HL7 Terminology Authority Call
Minutes
HL7 Terminology Authority Meeting AgendaLocation: San Antonio, Texas, USA / Date: 2016-01-20
Time: 9am – 12:30pm
Timezone, USA Central Standard Time
Facilitator / Heather Grain / Note taker(s) / Heather Grain
Attendee type H - HTA Member
O - observer
L - liason / Attendance
P - present
A - Apologies
N - not present without apologies / Name / Affiliation
M / P / Heather Grain / Global eHealth Collaborative
M / P / Rob McClure / MD Partners
M / A / Sandy Stuart / Kaiser Permanente
M / P / Jean Narcissi / American Dental Association
M / P / Ted Klein / KCI Inc.
M / A / Julie James / Blue Wave Informatics
O / P / Susan Barber / TN Dept of Health
Quorum Requirements Met: Yes 3 members plus chair
Q1
1Opening Business
1.1Welcome and Agenda Confirmation
PSS review and Harmonisation meeting report were handled earlier due to the need to get information to the meeting before people disperse.
1.2Minutes of Previous Meeting
Minutes of meeting 10 January 2017
Motion: Jean moved that the minutes be accepted with the following note about SNODENT and that the new format is acceptable. Seconded Rob McClure
Discussion on SNODENT – the relationship between SNODENT and Snomed international is not relevant to HL7. SNODENT is an independent code system, it requires acknowledgement of the IP independent of SNOMED International.
Vote: Against 0, Abstain 0, in Favour 3
2SNOMED International
2.1Free Sub-Set
2.1.1Rob Hausam potential free subset from International Patient Summary Project
Presentation
Questions:
- We would also like to understand the potential overlap of use for the value sets by other HL7 products.
- It is yet to be determined whether large value sets will be accepted in the 'free subset' offering. If they are not, we will then have to consider what HTA will do about it.
Rob Hausam was not present but the meeting discussed the approach to take to the free subset to meet HL7 needs. This approach is described in 2.1.2 and 2.1.3 below and this was discussed with Rob Hausam in the break between quarters. He was supportive of this approach.
2.1.2New Content
Should any requests that come to HTA for the international release go into the HL7 Free Subset? The feeling is yes. If information is coming forward for national use from a group not currently a member of SI – we are unable to request or provide this information as it is not international. If information is an international requirement and it goes through HTA.
Moved: Ted Klein and seconded Rob McClure that all new SNOMED CT content requests specific for HL7 be requested to be part of the free subset.
Discussion:
If a workgroup puts a request to harmonization for data which includes value set content which is SNOMED CT will generate a request for inclusion of this material in free content. We do not yet know the mechanism for establishing and maintaining the list of concepts be part of the free set.
Vote: Against 0, Abstain 0, In Favour 3
Action: Initial request for free subset to be made for the FHIR nutrition set. HG to discuss the process for free subset with SNOMED International.
2.1.3Free Subset Content Approach
Focus on core areas of HL7 standards, FHIR and specific requests from individual working groups particularly asFHIR is the leading edge of HL7 standards. It is understood that free content includes the concept ID use and the FSN Description use without relationships or additional descriptions or any functionality specific to SNOMED CT
Motion: Moved Rob McClure and seconded Ted Klein that:
- HTA define the process for free subset development and communicate to the Board for their approval
- Initial free subset to be defined as SNOMED Concepts represented in FHIR core SQ3 (except for those which references all of SNOMED CT).
- Additional content to the free subset will come from
- New content requests from HL7
- Workgroup specific requests for additions to the free subset.
Vote: Against 0, Abstain 0, In Favour 3
Action: Pre-draft process for Board submission – this document should not be detailed but cover the basic processes. This is because the details may change but the basic steps are less likely to do so. Rob McClure and Heather Grain.
The motion will be the basis of this document
Action: Heather to ask Grahame to provide a list of all the SNOMED CT International content used in core FHIR
Action: After Board approval submit the list, plus the new content request to SI
2.1.4Harmonization question
During harmonization, the question must be asked whether any of the content is new. And if it is new and has not gone to HTA it will be sent into the HTA request submission process.
2.1.5Definition of sub-set requirements and specification
Review of DICOM agreement between SNOMED International and the draft process and example use case for IHTSDO.
3Content Requests
3.1FHIR
Discussion on process for requesting content and method of enabling this change. The initial request from FHIR was for nutrition content to be promoted from the US edition.
Heather has access to the IHTSDO workbench and will make the submission for the nutrition information from FHIR- Heather will document and share the process with the HTA and the next request we get will be done by another member of the HTA so that the process can be improved.
Ted will add this documentation and process for request submission for harmonization. Ted will put this together in the next week or two and report on the next call.
Heather to prepare a short statement for the newsletter
Heather to continue discussion discussions with Pat on Alternatives for communication.
Jim Case indicated to Heather that he will forward any such requests received in future to the HTA.
3.2SNOMED CT
Alleles
Rob McClure to report on advance requirements for Alleles question (from Montreal meeting)
No further action is needed – the group are considering their content requirements and these may come to the HTA in the future.
Q2
HL7 Terminology Authority Meeting AgendaLocation: San Antonio, Texas, USA / Date: 2016-01-20
Time: 9am – 12:30pm
Timezone, USA Central Standard Time
Facilitator / Heather Grain / Note taker(s) / Heather Grain
Attendee type H - HTA Member
O - observer
L - liason / Attendance
P - present
A - Apologies
N - not present without apologies / Name / Affiliation
M / P / Heather Grain / Global eHealth Collaborative
M / P / Rob McClure / MD Partners
M / A / Sandy Stuart / Kaiser Permanente
M / P / Jean Narcissi / American Dental Association
M / P / Ted Klein / KCI Inc.
