HL7 Vocabulary Minutes – San Antonio
January 2017
Q3 Sunday - Agenda Planning
HL7 Vocabulary Meeting MinutesLocation: San Antonio, TexasUSA
(CP co-chair present), P Present, T present on telecon. / Date:2017-January 16 – 20
Facilitator / Ted Klein / Note taker(s) / Heather Grain
Attendee / Name / Affiliation
PC / Jim Case / NLM / .
PC / Ted Klein / Klein Consulting / .
P / Hugh Glover / Blue Wave
P / Greg Gustafson / PenRad
PC / Rob Hausam / Hausam Consulting
PC / Rob McClure / MD Partners
PC / Heather Grain / Global eHealth Collaborative
Quorum Requirements Met:Yes
All changes to the agenda were logged on the wiki: http://wiki.hl7.org/index.php?title=Baltimore_Sep_2016&action=edit
Sunday Q4 Project review and Training Review
HL7 Vocabulary Meeting MinutesLocation: Baltimore, USA / Date:2017-January 16 – 20
Facilitator / Ted Klein / Note taker(s) / Heather Grain
Attendee / Name / Affiliation
PC / Jim Case / NLM / .
PC / Ted Klein / Klein Consulting / .
P / Susan Barber / TN Dept of Health
P / Greg Gustafson / PenRad
P / Oyvind Aasse / Norway Directorate of e-Health
PC / Rob McClure / MD Partners
PC / Russ Hamm
PC / Heather Grain / Global eHealth Collaborative
Quorum Requirements Met:Yes
Project Review
All Vocabulary projects on Project Insight were reviewed: (http://www.hl7.org/special/committees/projman/searchableprojectindex.cfm?sortBy=&sortDirection=&FilterKeyword=&FilterProjectNumber=&FilterProjectSponsor=Vocabulary+Work+Group&FilterProjectType=&FilterStatus=notArchived&FilterProductType=&FilterDateField=&FilterStartDate=&FilterEndDate=)
Only projects that are active (not awaiting approval) were discussed at this meeting.
Project 1197 Terminology Quality Development and Management Processes (TQA)
Project was reviewed. The scope of items within this project is being progressed through overview and focus on resolution of specific issues. There is a need for TQA review of the Governance process documentation. First project call for this project should review the scope items and the priorities for each action to ensure the coverage and progress management for this project.
Project 1247 HL7 FHIR vocabulary specification updates
Leader Rob Hausam, and Ruben Daniels - This project gives ownership of the Vocabulary specifications in FHIR to Vocabulary. The vocabulary pieces and resources should be governed by Vocabulary. This process is to define the management process for curation of the relevant resources.
ACTION – Jim will follow up with Ruben and Rob to find out the status of this project.
Project 1306 Unified HL7 Terminology Governance Process
Approved by Vocabulary, awaiting approval from MnM and HTA. Discussed formally tomorrow.
Action: Ted following up with other work groups. HG to put on HTA agenda (done).
Project 849 Terminfo
Focus between now and Madrid will be to establish guidance for the use of SNOMED CT in FHIR resources.
Project 1047 Characteristics of a formal ‘value set definition’.
This is DSTU seeking comments. No action now. Review issues identified in September meeting to plan actions beginning January 2018.
ACTION - done: Agenda requires a quarter for this activity in the September meeting Jim Case has put it in Monday Q3.
Project 630 Develop and publish principles and guideline for syntax for vocabulary binding
To be discussed in Q2 Thursday. Move this project to Vocabulary rather than conformance.
Project on Tooling
The group were unable to find the project details for Vocabulary Tooling. There is a known PSS which was approved but it is not showing in project insite.
ACTION: Russ will investigate and report.
Action Item Review
The action item list was reviewed and updated. See the updated file at: http://www.hl7.org/documentcenter/public/wg/vocab/VocabActions%20as%20at%2016%20January%202017.docx
Vocabulary Tutorial Review
Heather Suggested the following webinars for development
· Intro to TermInfo – needs a more descriptive title for those who don’t know what TermInfo is. – how use snomed CT in HL7, including FHIR.
·
Prepare a harmonization proposal
Heather prepared the first draft and the meeting reviewed the tutorial specification see V4 of this document.
Monday Q1 Terminology Governance Project and Tooling
Co-chairs in bold.
Facilitator / Jim Case / Note taker(s) / Heather GrainAttendee / Name / Affiliation
P / Jim Case / NLM / .
