<p> 1. HL7 VOCABULARY WORKGROUP Conference Call Minutes – 2016-08-18</p><p>This call has been scheduled for 1.5 hours duration today. It is being held on Thursday, August 18, 2016 according to the schedule setup in the Montreal Working Group Meeting planning session. The time for this call is 3:30PM Eastern DAYLIGHT SAVING Time (UTC-4). </p><p>AUDIO DIAL IN NUMBER: +1 770-657-9270 Passcode: 598745</p><p>Screen share: There is a join.me session for this meeting. The URL to join is: https://join.me/tedsnewsessions</p><p>Present: Ted Klein (chairing), Russ Hamm, Jim Case, Heather Grain, Rob Hausam, Rob McClure, Grahame Grieve, Susan Barber, Soraya Assar, Carmela Couderc, Carol Macumber</p><p>2. ITEM 3. Status/Discussion/Actions 1. Roll Call and Agenda - The call formally opened at 3:35 PM EDT when quorum was reached. check - Agenda and action list distributed on Tuesday August 16. - Ted Klein - Tooling slot added to end after agenda went out. - Slot added below for International Patient Summary PSS 2. Announcements - There is an announcement from NLM about a RxNorm Jamboree in September. - Ted Klein See https://www.nlm.nih.gov/mesh/Jamboree/2016.html - Interim PBS metrics were sent by Ann and Vocabulary got dinged on one item - eVotes for FTSD. We need to figure out how to address this; it is unknown if every vote must be responded to, or there is some minimal number that can be missed, Ann returns on August 10, and Russ will discuss with her. 3. Concall Action Items 4. The individual items reviewed today or updates provided by email are in - Ted Klein 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 Note there are some leftovers red font. Items completed in the past two weeks and documented here in from the action item review in green font. These will be removed from future action lists. Montreal - Draft description and proposal for table 396 issue (the ‘nnnn’ and the ‘zzz’ for vocab decision (Ted) – Done on 8/4 call. - Put together a group to begin drafting a policy for what external organizations must do if managing HL7 value sets (Rob M) - - Document the issue of publishing the URLs to HL7 content in implementation guides for further discussion on the 2/4 call (Russ) - - Communicate with Grahame about any additional documentation needed to improve understanding of the relationship of the FHIR Implicit Value Set functionality with the VSD (Ted, Carmela, Rob H) - - Get the latest tooling requirements document from Russ and see that it is shared with FHIR (Heather) - - Due to extended discussion on FHIR item #10277 expansion profile, there is a need to follow up on the discussions on expansion profile with the group outside of the vocab WG calls and let vocab know how we can progress this complex item (Rob H) - - Share to the list for the 7/21 call a Word document with a table in it that identifies terms with more than one definition that have been used in the context of HL7 for glossary discussion (Heather) - - Share to the list for the 8/4 call a Word document with a table in it that identifies terms with more than one definition that have been used in the context of HL7 (Heather) - - Setup the Tooling calls and send out a notice of the new proposed schedule as determined on the August 4 concall (Russ) - Done. - Create a tracker item for the conceptMap equivalence item (Rob Hausam) - - Update the Glossary Project call schedule on the concall page (Heather) - - Put on the wiki under vocabulary policy the final decisions on the table 396 naming (Ted) - Awaiting final coordination with INM, will be discussed in Baltimore. - Update the descriptions in table 396 for the 'HL7nnnn' and '99zzz' entries as per vocabulary and INM final decisions (Ted) - - Forward the Vocabulary WG motions text to INM for approval on the table 396 items (Ted) - Done. - 4. Action Items from 2. Develop a policy statement on vocabulary policy for management of post Orlando WGM coordinated concepts. Include 5656 language tags, units of measurement and - Ted Klein SNOMED CT as the known examples (Rob McClure) - 3. Reorganise the document store and Wiki pages on the HL7 website so that the titles are correct and it is more appropriately labelled (Heather, Anna Orlova, Ted) - 13. Take proposal for CDA to unlink vocabulary value set definition and updates from the CDA IGs to HTA for eventual Board approval for SDWG new process (Heather) - 16. RIM modifications relative for TermInfo for the SDWG/CDA request for the RIM forking (Rob Hausam) – need to determine what (if anything) is to be done for this as it is really relevant to CDA r2.1? Note last week it was discovered that there seems to be an issue with ActClass where the BATTERY code used to be under ORGANIZER code and was moved to be under OBSERVATION in the current RIM, whereas CDA (using the older RIM) still has this vocabulary term in the old location. CDA needs to maintain backwards compatibility somehow and it is not clear how to do this for r2.1. 