HL7 VOCABULARY WORKGROUP Conference Call Minutes – 2014-10-16 Note that the US is still on Summer Time!

This call has been scheduled for 1.5 hours duration today. It is being held on Thursday, October 16, 2014 according to the schedule setup in the Chicago Working Group Meeting planning session. The time for this call is 3:30PM Eastern DAYLIGHT Time (UTC-4). Please check the time in your local area!

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Present: Jim Case, Amy Wang, Ron VanDuyne, Rob Hausam, Russ Hamm, Rob McClure

ITEM Status/Discussion/Actions 1. Roll Call and Agenda - Quorum was reached. Rob Hausam communicated that he would not be able to check join the call until after 4pm ET. - Jim Case - San Antonio version 1, distributed two weeks ago is still the valid version 2. Announcements - IHTSDO business meeting and implementation showcase will be held in - Jim Case Amsterdam October 26 – 31. http://www.ihtsdo.org/events/ - The TSC has approved the recirculation ballot request for CTS2. Ballot opened Oct 14 and will close Oct 28, 2014. http://wiki.hl7.org/index.php? title=FHIR_Terminology_Service#Introduction 3. Concall Action Items The individual items were not reviewed today although a few specific updates - Jim Case were provided by email; those that are updated are in green font. Action items that are new have no status, and those that have been on the list for a long time and are still not closed have their status in red font. Items completed in the past two weeks and documented here in green font. These will be removed from future action lists. - Contact Andrew McCaffrey (who is doing the certification testing for CDA at NIST) about the issues around coding strength and terminology binding (Ted) – Still pending. - PSS for the IHTSDO WB for harmonization project (Russ/Woody) – AT the WGM we walked through the rescoping and it has been changed to NOT be specific to the WB. It was made generic for tooling. Some placeholder dates need to be completed and the completed PSS will be reviewed on the next call. - Update/modify the IHTSDO WB project to be more generically focused on terminology tooling (Russ) – See above. 4. Action items from San 6. Correction of vocabulary and coded datatype examples in v2.9 (Ted) – Not Antonio WGM started. Discussed in Phoenix with INM and Publishing. Needs planning. - Jim Case 7. Define process for declaring single preferred value set and/or code system for specific coded attributes in HL7 standards (Ted) – Not started. 10. The Mayo CTS2 profile for SVS (Russ) – Request made to put on hold. 14. The Mayo CTS2 Implementation Guide (Russ) – Request made to put on hold. 5. Action Items from 1. Develop initial tutorial outline specification and share with Jim then we will share Phoenix WGM with Vocab WG (Heather) – Pending - Jim Case 2. Develop material for facilitator roles and responsibilities webinar (Heather) – Pending 3. Review revised FHIR Value Set Resource as amended by Grahame in Phoenix (Ted) – Pending 6. Develop a one-page guidance documents for the table stewards for definitions of Concept Domains to be created for the tables project (Heather) – Pending 7. Continue further discussion on the full history of the value set versions for the 2.9 publication (project group) – Ongoing from the tables project. TBD. 13. Put on agenda for Chicago the item about moving conformance criteria out of the datatypes for v2 and moving towards deprecating CNE/CWE in favor of a single coded datatype for v2; joint CGIT/Vocab/INM; coordinate with INM (Rob Snelick) – Pending. Need clarification. Review the minutes from Chicago for any resolution 14. Develop explanation of intent for “testability” in the binding syntax document for the next binding syntax call (Rob Snelick) – Pending. 15. Develop questions and discussion materials around NullFlavor with Grahame and Lloyd and distribute for discussion by end of June (Ted) – Pending. 6. Action Items from 1. All open projects will be reviewed on the next conference call agenda. Pending Chicago WGM 3. Prepare draft update of vocab education specification for review on - Jim Case teleconference calls and informed by Russ’ recent delivery (Heather) - Pending 4. Schedule discussion on Vocabulary 2 tutorial for Sunday Q4 in January. This discussion incorporates consideration of the tutorial framework and specifications of the tutorials in that framework (Jim) – Pending. Jim will follow up with Heather. 5. Prepare new tutorial on External Terminology Resources for delivery in January, Ted to assist. (Heather) - Pending 6. Review and prepare tutorial specification for Binding course (Heather and Ted) – Pending 7. Update the Vocabulary Tutorial Framework document (Heather) - Pending 9. Put Binding Syntax project on Hold in Project Insight (Ted) – Pending 10. Withdraw Project 839 CTS2 Implementation Guide (Russ) – Put on hold. 11. Withdraw Project 945 NLM USCRS evaluation (Ted) – Pending 12. Withdraw CTS2 SVS incorporation Project 946 and follow up with Kevin and Craig (Russ) – Put on hold. 13. Reach out to Nancy Orvis and Russ Ott on Project 1022 HL7 LOINC DOTF the PSS and the fact that it is specified right now as a DSTU and why this still is around or if it as an HL7 project that should be withdrawn since all the work seems to be underway at LOINC (Ted) – Pending 15. Provide details to HTA to support their followup on discussions around v2 vocabulary hierarchies and the lack thereof (Ted and Jim) – Pending. Still need to finish up a report for NLM that pertains to this project. Will use that as a starting point. 16. Followup with Tony Julian on the new PSS for the datatype change for v2, and put slot on calls when ready (Ted) – Pending 17. Schedule a call for Binding Syntax through doodle poll aiming for a meeting in November after the background documentation has been gathered. This call should go to the Vocab and CGIT lists and the InM Chairs. Once the time is established the Vocab and CGIT lists will be informed of the meeting. (Ted) – Pending 18. Find the place in the V2 spec that says to use a specific OID type for v2 tables – type 12. This needs to be found and removed. (Ted) – Pending 19. Make Request of HTA to look at some of these fundamental content issues as discussed in Chicago on Thursday Q2 (Ted/Jim/Heather) – Pending next HTA meeting scheduled for Oct 23. 20. Request HTA to consider how to obtain funding to clean up our act across our products (Rob McClure) – Pending. Rob has asked for clarification from the co- chairs. Need clarification on how IHTSDO sees its products being used in HL7 artifacts. This is especially true in the context of publishing SNOMED CT content in HL7 ballots. There may be differences between realm specific and universal contexts. 23. Go over the process of Table 396 publication with Juba (Ted) – Need to refer this to Lynn Laakso as she is now the Head of technical Publications. 24. Follow up with Jane Millar regarding future changes in IHTSDO representation (Russ) – Jane sees a role continuing in some capacity especially WRT alignment of tooling. More discussion on licensing as well. The role needs to be made more specific (is liaison the right moniker) and how it relates to HTA. Request that this be added to a future HTA agenda. Russ will explain his past role and a discussion of future interactions between HL7, the HTA and IHTSDO. Russ will communicate with Jane Millar and the HTA to get this on the agenda. 26. Post WGM minutes to HL7 site (Heather) – Done. Minutes posted.

