2018-01-27 TSC WGM Agenda

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TSC Saturday meeting for New Orleans WGM

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TSC WGM Agenda/Minutes

HL7 TSC Meeting Minutes

Location: Newberry - 3rd Floor

Date:2018-01-27
Time: 9:00 AM
Facilitator: Wayne Kubick Note taker(s): Anne Wizauer
Attendee Name Affiliation
? Calvin Beebe HL7 Board Chair (member ex officio w/ vote)
x Giorgio Cangioli HL7 Affiliate Representative
x Lorraine Constable HL7 ARB Co-Chair
x Jean Duteau HL7 Affiliate Representative
x Floyd Eisenberg HL7 DESD Co-chair
x Russ Hamm HL7 FTSD Co-chair
? Pat Van Dyke HL7 Immediate Past Board Chair (member ex officio w/ vote)
? Chuck Jaffe HL7 CEO (member ex officio w/o vote)
x Tony Julian HL7 ARB Co-Chair
x Paul Knapp HL7 FTSD Co-Chair
Regrets Austin Kreisler TSC Chair, SSD-SD Co-chair
x Wayne Kubick HL7 CTO (TSC member ex officio w/vote)
x Ken McCaslin Adhoc Member
x Mary Kay McDaniel SSD-SD Co-chair
x John Roberts Adhoc Member - GOM Expert
x Anne Wizauer(scribe, non-voting) HL7 HQ
x Melva Peters HL7 DESD Co-Chair
Regrets Andy Stechishin HL7 T3SD Co-Chair
x Sandra Stuart HL7 T3SD Co-Chair
Quorum Requirements (Co-chair +5 with 2 SD Reps) Met: (yes/No)

Agenda Topics

Q1 - 9 am to 10:30 am

  1. Roll Call and Introduction of visitors (including declaration of interests)
    • Guests attending Q3: Steve Hugnagel
    • Guests attending Q4: Lynn Laakso, Dave Hamill
  2. Additions to, and acceptance of, agenda
  3. TSC Temperature Check (15 min)
    1. What are we doing well?
    2. What could we improve?
    3. What is the current personal status of each member?
  4. Essentialism Roadmap

Q2 - 11 am to 12:30 pm

  1. Essentialism Roadmap, continued
  2. Future of HSI WG and other WGs affected by essentialism
  3. STU extension/GOM changes not accepted by EC - next steps?
  4. Naming conventions to accommodate FHIR Release 4

Q3 - 1:30 pm to 3 pm

  1. Revised ballot process proposal
  2. GOM Change update - ARB
  3. SGB Update
    • Precept Implementation Strategy
    • SGB/TSC flow
    • How should TSC manage management groups
  4. Planning for WG Health vitality assessment

Q4 - 3:30 pm to 5pm

  1. Review of Standards Withdrawal Process pilot
  2. Re-Review of updated Project Scope Statement template
    • Identifies two product families that don't exist, CIC and V3 (and probably never will) (Austin)
    • Does not include a CIMI Management which in the process of being formed (Austin)
    • Has a slot for SGB approval of PSS's which only occurs if TSC forwards a PSS to SGB. SGB approval should be removed from PSS as it is an extra ordinary step.
  3. Re-examine original scope of PLA
  4. Tooling update

Sunday evening Agenda Topics

  1. ArB
  2. BAM
  3. FHIR
    • Revised ballot process proposal

Tuesday lunch

  1. (January) Review TSC Mission and Charter
  2. (January) Review TSC Decision Making Practices

Minutes/Conclusions Reached:

