R4.
  • Expecting by May that GForge will be retired and we will migrate over to Jira.
  • Established a Zulip chat and is active. Not appropriate to log and track change.
  • Have moved to Trifolia-on-FHIR tool for development;
    • There were some technical challenges, but those have been worked through
  • Once the implementation tools are ready, they will be made available in github.
  • There will be requirement to include in specifications a statement on security minimum requirements. Template will be provided.
  • Will try to have Lloyd to come to a WG call to discuss

Action items