7. San Antonio WGM Status – Jim distributed the starter V1 on September 23. Agenda Planning Discussion – The assignment of the TermInfo quarters and the IHTSDO officers has - Jim Case changed so that the IJTSDO officers will meet Q1 Tuesday. Action – Change made to agenda. 8. Terminology Authority Status – Call was scheduled for today at the same time as the vocab call. - Heather Grain/Rob McClure Rescheduled for Oct 23, 5pm ET. Discussion – Action – 9. Vocabulary Education Status – Heather no on call. - Heather Grain Discussion – Action – 10. Report from Status – Ted is in Germany for the ISO TC215 meeting. Lab LOINC meeting Terminology SDO scheduled for December 3-4, 2014 in Indianapolis. Clinical LOINC will be scheduled in February around the FHIR value set connectathon schedule. Liaisons Russ - IHTSDO discussion about the role of the liaison and the future role for the - LOINC: Ted Klein interface to HL7 will be discussed by the HTA. - TC215: Ted Klein Discussion – - IHTSDO: Russ Hamm Action – 11. Vocabulary Tooling Status – Carol and Russ are working on the PSS. We will review it when their Project updates are complete. Hope to be completed soon and review it at the next call. - Russ Hamm/Woody Beeler Discussion – None. Action – 12. FHIR ValueSet review Status – FHIR has requested that Vocabulary WG review their design changes and items (cases 3138 and dispositions of theses two cases: 3138: 3258) Details - Jim Case/Ted Klein The ValueSet resource expansion.contains.system to be omitted but doesn't explain when this should occur. Documentation should be enhanced to reflect that this is for abstract codes. http://gforge.hl7.org/gf/project/fhir/tracker/? action=TrackerItemEdit&tracker_item_id=3138&start=125

3258: Details Currently, ValueSet.compose.include contains a code element which has a code datatype (i.e. a string) which is not associated with a display representation. I suggest we replace the code element with concept element which is defined with a similar structure as ValueSet.define.concept - essentially including a mandatory code element (of type code), an optional display element (of type string). The display element shall be populated with the representation of the string the value set author would like adopters of the Value Set to use. This may be the term (e.g. fully specified name, synonym, etc.) in the source of the code (e.g. a a terminology like SNOMED-CT), or it may be something assigned by the author (e.g. when the source of the code does not provide an acceptable display representation). http://gforge.hl7.org/gf/project/fhir/tracker/? action=TrackerItemEdit&tracker_item_id=3258&start=200