Q1 - 9 am to 10:30 am

  1. Roll Call and Introduction of visitors (including declaration of interests)
  2. Additions to, and acceptance of, agenda
    • Add external projects/Da Vinci to Q4 and Tuesday lunch
  3. TSC Temperature Check (15 min)
    1. TSC members asked to take a short time to answer the following questions:
    2. What are we doing well?
      • Ken: We’re trying to do essentialism
      • Melva: We do well dealing with the issues that come up
      • Jean: We do the small things really well
      • Tony: We are doing okay with the day to day
      • John: Doing well from the viewpoint of Public Health.
      • Giorgio: We’ve stepped forward in separating local activity from international.
    3. What could we improve?
      • Ken: We need to better communicate around essentialism
      • Floyd: I think we’ve taken a long time on essentialism
      • Melva: We need to make decisions more quickly and also rehashing things.
      • Jean: We need to get the bigger things done better without navel gazing
      • Tony: We kicked off the BAM project but we’ve not finished instantiating it, which is why we’re running into issues with Da Vinci and the like.
      • Mary Kay: Need to get moving on more pieces. Not a formalized way of bringing in comments from the industry; need to collect input in a systematic way so it’s part of the shared knowledge base. Discussion over feedback coming to steering divisions and international council; does it make it to TSC? Melva reports that we often miss that piece.
      • John: Public Health needs to get more people in from Public Health – too much work product that affects public health without their involvement. This is similar to other domains.
      • Giorgio: It isn’t always clear the separation between local and global topics.
      • Sandy: When we roll out essentialism we need to communicate a positive reason for doing it. We do talk too much without action.
      • Lorraine: We get lost in the weeds with things that aren’t urgent but are important. Wayne: Maybe we add an important issue to agendas on a regular basis (quarterly?).
    4. What is the current personal status of each member?
      • Ken: Struggling with work issues and
      • Floyd: Thinking about retiring but not sure
      • Melva: I am retiring at the end of March but am continuing with HL7
      • Jean: My oldest son is getting married, we built a new house, only one kid at home.
      • Tony: I won’t be here in May because of an implementation go-live. Found a new job within organization.
      • John: I am retiring but will be working half time again starting in February. Parkinson’s is under control
      • Giorgio: I am a consultant and most of my time is spent on HL7 - can participate as long as my participation is funded.
      • Sandy: I just spent the last week justifying why we need to be physically at a meeting. More and more pushback.
      • Lorraine: I am funded for this meeting for the first time in a long time. No plans for retirement. Grandbaby coming around the time of Cologne.
  4. Essentialism Roadmap
    • Ken presents.
    • Goal is to keep to four steering divisions, group the WGs logically, and attempt to equalize WG distribution.
    • TSC splits into groups to work on each steering division.
      • MOTION to accept the proposed Steering Division names and associated target WGs: Clinical, Administrative, Infrastructure, and Functional Support: Jean/Tony
        • AMENDEMENT to motion by Sandy: Change functional support to Organizational Support.
        • Discussion over how to begin thinking about evaluating appropriate location of WGs.
        • AMENDMENT that we take the four SD slides and accept those as stated, changing functional to organizational and adding in the WGs that are not currently in those slides: Jean/Tony
      • VOTE: All in favor
    • Ken proposes that all SD cochairs work on populating each SD one at a time. Discussion over whether there needs to be movement beyond what was just agreed upon and whether WGs will be upset by moving/how and what to present Monday night. Floyd suggests that instead of going to the steering divisions and stating what is going to happen; he suggests we go to the WG first to gather their input. Lorraine: The profound change is within Structure and Semantic Support. Paul states that on Monday we should announce the high level structure and discuss it further within SD meetings. Wayne: We also need to figure out the loose ends, but not by Monday.
      • ACTION: Add interest/user groups to Parking Lot

