Atlanta Working Group Meeting

Minutes Vocabulary WG

Atlanta Working Group Meeting

May 5-10, 2013

Sunday 5/5 Q3 Agenda review and v2.x tables project

Chair: Jim Case Scribe: Ted Klein

Attendance

Name / Organization / Email
Jim Case / NLM /
Wendy Huang / Infoway /
Sandy Stuart / Kaiser /
Julie James / Blue Wave Informatics /
Rob Hausam / Hausam Consulting /
Ted Klein / KCI /
Frank Oemig / HL7 Germany /

We began with the most recently published agenda – v7 – and went through each of the quarters assigning Chair and Scribe responsibilities. Jim agreed to send out V8 with the final assignments. We finished quickly, so decided to work on the v2.x tables review, as most of the key personnel on that project were in attendance. We began with table 78, and worked down to table 66. We also had a request to look at tables 64 and 62 from Michelle Williamson, as they are needed ASAP for a guide that she is working on getting released. We did those two tables as well. The minutes document from the tables project and the updated spreadsheet 32 were distributed.

We adjourned for the day at 3:00PM. No meeting Q4 today for vocabulary.

Monday 5/6 Q1 - Planning for week

Chair: Jim Case Scribe: Ted Klein

Attendance

Name / Organization / Email
Russ Hamm / Lantana /
Tammara Jean Paul / CDC /
Ana Estelrich / Phast /
Carol Macumber / Apelon /
John Carter / Apelon /
Russell Ott / Deloitte /
Rob Hausam / Hausam Consulting /
Amy Mayer / HL7 Australia /
Jim Case / NLM /
Nancy Orvis / DoD /
Ted Klein / KCI /

We focused on a list of specific items to work through in this planning and cleanup quarter. These were:

A. Agenda planning:

We tweaked some chair and scribe quarter assignments. The updated v8 agenda will be sent out immediately.

B. Document Ontology Project

Russ Ott showed the marked up PSS with the changes that Vocabulary had requested on the last conference call last week. Nancy Orvis (DoD) gave a brief overview of some of the Use Cases driving this project need. We reviewed the updates to the text, and removed the references to document type codes in SNOMED CT, as there are no compelling reasons to do any cross-map to SNOMED CT in this space. The proposers will decide with folks back at DoD and VA whether it can go as a DSTU, and Vocabulary will vote on this in Q3 today.

C. Action Items from calls

We will request an update on the conformance table wording from CGIT in our joint session later in the week.

Russ will get some harmonization process facilitator materials to Jim for Friday morning.

Russ will follow up with some USCRS information for the tooling session.

D. Action Items from Phoenix

We will discuss the IP IHTSDO letter in this quarter.

The MVX/CVX document still has not been started.

The v2.8 INM item will be discussed in our joint INM session

The publishing item will be discussed in our joint Publishing session.

E. IP letter to IHTSDO

Ted described the two issues. We agreed that the two issues described in the letter are the only value set issues around IHTSDO IP.

We adjourned at 10:30AM; we will reconvene in the same room for Q2.

Monday 5/6/2013 Q2 – PBS metrics and vocab projects

Chair: Ted Klein Scribe: Jim Case

Attendance

Name / Organization / Email
Russ Hamm / Lantana /
Rob Hausam / Hausam Consulting /
Amy Mayer / HL7 Australia /
Carol Macumber / Apelon /
John Carter / Apelon /
Ana Estelrich / Phast /
Tammara Jean Paul / CDC /
Jim Case / NLM /
Ted Klein / KCI /

Lynn Lasko was asked to attend to help the WG determine how to improve the status of the WG with regards to the PBS metrics. The specific issues included:

-Of the 11 projects that vocab have on project insight, we are behind 120 days on updating the milestones for 5 of them. Each project needs to have a status update and then update on project insight.

-We have a project on hold that has not been reviewed.

-The WG has not done a revision of the three year plan and have no three year planning items; i.e. what is the WG planning on doing for the next three years. Medium term objectives for future work. If we do not have plans to take on new work over the next three years, we cannot fulfill this requirement. The WG is primarily reactive with the projects due to changing priorities. To get around this, we need to put a three year planning item at the maximum milestone date. Alternatively we can expand the scope of existing projects if we anticipate that one existing project is sufficiently close to completion.

• ACTION: determine the responsible party to do these updates.

Project review:

Item 806 – Development of policies and procedures for terminology authority. Need to update the milestone date ACTION: Jim will update project document repository link and date and send to Lynn.

Item 947 – HL7 vocabulary maintenance in IHTSDO workbench – Need to update the milestone date. ACTION: Russ will provide a new milestone date for the project.

Item 849 – Terminfo. Need to provide a new project milestone date ACTION: Rob will provide a new milestone update date.

Item 495 – SKMT glossary. Need to know the new end date for the project and a new milestone date. ACTION: Heather to provide these dates for the project as well as a project repository URL. Any additional updating that would clarify the status of the project would be helpful. The end date will be the finalization of the processes for updating the SKMT.

