2013-09-21 TSC WGM Minutes

TSC Saturday meeting for 2013Sep Cambridge WGM

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TSC WGM Agenda/Minutes

HL7 TSC Meeting Minutes Location: Hyatt Regency Cambridge William Dawes A		Date: 2013-09-21 Time: 9 AM-5 PM EDT
Facilitator: Austin Kreisler		Note taker(s): Lynn Laakso
Attendee	Name	Affiliation
x	Calvin Beebe	HL7 SSD SD Co-Chair
x	Woody Beeler	HL7 FTSD Co-Chair
	Giorgio Cangioli	Ad-Hoc member, HL7 Affiliate Representative-elect
x	Lorraine Constable	HL7 ArB Vice-Chair
	Bob Dolin	HL7 Board Vice Chair (member ex officio w/o vote)
x	Jean Duteau	HL7 Affiliate Representative
x	Freida Hall	HL7 TSS SD Co-Chair
	Chuck Jaffe	HL7 CEO (member ex officio w/o vote)
x	Tony Julian	HL7 FTSD Co-Chair
x	Austin Kreisler (Chair)	HL7 TSC Chair, Ad-hoc member
x	Lynn Laakso (scribe, non-voting)	HL7 HQ
x	Ken McCaslin	Ad-Hoc member
	Don Mon	HL7 Board Chair (member ex officio w/ vote)
x	Ron Parker	HL7 ArB Chair
x	Melva Peters	HL7 DESD Co-Chair
x	John Quinn	HL7 CTO (TSC member ex officio w/vote)
x	John Roberts	HL7 DESD Co-Chair-elect
x	Andy Stechishin	HL7 T3SD Co-Chair
x	Pat Van Dyke	HL7 SSD SD Co-Chair
x	Mead Walker	HL7 DESD Co-Chair
Quorum Requirements (Co-chair +5 with 2 SD Reps) Met: (yes/No)

Agenda Topics

Q1 - Governance - 9 am to 10:30 am

Roadmap and HL7 Strategic Issues:

1. Roll Call and Introduction of visitors (including declaration of interests)
2. Additions to, and acceptance of, agenda:
3. Link to Interim decision review since last WGM
4. Election of TSC Chair
5. Strategic Initiatives discussion
   • WGM Effectiveness statistics
   • Strategic_Initiatives_TSC_Dashboard suggestions
6. Work Group Health
   • Review of WGH metrics
   • Review draft results of Midtier Governance/Management group health

Q2 - Governance continued: 11 am to 12:30 pm

1. Member Benefits - Chuck Jaffe (30 Mins)
2. Governance Group reports
   • TRAC (Pat) (30 minutes)
   • Overview of TRAC process
     • Inventory sources of risks reviewed and associated vitality triggers
     • Identified issues
     • Critical Risks
     • Proposed Governance Points
     • Sources for Continued Review

Q3 - Governance continued: 1:30 pm to ? pm

1. TSC Messages for the week
   • Co-chairs dinner
   • General session (time limited to 5 minutes)

Q3 - Management - ? - 3 pm

1. High Priority Issues
   • Issue - IHE Balloting - Form a task force?
   • Issue - Making final "draft" versions of standards available for work group QA review
     • Problem is that this content is close enough to final that posting this publicly (wiki or hl7 website) may violate new 90 day members on availability policy
     • Need a mechanism to make available for QA review while restricting access to HL7 members only

Q4 - Management - 3:30 pm to 5pm

1. TSC Review and Planning
   • (Sept) Review and re-confirm ArB membership (even numbered years)
   • (Sept) Review and confirm ORC liaison assignment
2. Management Reports
   • CTO/Tooling Report (John Quinn)
   • US Realm Task Force
3. (45 mins) Review Open Issues List
4. TSC Project Review

   TSC-Sponsored projects

   • HL7 Product Line Architecture PI# 916
   • HL7 BAM (Business Architecture Model) PI# 915
   • Risk Assessment and Governance for HL7 Architecture Program PI# 901
   • FHIR DSTU Ballot PI# 891
   • TSC Governance System for HL7 Business Architecture PI# 890
   • HL7 Strategic Initiatives Dashboard Project PI# 799
   • SAIF Pilot Coordination PI# 764
   • HL7 SAIF Implementation Guide PI# 763
   • SAIF Architecture Program PI# 751