Q2 - 11 am to 12:30 pm

  1. Essentialism Roadmap, continued
    • Next step is to look at WG placement. Need to decide which steering division to work on first to kick off the process. Discussion over transition with SSD-SD. SSD cochairs will transition into being cochairs of the Administrative Steering Division.
    • Reviewed Melva’s sheet with proposed organizational structure and discussed potential moves. SSD’s scope will change greatly. Mary Kay notes that the language that we use on Monday will set the tone. The point is that we’ve reorganized to make things clearer and welcome feedback. Paul suggests showing them in the old structure who will move where. Each WG could look at their structure and discuss whether there is discomfort over where they would be going to. Ken: So on Monday would show the old and the new proposed structure, and the WGs would discuss in their current Steering Division meetings whether or not their proposed placement makes sense. Melva expresses concern that it will take up the entire meetings on Monday night. Discussion over how to go about it with the least amount of disruption.
    • Lorraine: The next question is when this will take effect.
      • MOTION to accept initial recommendations of WG placement: Melva/Paul
      • AMENDMENT to include date of 2018-04-06 as the date the plan will be handed over to staff for changes. Staff will coordinate with EST for planning purposes.
        • ACTION: Steering divisions to start revising their missions and charters now.
      • VOTE: All in favor
  2. Future of HSI WG and other WGs affected by essentialism
    • Discussion over HSI’s placement in T3SD so they couldn’t ballot material. Currently they must coordinate with WGs. Their charter states that they coordinate and facilitate with organizations that include external groups such as IHE. There are discrepancies between what individuals within HSI and the cochairs have said and agreed to regarding individual projects. Ken: HSI agreed that their intent would be to facilitate projects with IHE, engaging the right domain, but it needed to be driven by the WG that owned whatever it was they were delivering. Paul: What question do the cochairs have for us? Wayne: The question is whether the group should exist or not – they were going to dissolve but then there were outstanding questions. They could stick to their current charter, propose a new charter, or disband. Lorraine: The cochairs may need TSC support with their differences of opinion; they need to talk through where they want to go vs. where they are now. Jean: They met for one quarter in San Diego regarding their objectives and charter. Lorraine: We are still working with IHE through other WGs. Wayne: So we’ll leave it where it is right now and they need to disband or figure it out. Paul: They need to make a decision by May. Lorraine notes they are meeting Tuesday. Lorraine: Is anybody running in this election for cochairs? If not they need to elect an interim cochair. Ken confirms they aren’t on the current election.
    • Other groups: Clinical Statement may be appropriate to move into OO. Attachments may be a potential merge into Financial Managements. International Mentoring may move under the International Council. Mary Kay notes that their current project isn’t an attachment. Melva will discuss International Mentoring at the International Council meeting on Thursday.
      • Wayne asks people’s opinion on User Groups. Should we put them all together in one spot, or go back to the SIG model associated with a WG? Paul suggests creating a division of their own. John: They could work with standards but not develop. The logical place is to associate them with WGs. Floyd: I don’t think we should tie them to a specific WG. Perhaps a WG could mentor them. Ken: The goal of user groups was that they would bring in different membership than the developers. The problem we never solved was how do you plug them in? Paul: If we have a steering division that they’re in, then we can manage them through that. Lorraine: The other example is that group that wanted to do the cancer stuff. They were trying to get information across WGs rather than have it divided up, so associating with one WG may not be best. Ken: The cancer piece really was work to be done, not a user group.
      • ACTION: Wayne to discuss next steps on HSI with Laura.