Item 945 – USCRS evaluation. Correct the TSC approval date. New milestone date needed and new project end date determined. ACTION: Russ will provide new milestone dates and project end dates as well as the document repository location.

Item 308 – Vocabulary conceptual model. No project end date and primary lead is no longer participating in HL7. Recommend cancellation of this project due to lack of resources. ACTION: Jim will notify Lynn that the project has been cancelled. MOTION: Cancel the project as an active and add it to the three year plan Jim/Rob VOTE: for 10/ against 0/ abstain 0

Item 324 – CTS 2 normative. Need to update the milestone date to September 2013. ACTION: Russ will update Lyn with the new milestone date.

Item 499 – review ISO principles and guidelines for terminology maintenance. No project end date and primary lead is no longer participating in HL7. Recommend cancellation of this project due to lack of resources. ACTION: Jim will notify Lynn that the project has been cancelled. MOTION: Cancel the project as an active and add it to the three year plan Jim/Rob VOTE: for 10/ against 0/ abstain 0

Item 839 – CTS2 IG. The milestone and project end dates need to be updated. ACTION: Russ will contact the project facilitators for new project dates.

Item 946 – CTS 2 incorporation of SVS. Need new project end date and milestone date. Need URL for project repository ACTION: Russ will contact Craig Stancil for new dates.

Discussion of the three year plan:

Using the Structured documents three year plan as a template the vocab three year plan was developed to include the two projects that had been cancelled as active projects will be added for initial review by the Vocab WG ACTION: Jim will provide the initial items and send them to Lynn upon approval by the WG.

Current items:

• Provide guidance on the use/role of interface terminology & reference terminology. To include the role of display names & discuss other types of terminologies such as indexing terminologies.
• Document methods for establishing how to do conformance with post-coordination for HL7 so that implementers and the community have some kind of solution. A schema for post-coordinated constraints has been produced by the UK. This will be leveraged
• Define a process leading to the ability to assign a single HL7 preferred value set and/or code system (as defined in core principles) for specific coded attributes in HL7 standards (V2, V3, CCOW etc) and manage these preferences.
• Determine a formal process for vocabulary maintenance that includes timelines, allows for interdependencies, and leverages the Vocabulary metamodel as and when developed. Define the requirements and analyze the gaps for tooling to support and implement the process. We acknowledge the requirement for funding to progress this project.
• Additionally, need to update the version 2 terminology model to match the version 3 terminology model.

We adjourned at 12:30PM for lunch, and agreed to continue a few unfinished items in the next session.

Monday 5/6 Q3 - Value set representation in printed implementation guides

Chair: Russ Hamm Scribe: Jim Case

Attendance

Name / Organization / Email
Jim Case / NLM /
Ted Klein / KCI /
Russ Hamm / Lantana /
Wendy Huang / Infoway /
Tammara Jean Paul / CDC /
Ana Estelrich / Phast /
Sandy Stuart / Kaiser /
Nancy Orvis / DoD /
Chris Brancato / Deloitte /
Russell Ott / Deloitte /
Tricia Greim / VA /
Rob McClure / MDP /
Carmela Couderc / Siemens /
Harold Solbrig / Mayo
SenthilNachimuthu / 3M /

Continuing the project review:

Document ontology PSS revision

This topic was continued from Q1 for the owners to decide how they wanted to represent the ballot in the LOINC clinical document ontology PSS, i.e either as a DSTU or informative ballot. Russ Ott made some minor revisions based on input from SD. They have decided that they will ballot as DSTU. The focus will be on data elements for query. The changed elements were approved by SD.

MOTION: To approve the revised PSS as presented RussOtt/ Ted VOTE: for 13/ against 0 / abstain 1

Value set representation discussion

Presentation by Russ Hamm to describe the issue. (Slides from Russ).

Question: what about expressions where there is no display name, since SNOMED CT does not provide displaynames for post-coordinated expressions? MIF did not support display names until version 2.1.7. HL7 has been silent on human readable display names on value set expansions.

Russ presented a draft disclaimer for value sets in implementation guides.

Additional question – Should HL7 make specific recommendations for what display name should be used? Discussion about being more restrictive than what came out of the displayname project ensued. Some wanted the description that is actually published to be more constrained to one class of description (e.g. FSN, Long common name, etc.) Suggestion that what is published in the IG would be listed as an “example” description in addition to the disclaimer describing appropriate use of descriptions.

Discussion around using descriptions that are not part of the code system exposed some difficulties with how to interpret the proposed disclaimers. It was suggested that the final policy be published as part of the general guidance for the use of displaynames in value sets in published IGs. Since this topic was limited to published implementation guides, the other identified difficulties with displaynames was deemed to be out of scope.

It was recommended that this topic be brought up with Structured documents as a recommendation from Vocabulary. Russ will add the additional disclaimer that the descriptions are only illustrative and not prescriptive in terms of descriptions for a particular value set.