M / A / Julie James / Blue Wave Informatics
L / P / Wayne Kubick / HL7 (CTO)
O / P / Susan Barber / TN Dept of Health
O / P / Patricia Van Dyke / HL7 Board
Quorum Requirements Met: Yes 3 members plus chair
Further discussion on Free Set
Review of activities from prior session.
4Tooling
4.1Identifying code systems in use (Trifolia)
HG to report back on discussion with Sarah Gaunt and Ted reported on his discussions. It has been identified that there is no single source of truth for migration to a single repository forCDA HL7 material. Trifolia is a source but not necessarily complete. The best complete and error free source is ArtDecor and secondly VSAC.
Rob McClure indicated that they have changed their tooling and are doing a better job of keeping things up to date. It should not be the place people go to get content. Until we can offer a better solution it is difficult for us to request content.
There will need to be a project for aggregation and migration of CDA content truth from the available pieces from the community. This is to be noted in the migration project report to the board.
Action: Ted to include in migration project.
4.2Requirements Review
We recognise that there are a number of new projects which this pevious work of the HTA should inform.
Actions: Heather to check project insite to identify projects and whether what should be done with them
Action: Heather to share the HTA documentation with Wayne and with relevant projects as background information.
Action: Project insite and requirments review to be on next call agenda
Action: Heather to circulate the document latest version to HTA.
5Publishing
5.1Ted to report back on meeting with publishing.
Publishing agreed that there is a need to work out how to publish terminology. They are willing to start working on the governance process. The extract for publishing must cover all product families.
They are willing to work on the unified terminology project. They realize that they must provide functionality to support browsing but also publishing and archival of metadata for artifacts being published. There is considerable governance metadata associated with terminology requirements.
The understanding that the value set expansions will change over time even if the definition does not.
As of this cycle we are no longer able to publish V3 models and other artifacts. There are some things that the tooling fails and cannot publish at all. The web page is being produced with manual intervention. L Where changes are minor the manual process can cope, but this is a high risk. The publishing tools cannot consume the core MIF content. The next cycle will use the vocabulary from the last cycle.
The cause of this problem is that there is only one person who knows the tools and that person is ill. Lyn indicated that the Board where aware of these issues. The timeframe for resolution of these issues is over the next 12 – 18 months.
This is the highest priority to solve for Terminology related activities for HL7.
Action: Ted to make sure Wayne is aware of these issues.
5.2External Terminology Web Page
Key messages and updates that are focused to direct people to Vocabulary requirements and keep it short on topics.
Action: HTA - Let Wayne know the things we want to communicate no more than a dozen things.
We need link to
-how to request new content from SNOMED International
-Access to external terminologies – one of which is the SNOMED CT portal
- What are external terminologies
- How to find them, (list them, starting with those in FHIR / MIF or other source) – Ted has provided the MIF list to Rob McClure and Heather Grain.
- IP restrictions
This page can be referenced in publication. It does not negate the requirement to include IP restrictions in the publications. The publication includes the requirements as at the time of publishing. Current requirements will be maintained on this proposed web page. The publishing information should be extracted from this page.
Action: Heather to talk to SNOMED international, Ted to discuss with publishing.
Action: Heather to develop a proposal for content in the pages.
-Where do we find the source for code systems?
-What training is available?
-Get help with value set and terminology development
- Choosing the code system
- Defining the value set
6Value Set Content Specification
Formal policy and public statement on value set specification requirements including definitions using the VSD as the base.
FHIR has implemented these requirements. CDA is less consistent but at this meeting SD was prepared to listen to this requirement. When we identify a problem area it is often difficult to get them to fix things.
The next task in improving the use is through an RFP which has gone out to review and identify in CCDA 2.1 are the definitions complete and correct. Identify the expansions and whether they are identified in VSAC. Also, to identify the process by which the changes can be fed back to the structured docs work group.
HTA does not need to take any current action.
Tutorials are being updated to reflect this work and Vocab are creating focused webinars on specific sections.
There have been discussions about where conformance is cared about and that most people don’t care about the standard except in that context. Some changes have been made to reflect this situation. We are adding conformance related guidance. This recognizes that CWE effectively means that anything goes.
7Other Business
7.1.1Unified HL7 Terminology Governance Process PSS
Motion: Jean moved that HTA approved this PSS. Seconded Ted Klein
Discussion
The PSS was reviewed, no changes suggested. There will be a request from the Executive to support tooling and migration. The dates will be changed in project insite as it took longer to get it started than expected but is still on a short time frame.
Vote: Against 0 Abstain 0, in Favour3
7.2Harmonisation Report
Ted reported on the Harmonization meeting last night. He intends a review of content coming forward and share with HTA to support issue identification and process review. Include this item on calls and face to face meetings into the future.
7.2.1Next Call
Fortnightly on Tuesday at 4pm (USA Eastern Time)
First call 7th February 2017: Apologies from Jean, and Rob McClure.
Known Issues not covered in Agenda
oCIMI
Namespace requirement and management
Susan Matney asked to provide information - deferred till after San Antonio.
oFHIR Capability
oInclusion of maps in publications
oProject 1169 - Vocabulary Mining Tool