TermInfo Conference Call Minutes
Wednesday, July 30, 2014- Time: 9:00 AM EasternTime (1300 UTC)

Chair: Rob Hausam, Scribe: Riki Merrick

Attendees: Rob Hausam, Jos Baptist, Daniel Karlsson, Yongsheng Gao, Riki Merrick, Clem McDonald

Regrets: Heather Grain, Lisa Nelson

·  Announcements:

o  Call for Nominations: As the U.S. Member of the International Health Terminology Standards Development Organisation (IHTSDO), the National Library of Medicine (NLM) is soliciting nominations of potential candidates for the four IHTSDO Standing Committees - Content, Quality Assurance, Implementation & Education, and Technical. These Committees have important roles in the ongoing development of the SNOMED CT clinical terminology and in the IHTSDO. Nominations are due to NLM by COB August 4, 2014.

o  Jos will not be available next week

· Review and approve minutes from July 16(deferred from last week)and minutes from July 23 – Motion to approve as distributed for July 16 and as corrected for July 23, Riki Merrick, Jos Baptist, no further discussion, against: 0 abstain: 1, in favor: 4

· Action items review and update(if possible, please send your updates in advance)

o From January 2014 (San Antonio) WGMTermInfo and Vocab quarters

§ Negation

§ Review and update Core Principles negation guidance (section 6.6 etc.)

§ Prepare Help Desk article on negation - when Negation update in Core Principle is completed, then this will be the follow up project to promote and make more accessible to general audience (?)

o From May 2014 (Phoenix)WGMTermInfo and Vocab quarters

§ Check with MnM if they want to Co-sponsor (Rob)

o Find and post remaining prior approved call minutes to the HL7 site (Rob)

o Need to group ballot comments so that group members can prepare ballot comment dispositions – send the ones you want to work on to the Skype list prior to the call (All)

o Create a FHIR "issues" document to track issues/items related to FHIR as we continue to progress through ballot reconciliation (Rob)

o Ask HQ if there is a way to give an introduction toTermInfoto the crowd at the FHIR Connectathon in Chicago (Rob)

§ example exercises

§ use of post-coordinated expressions

§ ASSERTION pattern issues

§ including query responses in FHIR

§ Observables discussion in IHTSDO

§ PRID property in LOINC

o Consider setting up a separate call to get Grahame on to get more clarity on what his query needs are for FHIR (Rob)

o Coordinatewith Linda Birdon IHTSDO work on allergies and adverse reactions (for potentialTermInfoimplications) (Rob)

o Coordinate withKirstine Rosenbeck Gøeg(from Denmark) on her IHTSDO SNOMED CT Implementation Advisor program work item that overlaps withTermInfo– use of SNOMED CT with different information models (HL7) (Rob)

· Ballot reconciliation forTermInfoDSTU(60+ min.)

o Clem McDonald will be joining us to discuss his comments - two Negative Major (#1 and #3), one A-C (#2), and one A-Q (#4)

#3: Section 2.2.3 Observation.code and Observation.value This is a universal realm standards – seems like this would work well in UK, but not in the US – where the HITS committee declared LOINC as the vocabulary for Observation.code (the OBX-3 equivalent in CDA) - this is a project of the HL7 Vocab WG

Post-coordination is allowed in v3, but this version of the document we were focusing on is CDA R2 – Clem’s concern is about representing the post-coordination in master files will cause a lot of issues – sa combinations

Post-coordination is allowed or not allowed by the data type in v3 – general principal

This document gives recommendations when you use SNOMED CT not that you have to use SNOMED CT

Would be nice to know, if there are instances where this is used in Lab reports. It is not very often used, probably wouldn’t hurt to leave it out and we should not explicitly disallow SNOMED CT expression

A SNOMED CT expression could be either a single concept or a grouping

In CDA we use R1 that only allows the use of qualifiers to sort of do this.

In LOINC we have the debate about including method in the code, so could potentially post-coordinate that - though there is a

Should just disallow post-coordination in THIS location, as it opens a whole lot of problems.

If we cannot forbid it, then at least don’t mention it here specifically.

Clem is not against using SNOMED CT expressions, just in THIS location.

So allow in Observation.value and be quiet on this in Observation.code – possibly create 2 subsections to deal with this.

Rob would like to do more research on the use of post-coordinated expression in Observation.code and possibly bring this up to the larger Vocab group.

Scope of TermInfo is to facilitate consistent use of SNOMED CT in HL7 standards – on top of this there are domain requirements. Particularly important for Observation.code, based on domain requirements.

Request is to not encourage it by calling it out specifically in Observation.code.

For the laboratory domain post-coordinated expression don’t seem to make sense with the master file exchange etc.

Send topic out to the larger vocab group and schedule a call, will inform Clem of the date and time, so he can attend.

#1: Overall comment: This is not giving normative guidance unless you are ONLY using SNOMED CT. We don’t want to have separate documents on how to use ‘vocabulary x’ with HL7.

Section 2.12: Not a lot in here – brings up mostly to look out for overlap of interpretation concepts described in SNOMED CT in Observation.value with codes used in Observation.interpretation.

Issue here is who controls the concepts that are part of Observation.interpretation, not so much whether this is represented in SMOMED in the long term. – Objection here is that the choice of content should not be open to everyone; need to double check the vocabulary binding on this field or base CDA R2.

Clem drops off – take #4 and UCUM discussion back up next week.

Clem seems to view this DSTU document in a different light than what we had intended – it was intended to give folks guidance when they decide to use SNOMED CT within HL7, which is allowed by the

o UCUM grouping comments (while Clem is on the call) - #36 (already voted), #84 and #85 – next week

o Four outstanding Neg-Mj comments (#196, #210, #211, and #215) from Lisa Nelson:

#196: Glossary improvement – should check with Heather, if she is willing to check the references for the existing entries. Not persuasive with mod – Ask Heather to take a look at existing terms in the glossary, Riki Merrick, Daniel Karlsson no further discussion, against:0, abstain:0, in favor:4

#210: Appendix A, Table 10: Possible rules – related to interpretation of double negation – this table is good example of why guidance is needed – may be add reference from Section 2.10 as well as mood code section above to this table. not persuasive – the tow preceeding paragraphs in A.6 explain this, so no action is required – Riki Merrick, Jos Baptist, no further discussion, against: 0, abstain: 0, in favor: 4

Status of spreadsheet at end of call:

Call adjourned at 10:33 AM EDT

Not further discussed:

o Additional Neg-Mi comments (32 outstanding), as time permits

o Review the comments and proposed dispositions sent to the TermInfo list yesterday by Riki, and further proposed dispositions expected to be sent to the list today

Additionalagendaitems (if time permits)

· Finalize updatedTermInfoPSS

o Final version on the updated template to be posted to the list

· Agenda items for next call

Futureagendaitems - pending

· Update onTermInfoIHTSDO 2014 SNOMED CT Implementation Showcase proposal

o Presentation dueFriday 10th October

· Update onTermInfowebinar and tutorial

o TermInfotutorial and webinar need coordination with the newImplementation of Terminologytutorial

o Expect that the tutorial will be presented again at the WGM in January

o Need to consider plans for webinar

· Update of planning discussion for DSTU re-ballot

o Jan. 2015 target

o Include LOINC? current RIM?

Call adjourned