2012-05-13 TSC WGM SDO Activities Minutes

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TSC Sunday Q4 Agenda - 2012 May WGM Vancouver BC CAN

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TSC HL7 activities with other SDOs Meeting

Location: TBD

Date: 2012-05-13
Time: Sunday Q4
Facilitator Austin Kreisler Note taker(s) Lynn Laakso
Opportunity for HL7 WGM attendees to review activities in collaboration with other SDOs such as IHE, OMG, and the JWG and JIC, and provide comment.
Name Affiliation Email Sunday 2012-05-13
Achdiat, Meya HL7 Australia meya.achdiat@standards.org.au x
Alschuler, Liora Lantana liora.alschuler@lantanagroup.com x
Blobel PhD, Bernd HL7 Germany bernd.blobel@klinik.uni-regensburg.de x
Brooks, Colleen HL7 Singapore colleen.brooks@mohhcom.sg x
Campos, Fernando HL7 Argentina fernando.campos@gmail.com x
Cangioli, Giorgio HL7 Italy giorgio.cangioli@gmail.com x
Canu, Nicolas HL7 France nicolas.canu@phast.fr x
Dixon Hughes, Richard HL7 Australia richard@dh4.com.au x
Drinkard, Tom US tom.drinkard@deltadentalva.com x
Estelrich, Ana Phast ana.estelrich@phast.fr x
Ferguson, Jamie Kaiser Permanente jamie.ferguson@kp.org x
Fridsma, Doug ONC doug.fridsma@hhs.gov x
Hamm, Russell Apelon rhamm@apelon.com x
Hay, Christian GS1 Christian.Hay@gs1.org x
Heggli, Beat HL7-Switzerland Beat.Heggli@nexus-schweiz.ch x
Heitmann, Kai HL7 Germany hl7@v_heitmann.de x
Jaffe, Charles HL7 cjaffe@HL7.org x
Koenig M.D., Helmut Siemens helmut.koenig@siemens.com x
Laakso, Lynn HL7 HQ Lynn@HL7.org x
Liu, James Siemens zhijing.liu@siemens.com x
McDaniel, Mary Kay Cognosante marykay.mcdaniel@congnosante.com x
Mense, Alexander Austria alexander.mense@hl7.at x
Richards, Julie HL7 Canada jrichards@infoway.ca x
Rubin, Ken HP ken.rubin@hp.com x
Schichilone, Rita AHIMA rita.scichilone@ahima.org x
Shanbhy, Avinash HL7 (ONC) avinash.shanbhay@hhs.gov x
Solomon, Harry GE Harry.solomon@ge.com x
Spellman, Lisa AHIMA-ISO/TC215 lisa.spellman@ahima.org x
Stegwee, Robert HL7 Netherlands robertstegwee@capgemini.com x
Stuart, Sandy Kaiser Permanente sandra.stuart@kp.org x
Thompson, Sue NCPDP sthompson@ncpdp.org x
Ward, Steven T HL7 US stw@lilly.com x


Welcome and Introduction - Austin Kreisler

Panel discussion: (1 hour)

Streamlining current cross SDO processes - project perspective

  • CDA Consolidation project: Liora Alschuler, Lantana/Health Story perspective; Keith Boone, IHE PCC perspective
  • Diagnostic Imaging Report IGs and DICOM part 20: Harry Solomon and Helmut Koenig
  • epSOS: Giorgio Cangioli
  • CTS2 - Russ Hamm
  • others TBD

SDO liaison activities and review of each JIC-sponsored event having HL7 engagement (25 mins)

Attached reports:

  • HL7 activities with AHIP: John Quinn
  • HL7 activities with ADA: Pat Van Dyke reports the ADA Standards Committee for Dental Informatics (SCDI) continues to develop their ADA Spec. 1067 using the EHR-FM R1.1 as a reference. The project to develop a joint ADA/HL7 profile based off of the Electronic Health Record Functional Model has been delayed. The ADA may bring that project forward in 2013 (as of a February discussion with Mark Diehl who is leading that project.)

There will be renewed interest in the Periodontal Attachment from the Attachments Work Group. We hope to find joint resources to update and complete that attachment.