Q3 - 1:45 pm to 3 pm

  1. STU extension/GOM changes not accepted by EC - next steps?
    • Proposal was to make STUs viable up to 7 years. EC didn’t feel that was a good thing. John notes that it was that we wanted to keep the same named document in place for 7 years. Most of the time the issue is to avoid renaming the standard, especially when cited in regulation. There is an STU that is really an STU and then others that are in a different state. Ken: When we were doing the LOI and LRI and eDOS, the issue was more around having the material stay while in regulation. Wayne: Then we should discuss naming conventions because that is part of the process. Lorraine: What is the current state of the rule? Reviewed 13.02.07.02 in the GOM. Currently one year plus one TSC extension of one year, then up to a total of 5 years with EC approval. Reviewed 13.02.07.03 regarding regulatory issues. John: Need a state where it’s an STU but it’s gone beyond the change period. 13.02.07.03 is a problem because it says that the STU available for comment must be the current version. In many cases there are subsequent versions. Wayne states we could ask the EC to accommodate us at this point.
      • ACTION: Add to parking lot and review as part of the GOM update
  2. Naming conventions to accommodate FHIR Release 4
    • Reviewed Lloyd’s document. Calvin was also working on a document but we haven’t reviewed it yet. Ken suggests a cover sheet that explains some of the data that appears in the title. What is the minimum information needed in the title?
      • MOTION to table until we see Calvin’s document: Mary Kay/Lorraine
      • VOTE: All in favor
  3. Revised ballot process proposal
    • Lloyd will come to tomorrow’s meeting to discuss.
      • Steve Hugnagel arrives to observe.
    • Lorraine notes that this proposal supposes that we’re going with Jira as our tool; we could use a better job at using the features of the tool than is stated in this document. The other thing is that the requirements reflected here are sort of buried. Would like to see a much clearer statement of requirements.
  4. GOM Change update – ARB
    • Reviewed table of contents. Purpose, Objectives and Approach section doesn’t talk about the document. Section 9 down starting with WG that describes structure needs to be adjusted for flow. SGB is also not represented. Section 2 needs to be revised for accuracy re: methodology, etc., which is the most emergent issue as it is non-compliant. TSC will make recommendations to GOC regarding TSC observations. The Essential Requirements document will likely have similar updates to be made.
  5. SGB Update
    • Reviewed Paul’s slides regarding SGB activities.
    • FHIR governance board has been an SGB committee. Our expectation is that committee will shut down at their meeting on Monday and SGB will fold in some of their members. On the Tuesday lunch we may come to TSC with recommendations for new members. On Friday we will also be replacing Austin’s cochair role.
    • Precept Implementation Strategy
      • While SGB creates the precepts, TSC must see that the WGs stay in line with those precepts. Need to figure out how the TSC will manage the WGs and MGs adherence to those policies. Reviewed Austin’s document. Do we want a task force to work on addressing this issue? Lorraine: It might be part of PLA’s responsibility and handling the implementation of the BAM. Ken: We do need to make an adjustment because the BAM was erroneous in suggesting that management should go under governance. Lorraine: There are other updates that need to be made based on things we’ve learned from experience. Ken: We are really bad at communicating currently. Lorraine: Lloyd suggested putting the cochairs of the management group on the SGB list for the communications. Tony: The governance groups aren’t responsible for the management groups according to the BAM. The governance group will stand up the management groups and review the management group decisions.
      • Recommendations from Austin for TSC
        • Develop a precept implementation strategy
        • Identify and implement the appropriate work flow processes between TSC, SGB, Management groups, and WGs
        • Figure out how TSC is going to manage the management groups
      • Discussion over how to handle. Seems to be an inclination that PLA should be considered for this role, although their scope would need to be adjusted. Or there could be something like a management steering division.
    • Went back to Paul’s slides. Discussed precept that was developed for handling multi-level ballots; must have a separate ballot pool for different levels of content (normative, STU, etc.). Tony: How do you cite and reference these? There must be some way to manage and present a point in time. Paul: The release does tell you. Melva: It’s the same thing that happened in V3.
    • SGB/TSC flow – this is really the precept implementation strategy.
  6. Planning for WG Health vitality assessment
    • Wayne notes that HTA has no oversight or metrics. Ken thinks it will be difficult to evaluate this until essentialism efforts are completed. Melva states we should kick off the pieces we can do. Reviewed Austin’s document. Proposes a task force to review WG health metrics. Melva agrees and volunteers to participate. Ken likes the idea of outside participation as well. Wayne asks if SD cochairs should mention on Monday night to their groups to gauge interest. Jean: Is it WG vitality that we’re assessing? The team could step back and see if WG Health is fixing what it was intended to and is the original goal being met? Floyd: It’s important to make sure that WGs are doing what they’re supposed to do, but perhaps it’s also based on how they help the organization reach its strategic goals? Melva: I think it’s important to consider if the measures are a true representation of the health overall? At least one WG is green but they are not an effective WG. SD cochairs may mention on Monday night to see if any volunteers.
      • MOTION to convene a task force to look at WG Health: Melva/Ken
        • AMENDMENT that SD cochairs will seek input from WGs Monday night.
      • VOTE: All in favor

