2014-01-19 TSC WGM SDO Activities Minutes

ORC/TSC Sunday Q4 Agenda - 2014 Jan WGM, San Antonio, TX USA

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ORC/TSC HL7 activities with other SDOs Meeting Location: Regency Ballroom West		Date: 2014-01-19 Time: Sunday Q4
Facilitator	Scott	Note taker(s)	Lynn Laakso
Attendees
see attendance list

Agenda

Welcome and Introduction - 201401 Activities with other SDOs

• Liaisons Present
• Reports provided:
  • ISO TC215 liaison report Ted January 2014
• Others who choose to speak for/about an SDO

Liaison Reports

• Each liaison will be permitted time for a brief summary of activities for the SDO over the past "year" (a rough time period). This should include a brief statement about the scope of the organization. 5-7 minutes for the summary, adjusted for the number of reports/liaisons present.
• Each liaison is asked to respond to the following questions. Short answers, probably not more than a minute per response.
  1. What has been the most significant issue / problem / topic for your organization over the past year? (1 to 3 items)
  2. In the US, Meaningful Use has been a significant driver. What other regulatory or policy concerns is your organization facing? (1..3)
  3. If your organization could choose one project or resolving one problem, and be assured of completing that project/problem over the next year, what project or problem would that be?
  4. What impacts do you see for your organization in regards to the rapid acceptance of digital devices?
  5. Fun question: Where are your organizations next two in-person meetings being held?

The audience will be permitted some time to respond, but there will be a time limit in order to allow all liaisons to speak.

Discussion

Minutes

Convened by Scott Robertson at 3:43 PM

Liaison Reports

• Ted (ISO), Bernd (CEN), Christian (GS1), Bill Hash (IEEE), Harry Solomon (DICOM)
• Christian Hay (GS1)
  1. Most significant issue: UDI (manufacturer and user community); also worked on units for drugs and devices as an international standard, drug specificity and identification also law in U.S. recently passed unit of identification as LDE to fight falsification.
     • Recent HL7 UDI Task Force joint with HL7
  2. Regulatory and policy drivers: fighting falsification a regulatory task in Argentina, Korea, Turkey, etc., helping regulators adopt convergent and not divergent solutions.
  3. So many things on their plate but nothing requiring to be solved this year; they would love to see implementation of some of their work
  4. Digital Devices: UDI is a big part of this. Bar codes already on devices should be used to access instructions for the device in multiple languages.
  5. Next meeting in March in Seoul Korea and October in Copenhagen, next April in Mexico

• Ted goes next; he notes that HL7 continues to work closely with LOINC who has been responsive to issues. Document ontology formal names for value set definitions was a recent example. Now ONC MU objective for common orders is next on the list. While Ted works mostly with clinical LOINC he reports that laboratory LOINC is mature in model and content and continues apace with the recent release in December. Over 70k terms now in LOINC. Dividing up observations for LOINC as observations and SNOMED concepts as observables.
  1. Ted notes he cannot answer the questions for the whole ISO organization as he works on a small segment. As representative to ISO TC 215 last meeting in Sydney AUS he participates in WG3 on semantic content, code systems and terminologies. He works with TC249 on Traditional Chinese Medicine standards. Primary content of core principles ch 5 on terminology binding with ISO Harmonized Datatypes is underway from ballot and hopes to be ready by the next meeting. Japan and Berlin are the next ISO meetings. He notes there are administrative burdens the secretary struggles to keep up with. Project overlaps between TCs are also an issue. He describes efforts to define a meta-standard to classify sets of standards in the Traditional Chinese Medicine realm that may conflict with work in TC1.
  2. SDC an effort in US on 11179. They finally realized they don't have to reinvent the wheel. In LOINC there are discussions on including LOINC in US regulation but there are political issues with that requirement in the burden to maintain order masters. LOINC use outside the US is unknown.
  3. Big project this year - figure out how to get people (national bodies) to sponsor ISO meetings - they do not charge for attendance. LOINC is not a problem as Regenstrief is funded by NLM. He's not aware of any one particular problem in LOINC needing resolution.
  4. Digital Devices: devices don't spit out LOINC codes. LOINC is also looking at a fee-based membership model.