  • HL7 activities with CDISC: Becky Kush
  • HL7 activities with CLSI:
  • HL7 activities with CEN TC 251: Mark Shafarman
  • HL7 activities with DICOM: Helmut Koenig
    • Relevant DICOM Activities - Web Access to DICOM Persistent Objects (DICOM WG27)
      • DICOM approved Suppl. 148 Web Access to DICOM Persistent Objects (WADO) by means of Web Services final text in August 2011. This supplement deals with retrieval of persistent DICOM objects such as images and reports, corresponding to the evolution of the existing HTTP-based WADO to Web Services. Both native DICOM and rendered images can be retrieved as well as total or partial metadata of the object without the image pixels. DICOM WG27 is working on further WS*-based and RESTful WADO services.
  • HL7 activities with DSMO: John Quinn or Mary Lynn Bushman
  • HL7 activities with GS1: Chuck Jaffe
  • HL7 activities with IEEE (11073): Todd Cooper
  • HL7 activities with IHE: Keith Boone submits the attached report
  • HL7 activities with IHTSDO: Russ Hamm reports the following activities have been ongoing between HL7 and IHTSDO.
    • Technical Architecture of the IHTSDO Workbench
      IHTSDO recently completed a review of the technical architecture of the IHTSDO Workbench. HL7 participated in interviews towards this effort, providing feedback on both architectural and usability aspects of the Workbench. Recommendation from the technical architecture review includes:
      • Refactor existing code to create a core terminology data model API
      • Develop a new terminology-specific data model API
      • Refactor existing code to create a discrete data access layer
    • Mapping of H7 Vocabulary to the IHTSDO Workbench
      HL7 is currently investigating use of the IHTSDO Workbench to manage the HL7 vocabulary artifacts, and is progressing on a project to map the HL7 vocabulary to the IHTSDO Workbench data model. In addition, HL7 is investigating the feasibility of setting up their own extension namespace of SNOMED CT to maintain SNOMED CT content specific to HL7 structures. It is likely that HL7 would use the IHTSDO Workbench to maintain their SNOMED CT extension
    • Availability of the IHTSDO Workbench to HL7 Members
      • The “Member’s Release” of the IHTSDO Workbench has been released and is available on the IHTSDO hosted Collabnet site. The Member’s release is based off the Migration Release, which is the version that IHTSDO has been using for developing the latest version of SNOMED-CT. This version should be considered by HL7 as the “starting point” for Workbench development activity and is available to HL7 members through the IHTSDO.
  • HL7 activities with NCPDP: Margaret Weiker submits the Attached report
  • HL7 activities with NQF: Chuck Jaffe
  • HL7 activities with NUCC: John Quinn or Nancy Wilson-Ramon
  • HL7 activities with OMG: Ken Rubin
  • HL7 activities with Regenstrief/LOINC: Ted Klein submitted the attached report
  • HL7 activities with SCO: John Quinn or Chuck Jaffe
  • Hl7 Activities with The Health Story Project: Joy Kuhl reports since our previous board report, Health Story engaged in the following additional activities, bringing value to HL7.
    • Hosted a well-attended Health Story demonstration at the HIMSS12 Interoperability Showcase. Twelve Health Story vendor members worked together to apply HL7 CDA in a transition of care use case that was provided to Health Story by the American College of Physicians.
    • Hosted a well-attended press release briefing at HIMSS12 with HL7, IHE and the ONC S&I Framework to promote the work of the Consolidation Project and the Health Story HIMSS12 demonstration. Several follow-up articles in national publications featured the work of Health Story and HL7.
    • Provided education about Health Story and Consolidated CDA during three industry webinars promoting the use of HL7 CDA.
    • Supported IHE in exploring options for HL7 CDA testing in the next Connectathon.
    • Recruited Health Story vendor members to participate in another demonstration of HL7 CDA at the HIMSS Government HIT Conference this June in Washington DC.
    • Coordinated a response to the call for public comments on the proposed ruling for Stage 2 meaningful use requirements, commenting on references to clinical documentation and the use of Consolidated CDA.
    • Began recruiting participation in Health Story from the consumer engagement community – enriching Health Story by enabling patients to contribute to their own health stories.
    • Health Story members are encouraged to become early adopters of HL7 CDA, and members are directed to participate in training at HL7 Working Group Meetings and Education Summits.
    • We look forward to further collaboration, including, most immediately, completion of and advocacy for adoption of the HL7 IG for CDA Release 2: IHE Health Story Consolidation, Release 1.
  • HL7 Activities with TIGER: Pat Van Dyke reports that this group initially started by Linda Fischetti and sponsored by Ed Hammond, continues to meet for a Tuesday morning breakfast at each Working Group Meeting. We will focus on Nursing Education opportunities during this meeting. Several of the attendees currently teach informatics and have a desire to create and offer nursing informatics classes for HL7. We will also continue to explore methods of introducing HL7 into the curriculums of nursing schools and nursing organizations.
  • HL7 activities with W3C: John Quinn
  • HL7 Activities with WEDI: John Quinn
  • HL7 Activities with X12: John Quinn


Austin and Scott introduce themselves, the session, and the panel of 'sausage-makers'. Panelists will introduce their project, their observations about it and presentations, and then later will have an opportunity to ask questions.