Q4 - 3:30 pm to 5pm

  1. Review of Standards Withdrawal Process pilot
    • Lynn Laakso and Dave Hamill here for this item and the next.
    • Withdrawal process pilot started last January – this is the one year review. Lorraine: Paul has noticed that once something has been withdrawn, it’s no long available. Some people feel that 30 days to the cochair list might not be wide enough. Ken: Maybe it becomes a balloted item like a reaffirmation ballot only it’s withdrawal instead. That would widen the audience. Another issue was that this applies to items that have been balloted but not published. The form applies to everything. Lorraine: There is a difference between withdrawing something balloted and not published and something that has been published. Floyd: We have something now that someone wants to publish two years after the ballot. If they decided not to publish, it would be nice to notify people of that. Lynn: It is technically feasible that you could forget about it and not publish, but it will be on your work group health that you’ve not done anything. Lorraine: So for the ballots we need something simpler to notify community and staff. Lynn: This template needs to be divided into two. If we ballot the withdrawal of a published standard, at what level do we ballot? Agreement that we would handle similarly to reaffirmation. John states it should matter if reconciliation has occurred for non-balloted things. Jean: Need to clarify what a withdrawn standard means. Discussion over current process. Jean: If balloted but not published, we need them to go through a formal notification to HQ; don’t need them to go through this process. For published documents, we should have a ballot similar to reaffirmation.
      • MOTION to revise the process such that published standards to be withdrawn would have a process similar to reaffirmation; without publication, staff/HQ/CTO notification is made: Floyd/Ken
        • AMENDMENT: WG approval is necessary
          • ACTION: Lynn to draft new templates. Tony asks that the process be paperless.
          • Lorraine brings up notification for things that are unpublished. Lynn will consider that in her drafts. Wayne suggests notifying the people who voted on the original ballot.
        • VOTE: All in favor
  1. Re-Review of updated Project Scope Statement template
    • Identifies two product families that don't exist, CIC and V3 (and probably never will) (Austin)
    • Does not include a CIMI Management which in the process of being formed (Austin)
    • Has a slot for SGB approval of PSS's which only occurs if TSC forwards a PSS to SGB. SGB approval should be removed from PSS as it is an extra ordinary step.
      • Discussion: Should be CIMI, not CIC. Management group listed should be FMG, CDAMG, V2/Publishing, and CIMI-MG. Remove V3.
      • Mary Kay will send some comments re: investigative projects.
      • Normative notification process via NIB needs to be explored as part of the online PSS process.
        • ACTION: Dave to update and resubmit for future call. Can announce forthcoming updates at cochair dinner, but May ballot can use old form while this is being approved.
  2. Re-examine original scope of PLA
    • Add to future agenda
  3. Managing external projects, eg Da Vinci
    • Also add to Tuesday lunch
      • John states we should not allow people to come in fire hoses - fully completed projects wanting people to approve it and then shopping it around. Need to look at what the BAM says about introducing new products. Da Vinci isn’t looking at a new product family, however. Floyd: Da Vinci’s goal is to develop the use cases and go to whatever WG would be appropriate and work through the standards process to make it happen. It’s different than others coming in wanting a new product and product family. Melva: I think they’re also going to be developing some things and bringing them forward. We would then use our existing ARB review process. Lorraine notes they’ve re-written their PSS to be clearer. Discussion over whether or not Da Vinci is actually an HL7 project. How do we interact with this group, and where is the right place to have the interaction? Is it TSC? US Realm? FMG? Those are the questions we need to answer. Wayne: We need to list some questions/issues/concerns to direct back to Da Vinci. Floyd: How are they different than say, Epic wanting to do some work and coming in here to do that? Not sure why it’s different than a commercial company coming in. Once we get to the individual projects it will be similar. Should Da Vinci become an organizational member? That’s a discussion for the Board. Mary Kay: So do we just look at individual scope statements as the TSC and not care about the other pieces? Lorraine: I think we do care, and that’s why putting together a project was something I supported. Wayne: We can’t tell them how to organize, but we can raise questions and make sure the TSC is appropriately informed. We can also define how we want to collaborate with them. They have to figure out what they are, there has to be an SOU to define how we’re going to work with them. Perhaps there is a TSC liaison that works with them.