P / Heather Grain / Global eHealth Collaborative
P / Ted Klein / Klein Consulting
P / Carol Macumber / Apelon
P / Russ Hamm / IMO
P / A. Maclean / Infoway
P / Carmela Couderc / IMO
P / Brian Pech / KP
P / Daniel Karlsson / HL7 Germany
P / Raychelle Fernandez / VP DHIT
P / Rob McClure / MD Partners
P / Greg Gustafson / PenRad
P / Susan Barber / TN Dept. Health
Quorum Requirements Met:Yes 12 present plus chair.
Objective to provide a single source of truth for all terminology artefacts which an also support FHIR requirements. Ted Klein shared documentation about this project and sought input from the WG.
This is to develop a process recommendation to replace harmonisation process and fold in the governance requirements for all terminologies across all HL7 product lines. The process must also be open, asynchronous and maintainable. This is intended to be available to non-members of HL7. It must be easy to use and available internationally to encourage those who are not familiar with the detailed processes of HL7. The process must be reconciled with the ballot process, ANSI rules.
Drafts will be available on the project page but this has not yet been set up.
The process includes:
· Openness – anyone may submit a proposal. An artefact is saved which represents their requirements/changes etc. Submission notifies relevant stakeholders, different kinds of proposals for different kinds of objects may have different balloting rules to meet practical requirements.
At the end of timeframe, or all requirements are met
It may pass, fail, or have controversial elements. If failed it is archived. If it passes it goes into a queue to have the approved changes applied to the central terminology store. The terminology store is being defined by Vocab, HTA in collaboration with Tooling.
Specific issues include
· Structural terminology – bound to standards rather than records or clinical practice. Table of data types in V2 standards. In V3 these are the mood codes.
· Domain Content Terminology – codes chosen to represent concepts in HL7 standards
· External Terminology – the code systems used in HL7 standards but maintained by others.
Ted presented diagrammatic explanations of the draft processes. One of the issues is where comments are handled. There were two options.
a) That comments are dealt with either by terminology curator
b) Documented disposition which recycles into the ‘ballot’.
Input and assistance is needed to define a pass and consensus management
Link to document discussed: http://www.hl7.org/documentcenter/public/wg/vocab/UTGPdocument_v4.docx
Terminology curation must be adequately resourced. It is currently estimated that the terminology curation would require approximately 4 hours per week, based upon an estimate of the workload estimating the current number of requests. It is more difficult to estimate the load for harmonisation across the product family. The proposal includes the need to fund the hours required for terminology curation.
Alterntive methods of resolution of issues which arise were discussed. It is hoped that most content modifications will occur through work groups and simple, flexible resolution processes – documented and formal but able to be managed through calls etc. Where there is a highly contentious issue which cannot be resolved through the simpler process there may be a need for an HL7 Harmonisation Face to Face Meeting (occurring at HL7 WG meeting). The diagrams in the diagram seek to provide a simplified view of the process.
Monday Q2 Terminology Governance Project and Tooling
Co-chairs in bold
Facilitator / Jim Case / Note taker(s) / Heather GrainAttendee / Name / Affiliation
P / Jim Case / NLM
P / Heather Grain / Global eHealth Collaborative
P / Ted Klein / Klein Consulting
P / Carol Macumber / Apelon
P / Russ Hamm / IMO
P / A. Maclean / Infoway
P / Carmela Couderc / IMO
P / Daniel Karlsson / HL7 Germany
P / Rob McClure / MD Partners
P / Greg Gustafson / PenRad
P / Susan Barber / TN Dept. Health
Quorum Requirements Met:Yes 10 present plus chair.
Continuation of the previous discussion in Q1.
Confirmation that the process is not limited to the HL7 ballot process it operates outside that cycle. The publication of ballot content would be an extract from the current or specified version of content from the terminology store.
It was acknowledged that there is still considerable evolution required, including the definition of extensions to the HL7 vocabulary model to support our requirements. It is expected that none of the existing models will be sufficient for what is required.
There is a need to make the relationship to ballots and engagement clearer.
Action: Ted will send out a revised draft to the vocab. List.
Consensus management
This process replaces the harmonisation process currently in place.
Step 1: is to determine the requirements for the consensus pool. What is pass / fail etc.
Step 2: how to make the community aware that there is a pool available for comment and that it is open.