20. Prepare Facilitators' Roles and Responsibilities webinar (Heather) – 21. Break up Vocab 1 tutorial into 3 or 4 webinars (Heather) - 29. Need to better resolve the naming and conversation issues around 'expansion set' and 'expansion and associated expansion-related metadata' for both the VSD spec and vocabulary communications in general (VSD project) - </p><p>5. Action Items from 2. Update the wiki for TermInfo to more clearly group information (Rob H) – Montreal WGM 3. Get moving on project 1056 (V2 examples update) to prepare for the 2.9 ballot - Ted Klein (Ted) - 6. Documentation needed to improve understanding of the relationship of the FHIR Implicit Value Set functionality with the VSD (Ted, Carmela, Rob H) - 8. Provide an outline of suggested changes to the organization of the HL7 Wiki pages and provide details to Ted and Heather to implement (Anna Orlova) - 9. Follow up with CGIT on project 46 (Ted) - Email sent 8/1; no responses received. Note there is no project '46'; this is likely a typo in the WGM minutes, and was supposed to have been '1146', which is a CGIT project with vocab. 10. Attend EST calls to progress this request for fixing the ballot rendering of value sets of 'all codes' (Russ) - 11. Discuss with HQ improvement to Wiki editing (Russ) - 13. Work to get SD to agree that any changes to a V2 code system or V3 value sets used directly where published by work from Structured Documents should come through harmonisation (Rob H) - 24. Follow up on FHIR use of code datatype for non-structural data (Ted) - 25. Add requirement for HL7 Affiliates in non IHTSDO member countries which support their mapping efforts to the Tooling specification (Russ) - </p><p>6. Baltimore WGM Status – The WGM agenda is now on the Wiki at http://wiki.hl7.org/index.php? Agenda Planning title=Baltimore_Sep_2016 - Jim Case Discussion – Put the topic 'final wording for table 396 entries' on the joint Thursday CGIT/Voc/INM slot. There has been an email chain about a CIMI session with Vocabulary. The latest email includes: Jay - see the updated meeting agenda draft v0.6 I believe that I reflected your option 2: Tuesday Q1 - semantic alignment (assuming that this is joint PCWG-CIMI-CIC on Registry)??? Can you clarify? Thursday Q4 - Skin Care model, added vocab to the list. And Jay responded that he would go with this option. What is our option for Thursday Q4? Jim has not gotten a response from CIC on this; suggest that we get a concrete answer from them when they will have this discussion, and we send a rep to their session. We will ask them to supply us with a concrete list of items that they wish vocabulary to address. Action – 7. DMP Update Status – Continue work on the v6.0 of the Vocabulary DMP draft. - Ted Klein Discussion – Item tabled as we ran out of time. Action – 8. Vocabulary Facilitator Status – Susan got in touch with the new webmaster David at HL7, and they are Training updating the list on hl7.org any day now. Once this is done, the list will be updated - Heather Grain and posted. We can discuss next steps in Baltimore. Discussion – For the facilitators training slide deck, Heather suggests we trial it. Ted suggests we review the deck in detail in Baltimore on Sunday Q3. We should put it up as a webinar and try to get feedback from those that actually take it. There will be major changes in Harmonization proposals, but that is likely six months out or more. We should start on the training for preparing the proposals as soon as possible. We should discuss this also in Baltimore in the Sunday Vocabulary sessions. Action – Heather will talk to Sharon about putting it up as a webinar. Heather will update the Harmonization Proposal tutorial spec to v.4 and distribute to the list. 9. Glossary Project Status – There was a call held Tuesday August 16. The team met and went over thte - Heather Grain use of the SKMT, and adding all the definitions from various HL7 documents (Core Principles, CTS2, TermInfo, VSD, etc.) Once they are all in there, we will examine them in parallel, and begin to build the master