Vocabulary Working Group

Meeting Minutes

January 2014

1  Attendees

Given Name / Family Name / Affiliation / eMail
Lester / Arthur / Miss Dept of Health /
Jos / Baptist / NICTIZ /
Rhoel / Barelds
Jim / Case / NLM/ NIH /
Kathleen / Connor / VA /
Carmela / Couderc / Seimens / carmela.couderc@siemens
Patty / Craig / The Joint Commission /
Rory / Davidson / IHTSDO /
Jean / Duteau / DDI /
Floyd / Eisenberg / Iparsimony /
Ana / Estelrich /
Chris / Fillmore / Systems made simple /
Sarah / Gaunt / Lantana /
Heather / Grain / eHealth Education /
Patricia / Greim / HHS/ONC /
Marc / Hadley / Mitre /
Russ / Hamm / Lantana /
Kendra / Hanley / AMA-PCPI /
Rob / Hausam / Hausam Consulting /
Peter / Hendler / Kaiser Permanente /
Catherine / Hoang / VA /
Wendy / Huang / CHI /
Stan / Huff / Intermountain Healthcare /
Julie / James / Blue Wave Informatics /
Crystal / Kallem / Lantana Consulting /
Daniel / Karlsson / phone
Rosemary / Kennedy / Ecareinformatics /
Ted / Klein / KCI /
Carol / Macumber / Apelon /
Rob / McClure / MD Partners /
Frank / McKinney /
David / Markwell / IHTSDO /
Riki / Merrick / Contractor for APHL /
Jane / Miller / IHTSDO /
Senthil / Nachimmuthu / 3M /
Lisa / Nelson / LOTS /
Frank / Oemig / HL7 Germany /
Craig / Parker / Intermountain Healthcare /
Vaspaan / Patel / NCQA /
Divya / Raghavachari / Accenture /
Guillermo / Reynoso / Termmed IT /
Mark / Roche / ONC /
Atanu / Sen / Accenture /
Mark / Shafarman / Shaferman Consulting /
Abdulmalik / Shakir / HI3 Solutions /
Anne / Smith / National Committee for Quality Assurance / On phone
Kimberly / Smuk / American Medical Association /
Robert / Snelick / NIST /
Harry / Solomon / GE /
Sandra / Stuart / Kaiser /
Sheryl / Taylor
Sylvia / Thun / HL7 Germany /
Robert / Turnbull / IHTSDO /
Lee / Unanyst / AND /
Mead / Walker

2  Sunday Q3

Chair: Ted Klein

Scribe: Heather Grain

Number of attendees: 9

2.1  Co Chair Assignments

Chairs and scribes for each session were established

2.2  Facilitator Training

There is an agreed need for consistent terminology use between SDOs to assist HL7 connection and interconnection for standards. Julie James offered to Assist Ted with resolution of comments related to Terminology Binding ISO work item. Binding Intensity is a term related to implementation which is not clear outside the immediate vocabulary community. Provision of material to support processes and implementation is needed. It is not clear how to structure much of this information for those who enter it new.

Educational material and tutorials need to be designed for a given audience -

For example: Vendors might include FAQs such as

·  What is an Hl7 vocabulary facilitator

·  Why and how does V2 differ from V3?

·  Is CDA different to V2 and V3?

·  Who needs terminology implementation knowledge?

·  How is HL7 coded content maintained?

Butch Arthur as a new attendee who offered to provide comment upon documents offering a new person perspective. Ted Klein offered to mentor Butch to assist with questions and access.

Action: Vocabulary WG to consider how to publish and develop FAQs. Heather to share the suggested questions with the list

Tutorial planning:

Action: Ted – review content of Vocab 1 to ensure data types are introduced. Heather updated the tutorial specification for this Tutorial and sent to Ted for confirmation.

Priority tutorials for Phoenix meeting - Vocab 1 (Introduction) and a new tutorial, using largely existing material Best Practice in terminology content development. Reconsidered on Thursday Q3.