   TSC Co-sponsored projects:

   • Extend DSTU comments site functionality to informative and normative PI 1032
   • Pilot SAIF ECCF SFM in publication request (on hold) PI 996
   • WGM Room Assignment Project 2013 PI# 944
   • Interoperability Resources for Healthcare (IR4H) Methodology Design PI# 809
   • Preparation of SAIF Book for Informative Ballot PI# 807
   • EHR System Function and Information Model (EHR-S FIM) PI# 688

   TSC Three-year planning projects

   • FHIR Program PI 883 next milestone date currently 2013May...
   • Maintenance project: Work Group Visibility
5. Next WGM Planning - next two WGMs - agenda links
   • 2014Jan TSC Saturday meeting Jan 18, 2014 to Jan 24, 2014 - San Antonio, TX
   • 2014May TSC Saturday meeting May 4, 2014 to May 9, 2014 - Phoenix, AZ

Architecture and Tooling:

1. BAM
   • Enacting Steering Division review of projects; specificity of project scope vs ballot artifact
     • vitality triggers by time-based (aging) or event-based (NIB)

Sunday

1. • FGB (Ron) (30 minutes)
     • TBD
   • FMG (30 minutes)
     • New member appointment
2. ArB (30 minutes)

Wednesday lunch

Data Access Framework (DAF) of S&I Framework (John Feikema)

1. WGM Planning - agenda setting next two WGMs - agenda links
   • Schedule:

     (January) Review TSC Mission and Charter

     (January) Review TSC Decision Making Practices

     (May) Review TSC Three-Year Plan

     (September) Review TSC SWOT

Minutes/Conclusions Reached:

Q1 - Governance - 9 am to 10:30 am

Roadmap and HL7 Strategic Issues:

1. Roll Call and Introduction of visitors (including declaration of interests) Convened 9:01 AM, with no visitors, John Roberts attending as invited guest.
2. Additions to, and acceptance of, agenda: move Q2 FGB to Sunday, may move Q4 ArB membership re-confirmation to Sunday. Wednesday lunch will also have DAF initiative presentation from S&I Framework. Chuck's presentation is nominally in Q2, but whenever he breaks away we will insert his topic. Agenda accepted by general consent.
3. Link to Interim decision review since last WGM
4. Election of TSC Chair - Andy moves and Lorraine seconds naming Ken McCaslin as TSC Chair for 2014-2015. No substantial discussion ensued. Unanimously approved.
5. Strategic Initiatives discussion
   • WGM Effectiveness statistics
     • WGM Effectivness spreadsheet reviewed. Draft TSC weighting of the different factors discussed. One example criteria representing tutorials could be indicated by the number of tutorials cancelled noted Melva. After the Sydney meeting, the statistics are consistent with US attendees vs non-US attendees.
     • Tutorials in Sydney were higher across the board, number of tutorials, number of students, students/tutorial, similar to Baltimore.
     • 'Students' column is for the paid attendees to the tutorials.
     • Profit/loss weighting discussed, drafted as a 1, but as a factor under the influence of the TSC it means little. However, Melva notes that the quotes for the venues and locations are all over the board for international locations, and some locations are scheduled with the deliberate knowledge that they will lose money. Rather than profit/loss, using delta to budget would be another metric.
     • General trend is positive 2011 to 2012 to 2013, in terms of representation of TSC efforts on this Strategic Initiative, to report to the Board. The incoming Board chair has an opportunity to revisit/revise the
   • Strategic_Initiatives_TSC_Dashboard suggestions
     • We will not differentiate between international and US based meetings for SI dashboard, as comparing US based meetings among themselves gives little feedback. Care must be taken to consider local/national holidays in scheduling international meetings. Local representation is difficult to measure for locations like Cologne, or Rio de Janeiro
     • Other dashboard gauges needing report: Industry Responsiveness and easier implementation, Product Ballot Quality. Product Ballot Quality has started but the team has not met again to review the comparison of the statistics to the manual review.
     • Cross artifact consistency question: should DAMs or foundational standards which define no artifacts be included among the standards publications on which the checkmarks are counted for using HL7-managed CMETs, harmonized design patterns, or consistent with common Domain models. Harmonized design patterns have not taken off. Ron notes that conformity assessment with the re-emergence of SAIF will obviate drivers for such design patterns that have not been previously surfaced.
     • DAMs should consider the common domain models elsewhere in the organization, like clinical statement or common product model. Calvin notes that DAMs are not necessarily (by definition) RIM-based expressions. The examples are expressions of RIM-based semantics. He feels that the DAMs should not be held to these expressions. DAMs have been expressed as V3 artifacts when they are not necessarily so, but the business-level requirements not associated with a paradigm. DAMs can be considered foundational standards. We may wish to change this to survey of newly published V3 logical standards (not conceptual - DAMs - or implementable - IGs). John notes that CIMI has as an expression of bringing in different models and exchanging this with others. For example they use an input of the RIM and an output of CDA - you lose property information from the RIM when expressed in CDA… backwards traceability is a highly desired property.
     • Methodology of doing DAMs, reflecting the views of the people in the domain, is the central notion. Consistency between DAMs discussed. Behavioral pieces, model pieces, an elaboration of the original definition into the common parts need better expression. Jean notes that looking at different DAMs yielded completely different results. Mead notes fundamental differences in the approaches to modeling data that need to be resolved, not to a middle ground but to choose one approach. Need to address "how is HL7 going to publish DAMs". Similarly Implementation Guides have different approaches which led to CDS' perception that you could throw logical and implementable together into the big IG bucket. Each product line probably needs to define how their implementation guides should look. Andy suggests we look at IETF RFC 2119 for a starting point.
     • Austin asks about defining cross-artifact consistency for DAMs and IGs - IG conformance definitions would be by Product Family; DAM definition by ArB exists. Jean was planning to address DAM definition with CIC, who produces many of our DAMs, and have them establish something more than a style guide. How will we measure consistency, does it have a defined scope, etc. Andy suggests we ask CGIT for definition of IGs. While they have typically focused on V2.x we should ask them first. SDWG is the de facto group for CDA IGs, notes Calvin. For V3 would it be MnM? Does ArB need to make a one-page definition to drive the discussion with the other groups (Lorraine)? Austin notes that we created a one-pager for what defines normative versus informative, etc. and could be used as the kind of template or scope for which such a definition could be made universally and then made product family specific.
     • We are challenged by the CDS vMR, the SDC, are coming in completely agnostic to any existing work, not even a derivation from the RIM. Did they come to HL7 because they thought getting our SDO stamp was "easy"? HL7 has the best representation from the provider perspective, but not that we would rubber-stamp it and send it out the door. These initiatives are caught in the middle between proper standards development at HL7 and the Congressional requirements imposed upon them. Defer this to US Realm Task Force discussion.
     • Returning to cross-artifact consistency on DAMs, we need a statement on what kind of consistency we need, for a value proposition. We want to capture the thinking of the domain experts, and not prevent the SMEs from giving their knowledge without forcing them into a modeler's frameset. Developing the vMR from scratch with XML, elements of the ITS, etc should be in that statement up front, not overly burdensome to that level. What do you need to be carrying in your bag when you come through the door to HL7, e.g. terminology/vocabulary etc when you bring logical/implementable, and respect the level of SAIF ECCF you're at. OWL space ontologies are coming in as well in health care. What is an HL7 conceptual-level or logical-level ontology look like, notes Jean. What is a conceptual-level model, DAM or ontology - what is the desired level of consistency? ACTION ITEM: Calvin and Lorraine, aided by Jean will work on DAM desirable consistency value proposition, and conformance definition. They may wish to ask for aid by AMS.
     • What about a general definition of an IG - Freida and Andy have volunteered. Need someone from CGIT… Rob Snelnick is suggested. Freida will speak with Rob. ACTION ITEM: Andy, with Freida, Ken McCaslin, and John Roberts will work on IG definition and conformance and inviting Rob.