HL7 definitions list from those. The new master document (with no current definitions in it yet) has been created in SKMT. Discussion – It turns out in researching the proper source of truth for Core Principles R2 due to some administrative and scheduling snafus and was never published. Jim asks if there is a status and we can do a recirculation ballot and get it published as quickly as possible. We need to determine the current status. Ted will have to discuss with the MnM chairs, and perhaps follow up with Woody. Action – 10. FHIR Items Status – There are still a LOT of outstanding FHIR items on the Tracker requiring - Ted Klein, Rob Hausam action by the Vocabulary WG. Discussion – We began with two questions that have arisen. 1. The HL7 Race code system issue. Ted reviewed the history, and recommended that we address this in the November cycle. We do need to talk about this in Baltimore, perhaps in the context of harmonization process discussions. We need to talk about this, along with the issue of maintenance and the need to fix V3 vocabulary stuff. The point was brought up that for implementers that are using these codes in the FHIR codeSystem resource and available in the FHIR terminology services are becoming quite important, and just declaring that they need to get this stuff from the US CDC website is becoming increasingly an issue. As more support and services are built around implementer help, the impact of non-HL7 terminology that may have IP implications or national Realm implications becomes increasingly important. 2. The general issue of non-HL7 terminology content must be addressed. We need to do the deprecation of the duplicative stuff in November, and separately and in parallel work on implementer access to such codes. There was a discussion around what is the issue with the FHIR terminology services serving up content where HL7 is not the steward, such as the CDC content (and others that may be IP protected). </p><p>We will continue with more FHIR items next call.</p><p>It was decided to examine: no ticket number yet - ConceptMap equivalences http://hl7-fhir.github.io/valueset-concept-map-equivalence.html</p><p>We examined the states, we see some of the issue but this needs further discussion as we are out of time.</p><p>Remaining items on the list:</p><p>#9535 - ValueSet should allow intersections (Persuasive) #8766 - ValueSet/$validate-code definition should allow code and ValueSet.url as two input parameters #8830 - Consider the ability to perform a reverse $translate – CFU, voted #8447 - does @all include all versions of all value sets #8453 - ConceptMap.dependsOn must support valueQuantity and valueRange #8515 - Allow specification of multiple source codes in a single map element #8726 - ValueSet.compose.filter should be a modifier #8727 - Add comparators to filter operators #8884 - Need extension for min valueSet for DataElement.element.mapping.language #8911 - Expansion paging questions #8912 - Expansion Conformance question #8913 - Need a filter to manage inactive codes  We may have changed this? #8953 - Lack of code system version in ConceptMap  Already addressed? #9095 - Add http://example.com for examples #9033 - add OID for ICD-10cm to systems page #9121 - Add designation[0..*] to ValueSet #9132 - Additional SNOMED CT Implicit ValueSet  Is this affected by CodeSystem? #9196 - ValueSet binding to version specific ICD10 in Structure definition needs example or best practice advice #9385 - ConceptMap example using code system URI, not value set URL #9425 - When asserting a mapping, need to be able to assert a concept map for the resulting code (Persuasive) #9431 - How is ConceptMap used to map to DataElements and CDA #9540 - Change element names to 'system' and 'version' for consistency with ValueSet and CodeSystem #9555 - NDC documentation should explain product vs package ID #9922 - Use "include parent is-a code" instead of "include concept is-a code", "exclude concept = code" #10018 - Use v2/v3 aligned vocab for [Patient.]gender #10127 - Clarify use of word 'closure' #10129 - Clarify filter #10148 - Add designation to CodeSystem.property and CodeSystem.filter #10244 - Error in Terminology Service $expand example 10283 - Concept Map Translation: Incorrect Parameter Name In Example (Peter Jordan) 10303 - Value set Content Logical Definition rendering for intensionally defined value sets should include descriptions (Robert Hausam) 10356 - Add new data type toCodeSystem property/concept property (Russell McDonell) 