2.3  Sunday Q4: Facilitator Discussion on facilitation

Chair: -

Scribe: -

Lack of quorum

3  Monday Q1 Agenda Planning and Project Review

Chair: Jim Case

Scribe: Heather Grain

Number of attendees - 14

3.1  Project Review

Existing projects and their status were reviewed.

Title / Status / Action
Characteristics of a formal value set definition. / Actively working on this with calls twice a week. The outline has been provided and the plan is to move this further forward at this meeting. This is now aiming for ballot in the next cycle. / Ensure intent to ballot documentation is submitted
Version 2.x examples verification and management / – stalled. The process is reasonably clear but the bandwidth of workers is not yet available. The objective is to have this ready for V2.9 ballot. Requests for V2 expertise to complete this were made. / Due date now 2015 - to be updated
Provide guidance on the use/role of interface terminology and reference terminology / 3 year plan item / No action
Document methods for establishing how to do conformance with post-coordination for HL7 / 3 year plan item / No action
Define a process to assign a single HL7 preferred value set and/or code system for specific coded attributes in HL7 standards / The notion of this comes from core principles. For many coded attributes the modelers have in mind a particular value set for an action, but the descriptive property for terminology guidance in the RIM in order to carry the guidance from the modelers to the implementers.
This provides a communication pathway. Review the requirements and possibly reactivate the project, and add that once the process is established training updates are also required. / Update this to specifically consider the scope and to consider the existence of the Terminology Authority where relevant – V2, FHIR, and need for tutorial support. Add to conference call agenda – Ted.
Determine a formal process for vocabulary maintenance / 3 year plan item / No action
LOINC Clinical document ontology / Preparing for ballot.
Review ISO Principles and Guidelines of Terminology Maintenance / 3 year plan item
Awaiting document from ISO process / No action
Vocabulary Conceptual Model / Develop a document to support V3 terminology implementers
3 Year plan / No action
OWL representation of HL7 V3 artifacts / Completed / Request MnM close this project
HL7 work group facilitator training / Heather has provided the scope of vocabulary tutorials and the relationship of this to facilitators. This meeting determined priorities for development and new material will be prepared for delivery in May / Inform Education and request date update to 2015
Vocabulary maintenance in the IHTSDO workbench / a wiki has been established to identify what we need form a tool. The objective is to be able to create reference sets from SNOMED CT and potentially LOINC and other systems. A WIKI has been created to support requirement collection.
IHTSDO are working on a new terminology management infrastructure. Take the harmonization proposal forms and checklist and use that as a requirements specification. There is a need to talk to IHTSDO but we agreed that this project should be to gather the requirements generically not just as they relate to this tool, Review this after clarification on the direction of IHTSDO tooling. Then modify this project statement and resubmit to TSC if necessary / Russ to review and update if necessary
CTS2 incorporation of SVS / – no report and lack of clarity. There is a need to update the dates on the project. / Confirm project facilitator and update if necessary. Also confirm the timeline expected.
Evaluate NLM Vocabulary Submission Tool (SCRS) at HL7 / Ted reported that we are waiting to hear from NLM about availability. We would need an external host and prepare a proposal but we need the date of code availability. / Ted to contact Vivian to confirm availability and potential date of availability so that project dates can be updated.
Refinement, Constraint, Localization Release 3 / To be covered in discussion with CGIT later this week / No action
V2 Tables Project / First pass complete but documentation of rules and review of decisions still underway. Suggestions for new formats will be discussed with publishing on Wednesday.
V2 code table versioning and alignment to V3 vocabulary model (Tables Project)
Project end dates and milestone dates. The project scope must also be reviewed to indicate V2.9 rather than V2.8. / Ted to update.
Ballot release 2 of core principles of V3 models / Ballot release 2 of V3 limited scope update.
Vocab content is resolved / Request an update from MnM on Wednesday
Ted to establish and publish location of a wiki page to hold all the actions needed for update of core principles.
Term Info / Ballot completed this round. Ballot reconciliation is to be undertaken this meeting and over the next few weeks. There is also further work required on the document. There will also be a need to address LOINC input shortly. / Rob H to update the project milestones after discussions this week.
Common Terminology Services - Release 2 - Implementation Guide / No report and lack of clarity. Dates on the project need to be updated / Confirm project facilitator and update if necessary. Confirm the timeline expected
Implementation model metadata documentation / Awaiting approval / No action
Binding Syntax for implementation guides / Target ballot was May 2011 / Update milestones and project end date as a result of binding syntax discussion at this meeting - Ted
CTS2 Normative / Comment disposition largely done, some model updates are needed but the final work completion date is the end of January. / Russ to update project end date to be updated to May 2014.

