HL7 Terminology Authority Meeting Thursday, 21st July 2016 5pm EST USA

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Members: Heather Grain, Julie James, Jean Narcisi, Sandy Stuart, Ted Klein, Rob McClure, Additional Invitees: Wayne Kubrick, Shelley Lipon, Jane Millar, Russ Hamm, Rob Hausam, Karen Van Hentenryck, Jim Case

Minutes

1 Minutes of Previous Meeting Minutes of meeting July 7th Jean moved that the minutes be approved. Seconded Ted Klein. Minutes approved.

2 Standards Governance Board Comments or actions required after review of notes from the SGB meeting circulated by Wayne. We request that Wayne continue to keep us informed of activities of the SGB and will inform them of anything relevant occurring in the HTA.

3 CIMI CIMI content creation and IHTSDO request process – Ted Ted reported that Susan Matney and he have been discussing tooling. At the moment Harold is the primary tooling user. Further information will be sought.

4 FHIR and Terminfo

4.1 Binding Heather asked Russ to send the terminology tooling requirements to Grahame Grieve to inform FHIR terminology service development. Policy Page to be reviewed on this call and updated to include:  HTA policy required on the use of code systems.  Policy page needs to be more obvious and findable.  Include: code system owner, license requirement and contact. And other policies.  Policy – that HL7 publications do not create code systems that are copies of existing code systems which are published by others (implying that the codes are HL7 codes).  External code systems are referenced in standards with notification to the implementer that they must be compliant with licensing requirements of the owner. HL7 is not an implementer but reference these code systems in standards. HL7 will ensure that implementers are informed of the existence of code system ’owners’ licensing.

5 Content request process Form reviewed and generalized. It was agreed that the process be reviewed as new terminology requirements are identified, e.g. adding requirements for LOINC. The process may need to include an iterative element as the form, though intended to collect everything required it is processed, and if additional information is required that information would be sought from the requester on a case by case bases. The issue of internal management and ‘clean up’ of the requests by HTA was recognized. It is expected that people will have difficulties getting this right and we accept this review is educative and that vast documentation will not necessarily improve results, but the review process has proven to be the most effective mechanism for such education (in harmonization). This approach is viable while the volume is low and we will begin from this perspective, and reconsider the procedure should the volume become unsustainable. November cycle of harmonization – this process could be included in the proposal submissions. People don’t begin to schedule meetings to identify what they need until they have had preliminary discussions. We need vocabulary content to be reviewed well before harmonization. The harmonization submission dates are the date by which the new content or modified content must be specified before is date. People need to be aware that though requests may pass harmonization the availability and precise actual content created by code system owners may occur some time after not just harmonization, but ballot. FHIR have a check pointed scheduled set of processes not built around publication cycles which are part of the problem. Initial proposals on this approach may be ready – initial outline at least = to be presented in Baltimore.  HTA support the implementation of a check point based, continuous flow process for evaluation of vocabulary content, which supports snapshotting of content for ballot.  We have a draft process for content requests for international terminologies and this should also be communicated as part of the schedule and process review.  HG to load the updated draft to the HTA wiki.  The content request form to be reviewed by trial in a working group and at the point that it works for us, confirmed with IHTSDO. Shelly indicated that this would be acceptable.

6 Liaison

6.1 IHTSDO

6.1.1 Variation of SNOMED CT Affiliate License Agreement Shelly or Wayne to report. – no report this call due to lack of time on the call.

6.1.2 Free SubSet FHIR community objections to SNOMED CT use to be considered. They include:  Use of fully specified name is not always sufficient to clearly define meaning for processing. The material which is published under the universal free access rules are sufficient as unambiguous identifiers only. Other use cases will require a full license – further discussion required on this topic seeking a workable solution to these known  A data element relevant to processing includes the active status of the concept.  New content includes a textual definition. Old concepts can have textual definitions added. Requests for textual definitions from WGs can be accepted by HTA and forwarded to IHTSDO.

 Questions o are textual definitions part of RF2? – HG to confirm. o can textual definitions be included in publications of HL7? Report on Action: HTA ask IHTSDO about the publication of textual definitions. Rob will craft some words to state what HL7 will do, and seek their feedback. We intend to publish the FSN and the textual definition. HG to send to Jane with copy to Jim. Establish a use case to demonstrate – Rob M and to obtain requests for updates to SNOMED CT Not discussed on the call.

6.1.3 Portal Access report from HTA members who have tried to use the portal. – Not discussed on the call due to lack of time.

6.2 ISO Karen to report on action taken – no report

6.3 LOINC Karen to report on action taken. No report

6.4 Other

7 Tooling Project 1169 - Vocabulary Mining Tool - previous Vocabulary WG project - Vocabulary WG request movement to HTA . 947 project exists - this is repetition. No report

8 Value Set Content Specification Rob McClure to report on advance requirements for Alleles question (from Montreal meeting) Consider how HTA is to support this project. Question received In V2 Table 0291 Subtype of referenced data there were found three codes not in Iana. In a meeting with the table project InM agreed to forward a request to HTA to have the following added to Iana. This will allow us to deprecate HL7 Table 0291 and instead refer to a external code system. Value Description

x-hl7-cda- HL7 Clinical Document Architecture Level level-one One document

PICT PICT format image data

JOT Electronic ink data (Jot 1.0 standard) Please let InM and Vocab know your intentions. No report

9 Publishing Publication mechanism from single source of terminology (TK) Inclusion of maps in publications No report

10 Communication Need to inform WG Chairs of content request submission form.

11 Policies

12 Other Business V2 Tables - question on professional representation. Vocabulary will consider how to best move this forward. – not discussed. HG to investigate why the HTA calls aren’t being reminded. You need to subscribe to the HTA list to obtain the reminders. Those on the HTA list are not automatically subscribed. All conference calls by workgroup and project = HTA is not listed. HG to follow up with HQ but in the mean time HG invite the vocab list.