• IHTSDO - since Russ isn’t here Jane Miller has a new role as head of collaboration and she is revisiting their agreements. Proposed collaboration should be supportive of the values of the organization strategies and priorities etc. The HL7 agreement is 5 years old so is time for review. Working with vocab, HTA, etc.

• Bill Ash works with IEEE
  1. Their primary issue is resources. They are working on 11073 nomenclature standard with terminology amendments.
  2. They are also working on devices, with insulin pumps and CPAP machines for example. MU stage 3 dealing with digital portable devices
  3. MU stage 3 focus on a completed partnership by April next year to demonstrate a pilot at HIMSS.
  4. See above
  5. Governing board/BOD in March in New Delhi, TAG meeting in Brazil and Beijing is standards board meeting.

• DICOM: Harry Solomon provides this report
  1. Key problem/topic: Working on ophthalmology imaging in eye care, radiation therapy moving into next generation, radiopharmaceutical safety is now under public comment and about to ballot for capturing dose information. Preservation of value of historic information, and access to imaging for the devices is part of their work in web services. This started as WADO in '99 for web services for imaging.
  2. Regulatory/Policy concerns: HL7 CDA IG for Radiology Reports in process for bridging clinical content from RSNA to CDA. Effectively R2 of the CDA R2 DIR. Harmonization of several hundred change proposals each year are also of concern. Harmonization with LOINC and RSNA RADLEX terminology is another project of interest to the HL7 community. Ted asks if they are looking at radiology orderables in LOINC - Harry states they currently have no reference to any coded observables. Collecting data for radiation physics, patient safety and so on are being watched in potential regulation. He notes MU has impacted them by sucking up all the investment dollars in healthcare IT
  3. The push this year to publish DICOM in XML format will provide persistent URIs for tables, requirements, etc for the standard.
  4. Web services is the impact in digital devices
  5. April they meet in Vienna along with IHE connectathon. August in Chengdu (China), and Chicago in December.

• Doug Fridsma addresses atypical SDO
  1. Significant issues: MU regulation coming out. Relevant to GS1 we want to fit with CCDA. They need standards on registries. Following SNOMED and LOINC efforts as well. Meetings with RSNA they have given some recommendations for DICOM. US MU between US and UK to be addressed on Thursday. They have breached 60% EHR adoption up from 17% and 80% of hospitals.
  2. MU impact is Affordable care act and accountable care orgs as healthcare reform goes into play as they start paying for quality not just procedures. National standards strategy in US and approach to transformation will be addressed. Meaning, structure, transport, security, and services are five fundamental building blocks of their standards. ICF is of concern, and they want to move from declarative semantics to computable semantics. Structure addressing CCDA, HQMF, etc standards supporting those activities but move from document-centric to data-centered ways of looking at this information. Transport will rely on FHIR coming into the portfolio. Security is currently managed with direct certificates. Trusted identity in cyberspace gives new directions for identity management. Services: not many in MU activities but have IGs that tell people how to build things but need to give people power to use things (like APIs). APIs can be thought of as encompassing all of the first four blocks.
  3. One project/problem: SDC and DAF (Data Access Framework)
  4. Digital devices: MU push has not given them much room to work on digital devices but will gain focus in the next couple of years. MU funded patient centered research outcomes initiative to support development of data infrastructure over next 5 years.
  5. Next meetings: ONC has annual meeting on Thursday in DC and introduction of new National Coordinator Karen De Salvo.

• OMG representative in place of Ken, Brian Postlethwaite reports services directory coming back to PA here and they are also working with FHIR. He notes the AUS human services directory as a nationwide adoption of the services standard. There is CIMI activity as well.
  • Doug Fridsma notes a prescription drug monitoring program project in NIEM is launching per his discussion with Richard Soley. Also working with NCPDP standards in prescriptions they will have to harmonize with the trifecta.
  • Brian also notes HSSP will be working on IGs

Scott summarizes from the answers to the questions

1. significant issue - UDI affecting many
2. Drug and prescription pedigrees to fight falsification is a significant driver in US as well.
3. Big projects: finding meeting sponsors, SDC/DAF receiving a lot of push in US
4. Impacts of digital devices: IEEE for digital device implementation and spitting out LOINC codes

Scott reports we still want an informational session Q4 Sunday and seeking ideas for marketing the session for member interest.

Adjourned 4:52 PM