IETF language discussion

Background – There is a data type property for language code defines a particular code system that it is bound to. For language, the code system that was defined has been superseded twice. The current code system defined in the R2 data type is twice obsolete. The organization behind the code system defined a code system that includes other code systems. There is no way to currently specify how a CTS 2 system can provide a value set expansion. Since the IETF codes system is made up of other code systems and these change every 2-3 years, you cannot specify a version for the code system. However, the language code is universally bound to the model, so there is no way to be complaint. At harmonization it was decided the human language code system is universally bound, but now it is not possible to fully populate the CD data type in any conformant way.

The problem discussion identified the ubiquitous use of the IETF code system in W3C documents. One suggestion was to create a reference set for “patient language” and then version the reference set. You would still use the IETF OID as the source. The issue is with the universal binding by HL7 that restricts the use by some jurisdictions to how the IETF values can be used. Vocabulary WG has asked to relax the binding, but MnM has pushed back on this request. Another suggestion is to create another concept domain to solve the problem, but that seems like a work-around that is not a true resolution of the issue. The position of vocabulary is to loosen constraints to meet the “real-life” use cases. This will be discussed at the MnM joint meeting on Wednesday Q2.

OIDs for v2 code systems

This topic was related to the v2-v3 terminology model project. PHER has requested 4 new OIDs for tables. They have expressed extreme urgency to get OIDs by tomorrow for their discussion. During the v2-v3 project, we have found hundreds of errors that need to be addressed by chapter editors.

There are two tables that have OID requests (62 and 287). Question is whether this should be addressed without the chance to fully review the request and get the value sets fully documented by the steward committee. We need some assurance that PHER will provide the complete documentation for the requested tables. Resolution was not finalized.

We adjourned at 3:00PM.

Monday 5/6 Q4 - Joint with Tooling, vocab hosting

Chair: Russ Hamm Scribe: Jim Case

Attendance

Name / Organization / Email
Jim Case / NLM /
Ted Klein / KCI /
Russ Hamm / Lantana /
Wendy Huang / Infoway /
Tammara Jean Paul / CDC /
Mark Shafarman / Shafarman Consulting /
Sandy Stuart / Kaiser /
Andy Stechishin /
SenthilNachimuthu / 3M /

The two projects joint with tooling are USCRS evaluation and IHTSDO workbench

USCRS status – working with NLM to determine the need for technical support by HL7. Query has been sent to NLM for technical infrastructure and then these will be communicated to HL7 technical staff to determine when/if they would be able to support an instance. Electronic services WG is aware of the project and they are not pushing the project due to lack of resources to implement.

Question: When the technical requirements are identified, will technical resources be available to work on the project or will this be a roadblock to the successful implementation of the project? It is unknown.

Review of PSS for USCRS evaluation. It is not essential that HL7 host the test instance, although it is not possible to test it in the HL7 hosting environment unless resources are available. Discussion on the approach to the evaluation ensured with additional details on how to structure the functional requirements.

Suggested that we begin taking a scheduled time on future conference calls to begin to develop the functional requirements that will be needed to fully evaluate the tool. A limited set of high priority use cases will be used as the starting point for the development of these functional requirements.

ACTION: Russ shall enumerate the high level harmonization requirements as the starting point for the functional requirements needed to evaluate the USCRS. He will present at a future vocab WG conference call.

IHTSDO Workbench

Russ has started to put together the evaluation criteria and statement of work. The anticipated effort is most likely greater than can be accomplished by volunteer effort. Most likely this will be constrained by the current tooling budget.

ACTION: Russ shall complete the evaluation criteria and draft statement of work for the vocabulary maintenance and IHTSDO workbench evaluation project.

Andy mentioned that he is no longer able to serve as the tooling liaison to Vocabulary. The value of having joint meetings was recognized but there will be a need for a new representative. Ted asked for clarification of the liaison relationship. It is unclear whether another tooling WG member is available to serve as the liaison. It is possible for vocabulary to identify a person to serve in this role. Should be added as an agenda topic for future conference call.

ACTION: Ted shall add this to the agenda for future vocabulary conference call

Tuesday 5/7 Q1: Terminfo, negation discussion

Chair: Rob Hausam Scribe: Ted Klein

Attendance

Name / Organization / Email
Jim Case / NLM /
Ted Klein / KCI /
Julie Richards / RGC /
Ann Wrightson / NHS /
Jean Duteau / DDI /
Michael Tau /
Rob McClure / MDP /
Hugh Glover / Blue Wave Informatics /
Julie James / Blue Wave Informatics /
Jason Kratz / Epic /
Amy Mayer / HL7 AU /
Rob Hausam / Hausam Consulting /
Mark Roche / Roche Consulting /
Carmela Couderc / Siemens /
Lisa Nelson / LOTS /
David Markwell
Heather Grain / LG Informatics /
Jim Carlson / CAP
Ron Van Duyne
Wendy Huang / Infoway /

We had a number of remote attendees on the speakerphone – David Markwell, Heather Grain, Ron Van Duyne, Jim Carlson, and Daniel Kratz. We did introductions, total of almost 20 attendees (see attendance list).