Streamlining current cross SDO processes - project perspective

  • CDA Consolidation project: Liora Alschuler, Lantana/Health Story perspective; Keith Boone, IHE PCC perspective
  • Diagnostic Imaging Report IGs and DICOM part 20: Helmut Koenig
  • epSOS: Giorgio Cangioli
    • Giorgio notes that his perspective is from a standards user point of view within the project. He shows a slide presentation.
  • CTS2 - Russ Hamm
    • HL7 had CTS already published as normative service specification standard. First release doesn't address terminology maintenance operations or terminology versioning. Second release also addresses query operations. HSSP project as joint venture of HL7 and OMG (Object Management Group). HL7 develops the set of requirements in a Service Functional Model (SFM). The SFM as a requirements document goes into an OMG RFP, soliciting prospective developers to build the technical specification, or Platform Independent Model. Challenges were encountered on separation of ownership of artifacts between HL7 and OMG. Some cross-contamination occurred where expectations of design were held by the SFM developers but not interpreted by OMG RFP respondents. The process has been overengineered into an implementable model from a logical model. One unexpected challenge in developing service granularity, with questions of whether the technical specifications should have one to one relationship to the functional requirements.

Austin asks how many SDO liaisons intending to give brief verbal reports. Keith notes that his report is in the minutes. Harry asks for a moment.

  • Austin asks Giorgio about the references to ECCF, if that is the same ECCF as is defined in the SAIF Canonical Definition. Giorgio agrees that they are trying to use concepts from the SAIF. Where a single artifact identifies its representation, they can use the ECCF to identify gaps in the specification stack.
  • Harry asks Russ on the HSSP process being a waterfall development process. Does it impede the ability to iteratively develop specifications with feedback on the requirements? Russ agrees that it is a limitation, but with a versioning process to go back through the requirements during CTS2 development they have completed mappings between OMG artifacts and previous HL7 artifacts, with an alignment between them, and finding things that were specified and not included in the PIM. However they found they were putting application level functionality in the service specification that didn't belong. They do, however have the opportunity to offer feedback. Ken Rubin adds that OMG may offer feedback that they chose not to meet a certain requirement and give a reason why. He adds that once a spec goes live, anyone in the world can comment on it and the feedback task force is obligated to respond.
  • Liora asks Giorgio on epSOS pilot program using CDA and CTS2 but future work considering ISO 13606? What's working today and working in production and changes in the future. Giorgio notes that the IHE PCC offers many ways for using CDA, but they do not understand yet how to categorize an archetype in CDA. Keith adds that CDA R2 ballot did a lot of harmonization with 13606, and OpenEHR has done a lot of work harmonizing with CDA. CIMI work is developing an implementation guide with the models. He feels harmonization across them all
  • Jill Richards, Canada. Asked about the 8 implementation guides under a single balloting process, and were other SDOs involved? Liora notes that the Diagnostic Imaging Reports had multiple ballots with DICOM and HL7. Up to the Consolidation ballot the only balloting had been within HL7. HealthStory provided requirements and reviewed specifications but balloting only happened in HL7. They ended up with two deliverables, the DIR CDA IG in HL7 and a separate artifact of a transformation guide to transform a DICOM structured report into a CDA, balloted solely within DICOM. While they talked about balloting them both in both organizations but found the proposed process intractable. Managing the ballot process through a single organization is a better way. Jill agrees, finding the HL7 EHR-S FM ballot process with ISO to be difficult. Keith notes that IHE had HIMSS signed up to provide feedback from IHE as well as IHE USA. Comments were coordinated from PCC but provided separately. Liora found that Health Story did not provide many comments while it was open to do so. Keith notes that IHE and HL7 both find the joint balloting perplexing; IHE has considered opening up their comment period like an out of cycle HL7 ballot for additional feedback on the IHE ballot and then take it back through the IHE governance process to respond to items. Frankly they've had so much activity going on that they haven't gotten back to the process, working on tactical efforts. Jill notes that they will only comment on the SDO they find more relevant and abstain on the other since there's not time to do both.
  • Richard D-H asks about work going on at a prior WGM just after Hurricane Katrina on harmonization with 13606. 13606 and CDA integration would be of interest to a wider audience. Giorgio noted that initially CDA was found to be alternative to, not in harmonization with 13606, so earlier efforts were not focused on integration. The use of the pieces and parts of each standard to solve a particular problem continues. Keith adds that Hugh Leslie has also done a prototype of archetypes in CDA in the Australia realm.
  • Liora asks Keith what they could do to agree upon a single ballot process on IGs with HL7 and IHE, IHE could develop use cases and business cases of its own and bring them though the HL7 process, and be more directly involved in HL7 ballots for CDA Implementation Guides. Keith turns the question to what would be wrong with HL7 adopting IHE process for balloting implementation guides. He adds that their publication dates drive their process, where if something doesn't make a certain date it doesn't go out, so the schedule-driven nature creates the difference. We might want towards a common type of process. Liora asks on publication dates, length of cycle, all things that might be worked out so as not to repeat parts of history.
  • Austin adds that we have another session Monday Q3 where we address ideas for what we want to see in the next WGM. Scott will be leading the Monday Q3 session.
  • Powerpoint presentations will be emailed to Lynn and made available online.
  • Harry talks about cross-SDO activity in LOINC. Coding scheme for orders is of particular problem in radiology. Prior codes were insufficient for radiologists who started their own RadLex playbook. They are now collaborating to create a singular reference set of orders within LOINC. This will probably be picked up by IHE Radiology as orderables set for connectathons.

Adjourned 4:51 PM