        • ACTION: TSC members should submit questions/concerns/recommendations to Anne for further review
  4. Melva asks about balloted content in the FHIR ballot that hasn’t been through the approval process. Grahame let some things go into the build so people could look at it but it never had an approved project. We have processes in place but FHIR operates differently. Need to take a look at what happened; where else do our current processes fall down in FHIR? Ken: Whenever you allow developers to create the versions and put them in production you risk some things. We’d have to hire someone to manage that. Wayne: We need clarification on what the process is from an FMG standpoint. Lorraine: The OrderCatalog project has new resources; Lorraine checked to see when the proposals are due. Lloyd stated they were due January 10th because they don’t really need the proposals before the content is done. In FHIR, each WG doesn’t create its own NIB, for example. There is no validation point. Wayne: Does the product director submit something like a bill of materials for review? Lorraine: What could happen is before the ballot goes out, WGs responsible for resources look at what’s there and make sure everything has been reviewed and approved. Jean: We need to find out what the process is.
    • ACTION: Wayne to discuss process with Grahame and report back
  5. Tooling update
    • Wayne presents tooling update slides.
      • Did an inventory of tools and there are too many; need a smaller set of collaboration tools. Tools should be more similar from one WG to another. There are tools for collaboration, standards creation, and implementation.
      • Need to come up with a defined, consistent base architecture/platform for developing new tools that are open source when appropriate and cloud-based.
      • We need to avoid major capital investments by leveraging grant opportunities
      • We want to make incremental progress over time
      • Plan to reduce number of tools in use by migration and retirement
        • Lorraine would like to see organizational decisions on things like tools for modeling. We can’t just absorb every tool that someone brings to us.
      • Can’t have different rules for every WG. Need to reduce heterogeneity with a simpler environment.
      • Pushing to use Confluence. Discussion over use at WGM for attendees. Some people don’t have ability to add themselves because they aren’t carrying a computer or phone.
      • Difficult to communicate tooling improvements. May be doing monthly webinars, confluence pages or chat streams, more regular emails, and identifying more knowledge and user support throughout the community.
      • Big ideas underway: FHIR registry, Confluence, UTG, Jira-based balloting
        • Suggestion that WGH eventually has a measure that reflects the use of standard tools
      • Wayne invites TSC to forward comments and suggestions. Mary Kay suggests having a member responsibility statement.
  6. Adjourned at 5:05 PM


Actions (Include Owner, Action Item, and due date)
  • Add interest/user groups to Parking Lot
  • Essentialism
    • Steering divisions to start revising their missions and charters now
    • At Monday night SD meetings, show WGs the current structure and the proposed structure to gauge whether or not they feel that their proposed placement makes sense
    • Coordinate with staff/EST regarding updates to website/wikis/member database
  • TSC members should submit questions/concerns/recommendations re: Da Vinci to Anne for further review
  • Wayne to discuss next steps on HSI with Laura.
  • Add STU extension issue to parking lot
  • Table naming convention topic until we see Calvin's proposal
  • Convene a task force to look at WG Health
  • Lynn to draft new withdrawal templates/processes and bring back to TSC for review
  • Dave to update PSS template and bring back to TSC for review
  • Add original scope of PLA to future call
  • Wayne to discuss FHIR resource approval process with Grahame and report back
Next Meeting/Preliminary Agenda Items
  • .