Discussion – We will wait for discussion until Ted returns as he will have input. Russ mentioned that there was a FHIR terminology service web page set up prior to the WGM in Chicago. It is unknown how or if it conforms to any of the terminology services standards (i.e. SVS or CTS2). The functions may map to these standards but the implementation seems ad hoc. Action – Ask FHIR to talk with the Vocab WG to discuss their approach to terminology services (Russ). 13. Value Sets of flavors of Status – Unknown if this is still an issue after the discussion in Chicago. The PHER Null representatives have decided to handle this through usage notes. - Jim Case Discussion – PHER had asked whether Vocab would endorse this approach. The vocab group should make a statement as to how it “should” be done, without endorsing any variation from that approach. Discussion is that this approach has serious issues that need further discussion. The major issue to be resolved is that you cannot use a version 2.x table OID as a code system OID in a V3 message. Thus you cannot have a single OID to represent the same values in both v2.x and V3 messages. Action – Need clarification from the tables project as to whether v2.x “tables” can be used in V3 messages. Also need clarification from PHER as to how they are planning on implementing in the short term (Jim). 14. TermInfo Project Status – TermInfo continues to make good progress with ballot reconciliation, with Update 22 A-Q and 31 A-S comments remaining. The TermInfo presentation for the - Rob Hausam IHTSDO Showcase in Amsterdam is still being finalized, and will be submitted by the (now extended) deadline on Monday (20th). We will be planning to publish the DSTU (joint HL7 and IHTSDO) early in 2015 (ideally by January, but as a DSTU there isn't a strict 1 year requirement). Discussion – Action – 15. Binding Syntax Project Status – No discussions making any real progress in Chicago. We called for - Ted Klein/Wendy Huang volunteers to assist. Project currently stalled. Discussion – One of the action items is for Ted to ask that this be put on hold. Action – Follow up with Ted when he returns. 16. V2.x Tables Project Status – Regular biweekly calls ongoing; 90 minute calls every other Thursday - Ted Klein/Wendy Huang alternating with the Vocab WG. The times have been reset to 3:00PM – 4:30PM EDT as per Wendy’s request. Discussion – No one who participated on the call was available for discussion. Action – 17. Next Conference Call Status – The next call is scheduled for 2 weeks hence October 30, 2014 at 3:30PM - Jim Case EDT (as determined in the Chicago WGM planning session). Discussion – Add as an agenda item: Value set mismatch between the OID repository and value set OIDs. The call convened at 3:37 PM EDT, Jim Case chairing. Call ended at 4:55 PM EDT. Minutes taken by Jim Case. Action – Call confirmed for Thursday October 30, 2014 at 3:30PM EDT.

Parking Lot List (items that cannot be progressed):

Parked Item Date Parked Reason for Parking From the San Antonio January 2012 WGM: 4/16/2012 Since procedures for VS maintenance 22) Develop procedures to maintain value sets based on are so dependent on tooling, Suggest external terminologies such as SCT – concalls? Other? we park this until we have a clear path (Jim, Russ) – Pending. Could develop high level forward on tooling. requirements, as processes are going to be more tightly woven into tooling. Could begin by identifying what external terminologies we already support. From the September 2012 Baltimore WGM: 12/24/2012 Kathleen never joined another call, 1. Provide an example that illustrates the need for guidance and has not updated us with what this on implied semantics where codes are in conflict with RIM topic was all about. I has been on properties (Kathleen Connor) – Unknown, Kathleen not on every call agenda since Baltimore. the call. Will follow up with Kathleen to determine if this can We will try to follow up with her on be removed. this at the January 2013 Phoenix WGM. From the January 2013 Phoenix WGM: 4/16/2013 11. Find out from Lloyd the items around metamodel definitions (Russ) – This project is still on hold.

From the Phoenix January 2013 WGM: 10/15/2013 It has been parked as we do not seem 17. Followup letter on OID changes for CVX and MVX to be able to progress this item, and it (Russ and Ted) – Not yet started. We failed to do this in is no longer being discussed Cambridge; should this be canceled or parked. anywhere.

From the Cambridge January 2014 WGM: 9/22/2014 We have been unable to make 2. Review and consolidate definitions terms (Ted, Russ) – In progress on these for 1 year. work. (Need to update this item with the context of the definition)… 11. Provide the feedback from OMG to the SOA and HSSP projects (Russ) – Need clarification - still pending. 12. Work with Publishing to update the style guides for v2 codes to reflect the findings of the v2.x tables project, and warnings about issues found (Ted) – Still pending.