10357 – Make CodeSystem.version a CodeableConcept so it can be chosen from a ValueSet (Russell McDonell) #5575 - Likely incorrect code systems or candidates for terminologies-system.html page - CFU </p><p>Action – 11. Liaison Reports Status – Newest release LOINC is 2.56 and RELMA 6.14, released June 26, 2016. - LOINC: Ted Klein Next ISO TC215 meeting will be in Lillehammer, Norway November 14-18. Next - TC215: Ted Klein Clinical LOINC meeting is scheduled for August 24-26 in Salt Lake City. - HTA: Heather Grain Discussion – Item tabled, out of time. - IHTSDO: Jim Case Action – - FTSD: Russ Hamm 12. Next Conference Call Status – Next call proposed for September 1, 2016 at 3:30PM EDT for 90 minutes - Ted Klein duration, Ted to chair. Note that next call will be the last in this cycle. Discussion – Call came to order at 3:35 PM EDT, and was adjourned at 5:01 PM EDT. Ted took minutes and ran the screen session. Action – Ted will distribute the minutes to the list. Next conference call confirmed for September 1, 2016 at 3:30PM EDT for 90 minutes duration, Ted to chair. 13. Tooling Project Status – Call held yesterday August 17. They are weekly on Wednesdays at 13:00 - Russ Hamm UTC-4 (Eastern US Daylight Saving Time). Discussion – We had a call, but no FHIR representative on the call. We reviewed the notions of using FHIR for terminology services, and begin to review the list of requirements - the link is now on the Wiki and it is in a Google docs sheet. Additional requirements will be worked on to get ready for the next call on Wednesday August 24. Ted hopes to be able to review and evaluate Michael Lawley's value set editing tool in Baltimore. Action – 14. International Patient Status – Rob Hausam sent out the PSS which was recently approved by SD. This is Summary PSS all about joint work with ONC, the US, and the European Commission. This has - Rob Hausam been going on for a while, and was accelerated in Montreal and also some work in ISO in Amsterdam. There are weekly calls for this project, and updates to reflect current realities on both sides of the Atlantic. It is now ready to bring to the WG for review and approval. Vocabulary has been requested as a cosponsor. Discussion – Rob reviewed the PSS for the group. Ted brought up the issue of maintenance and timeliness of value set content, especially if the value sets are enumerated. Rob will bring this comment back to the group. Ted brought up that there may be some dependencies about the definition of the value sets as the HL7 process for value sets right now is harmonization. Action – Rob H will bring the comments back to the team, and we expect to see an updated PSS for a vote on the next call; please distribute it early enough so folks can look it over before the call.</p><p>Parking Lot List (items that cannot be progressed):</p><p>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.</p><p>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.</p><p>From the Cambridge September 2013 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. From the San Antonio January 2014 WGM: 1/30/2015 We have been unable to make 7. Define process for declaring single preferred value set progress on these for 1 year. and/or code system for specific coded attributes in HL7 standards (Ted) – Still pending.</p><p>From the Phoenix January 2014 WGM: 5/18/2015 We have been unable to make 2. Develop material for facilitator roles and responsibilities progress on these for 1 year. webinar (Heather) – 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 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 From the Chicago September 2014 WGM: 10/26/2015 We have been unable to make 6. Review and prepare tutorial specification for Binding progress on these for 1 year. course (Heather and Ted) – Pending </p><p>From the San Antonio January 2015 WGM: 1/19/2016 We have been unable to make 28. Rob Snelick agreed to undertake the task of writing progress on these for 1 year. paragraph(s) on value set constraining in implementation guides that can be included in chapter 2c for V2.9 for CGIT. Ted Klein to prepare maps to version 3 vocabulary model to version 2 vocabulary content section (Ted and Rob Snelick) – Pending</p><p>From the Paris May 2015 WGM: 5/17/2016 30. Develop guidance and explanations around use of Null Flavor with Grahame and Lloyd (Ted) – unable to progress 34. Extract tables project status and minutes from the vocab minutes, repost to CGIT separately, validate against spreadsheet (Ted) – never done</p>