Some of these projects were described prior to work on definitions. The value set definition project may assist this project once it is complete.

Vocabulary Tutorials

Heather provided an updated

Facilitator training pathway was discussed as was the scope of Vocabulary tutorial content. The model below identifies the scope and the logical pathway for facilitator development. Pink learning topics are pre-requisites for vocabulary facilitator training. The green section is specific for Vocabulary Facilitators and is essential for them. They focus on requirements for vocabulary facilitation within HL7. The pale green is useful for Vocabulary facilitators and for others. The Blue represents a block related to implementation of vocabulary content and yellow to glossary development.

Rob McClure suggested that an additional tick on the Harmonisation Proposal Document be included for all HL7 products a question on whether vocabulary best practice has been followed.

Julie James suggested that vocabulary comments on ballots could be a means of educating and motivating. Heather suggested that this could be used in conjunction with having available appropriate training. The loop must be closed. It was agreed that the Vocabulary WG will take responsibility for getting the ball rolling and selection of a ballot or two to be reviewed with this in mind could be undertaken on a call.

There are significant issues wtih CDA vocabularies partly because it doesn’t go through harmonisation processes. This exception was granted in order to speed up the process. CDA ballots have far more vocabulary comment as a result of this.

4  Monday Q2 Value Set Definition Project

Chair: Ted Klein

Scribe: Heather Grain

Number of attendees: 20

Rob McClure provided details of the wiki: wiki.hl7.org/index.php?title=Value_Set_Definition_Standard_Project

This project identifies and describes metadata used in value set mechanisms.

This project also maintains documents on drop box. These documents are linked from the wiki to provide a permanent publically available document access mechanism. It was agreed that there would always be a publically available version on dropbox available through the link.

Meetings will be held on Wednesdays starting the 29th . The intention is to develop written materials for ballot consideration. The intention of the ballot is to describe names parts and to define whether they are required for a particular value set attribute. It is a normative specification. It has named components and their cardinality. In an annex the MIF will be included and an attempt to get a FHIR representation to indicate how the implementation might have different names but the components are used consistently.

DICOM is being published in XML this year and Harold indicated that there may be further examples which would be useful. Informative materials such as these could be published in many ways.

ACTION: Ted to submit intent to ballot

ACTION: Ted to arrange calls – Timetable Tuesdays at 4pm for 1 hour. Starting on the 28th of January.

ACTION: Rob to send updated meeting details

The value set element spreadsheet was reviewed. This document includes definitions, explanations, notes and metadata about each element, such as Source, Identifier, Name.

Heather suggested that specific headings are needed to describe what each component is, why we have it, how it is used, how it is constructed/represented or implemented to meet specific use cases.

This document is intended to represent a complete enough metadata statement to support governance of value sets. User stories are to be collected and included to make the content clearer.

Objective – persistent information authoring, maintaining, distributing, expressing, processing, to get a list of codes for use.

Value Set Identifier can be for example an OID what does that mean for me. What can change and what cannot change. Is directly associated with the semantic space for which the concepts in the value set are used. This is permanent the idea does not change.

The concept domain is the description of the purpose and semantic domain associated with the information model. The value set includes the business purpose and the means by which the implementation is achieved. The binding is where the two join. The value set will e more specific as it aligns with code system to be used.

IHTSDO have signed a contract on how to use SNOMED CT and LOINC together. The contractors would be interested in existing work on this topic. David requested members to contact him if they would like to contribute. Contact:

5  Monday Q3 Value Set Definition Project (Continued)

Chair: Ted Klein

Scribe: Heather Grain

Number of attendees: 30