Step 3: Submitter begins the process for changing/adding to the terminology store. This may be a person, a group or organisation. There is a need to differentiate between the point of contact (called the submitter) and the group responsible for the request (proposer).
Action: Ted – update Endorsement acquisition process document - should indicate community engagement more clearly. Update community on the diagram to consensus pool.
Information is needed on changes made to the request and the tooling must support these requirements.
There was significant discussion on the levels of status information. Canada’s experience shows that keeping it simple has many advantages. There may be advantages to keeping it simple in early tooling to learn what is really required. Reduce errors and efficiency of editing, proposing and applying changes needs to be considered. Tooling is there to make quality processes easier to achieve.
Monday Q3 Tutorials
Co-chairs in bold
Facilitator / Rob McClure / Note taker(s) / Heather GrainAttendee / Name / Affiliation
P / Russ Hamm
P / Heather Grain / Global eHealth Collaborative
P / Carmela Couderc / IMO
P / Greg Gustafson / PenRad
P / Susan Barber / TN Dept. Health
Quorum Requirements Met:Yes
Free tutorials – the PowerPoint should be available for these presentations. Heather confirmed that the PowerPoints for all tutorials are available when you enrol in a tutorial. If it is a free tutorial, therefore the PowerPoint is free.
Facilitator Roles and Responsibilities webinar is done and available.
Action: Ted to complete Harmonisation Preparation webinar
Request that Vocabulary do an audit on the FHIR vocabulary tutorial. This was welcomed by the Education WG.
When tutorials are given collect questions, which can be included in webinars. Webinars should all include what are the things we assume you know and where do you go next. Learning pathways should be clear and contact details for more questions and information should be provided.
Create webinar for code systems and terminology selection – short web session also has a specific page in resources with all the relevant linkages.
Divide the authoring value set into sub webinars. Examples of good and bad practice need to be collected. Select a collection which cover the bases, some intentionally defined and extensionally defined, some with includes and excluded. These examples should be able to be understood without being a clinician.
We need to create a repository of examples of good and bad or reasons why one approach is better than another. The intention is to gather resources which can be used in tutorials but also be referenced to help people understand the pitfalls and opportunities relevant to terminology specification.
Action: All send examples of good and bad terminology artefacts to Heather.
Action: Russ will come up with a few examples of value sets and represent them in FHIR specification format
Action: Heather Grain to collect and consider how a repository of these examples could be published.
Concerns over our ability to inform co-chairs and others regarding vocabulary activities – This page is specifically for facilitators and others interested in vocabulary processes.
This could include if you have new content requests, new tutorials available.
Ability to have a watch facility. If they subscribe to the page they will get a notice of what’s new. Could use the vocabulary standards portal
Q4 Monday TermInfo
Facilitator / Rob Hausam / Note taker(s) / Rob McClureAttendee / Name / Affiliation
P / Oyvind Aasse / Norway Directorate of e-Health
P / Susan Barber / TN Dept of Health
P / Jim Case / NLM / .
P / Carmela Couderc / IMO
P / Greg Gustafson / PenRad
P / Russ Hamm / IMO
P / Rob Hausam / Hausam Consulting
P / Mark Kramer / MITRE
P / Rob McClure / MDP
P / Ricki Merrick / APHL
P / Daniel Karlsson / HL7 Germany
P / Peter Jordan / HL7 New Zealand
Quorum Requirements Met:Yes 11 plus chair
SCT and HL7
SCT.org working directly in two places in HL7:
a) FHIR
b) CIMI
c) And liaison for content through HTA
HL7 Vocabulary portal allows download of SNOMED CT for use in HL7 artifacts – see link: http://www.hl7.org/portal/index.cfm?ref=common
TermInfo Implementation Guide
Discussed current ballot on V3 is now out 2 years. No discussion needed on this activity at the moment.
TermInfo and FHIR
Should Terminfo for FHIR be the next TermInfo task? SNOMED.org working on some guidance on use. Coordinate with SNOMED International (formally IHTSDO) work on that (Linda and David are on the implementation side, Jim is working on making the content work, if new content is needed)
Review the collaborative work proposal.
How is this different from working with HL7 overall work with other standards? Just the fact that they are picking the standard to work with – all product families have value sets may be a scope issue. We want to support rapid development of FHIR standard. FHIR has expressed interest in work with SNOMED International under the overall agreement with HL7.
CIMI is another group that is doing similar things, but they are not a product family, but CIMI models are being used in FHIR resources - CIMI representatives were involved in planning of this document.