Recessed at 10:30 AM

Q2 - Governance continued: 11 am to 12:30 pm

1. ArB leadership: Ron is leaving ArB; John explains his process for nominating Tony as new ArB chair. Motion: John moves and Lorraine seconds Tony's nomination. Ron explains that he can support the ArB until the end of the WGM. Tony now has a seat on the TSC as FTSD, but would potentially hold two votes so may need to find a replacement representative on FTSD. Tony notes that there is also a potential candidate for FTSD which can review on Monday night. Vote: Unanimously approved
2. Work Group Health
   • Review of WGH metrics - no new suggestions
   • Review draft results of Midtier Governance/Management group health
     • DESD does not have concalls and it's in their DMP. Does it have to be measured? They have been participating well on electronic votes after being threatened with having conference calls. Jean asks if the metric for whether they are getting their business done, then concalls may not be the only way. Austin notes that another agenda item today is the active role of monitoring projects, and re-assessing project scopes regularly. How would DESD do that by e-vote?
     • TSC concalls and participation in e-votes as a separate metric. SD concalls and e-votes participation are both measured for SD activity so DESD would be registered as having e-votes.
     • International Council chose not to participate. Should we measure them anyway? ACTION ITEM: Jean will talk to them about whether they should be measured.
     • Austin presents to them tomorrow morning, and he can offer this as an example of the measurement.
     • We can't assign a green supported group health for TSC until we know red/yellow/green for the other SDs.
     • FMG/FGB do not match up with many metrics. FGB has responsibility to provide governance to FMG regarding the FHIR exercise. Discussion of consolidation of governance will be in Ron's update. FMG doesn't necessarily feel they report to the FMG. ArB, FMG and FGB each don't have other groups they support, but only ArB has a seat on the TSC for measurement of participation.
     • Suggestion: zero is green, 1-2 is yellow, 3+ is red. The TSC would then overall supported group health be yellow.
     • Representation at TSC e-votes should be 85%. 75% is okay for calls. Conduct of concall/e-vote by SD is still >1.
     • What metrics would apply for FMG/FGB?
3. Member Benefits - Chuck Jaffe (30 Mins)
   • User groups would be by domains, not geography, to be international and virtual.
   • Concern with user groups is that a User Group (UG) would want to develop standards, notes Austin. Ron notes that UG can contribute to conceptual requirements and validation of requirements are met. CJ says UG are also focused on implementation. RP says the users of standards are different from users of systems. Lorraine notes that RIMBAA is already a UG. How do BOF fit into the UG model. CJ notes this is an added forum, asynchronous, not at WGM. CB asks if this is a new type of member. CH says not a new type just new members, to reach out to those that have not typically participated, to step individual members from huge corporations in order to obtain those organizational memberships.
   • Member advantage webinars: e.g policy webinar had hundred of callers to hear a distinguished panel. Also hoped to grow participation from stakeholder groups. Caregivers' effort unsuccessfully answered question "what's in it for me". Austin notes the last webinar was technically problematic; Chuck answered it was a Cisco problem.
   • Education platform: The new education portal is being rolled out, with the technical ability for online certification testing. It's still rolling out but they're using it this week notes Melva. Ken thinks it's great. Austin asks if the portal is members-only. Melva says there is tiered access.
   • Conformance Testing: This has been the most highly requested item, as a member benefit. HL7 members don't understand the business behind this. CDISC and IHE start at $25k, They aim not to set a low bar, but to offer feedback on errors, and permit re-use until a solution is conformant; instead of one-and-done. Jean notes that Infoway pays vendors for conformance testing. Chuck notes they considered the Canadian experience. Current specs are not stringent enough for testing. To what profiles can we test and what benefits or value does the testing process provide? Reduction of cost/time to implementation is the goal. ATM examples described. Jean notes that the stakeholder surveys' responses were skewed by the stakeholder perceptions of "conformance". John R notes that it pits our members against each other - NIST-compliant is no guarantee of acceptance of messages in PHER. This will be discussed further on Tuesday in the Board meeting: can we, should we, how do we do it. Checking with 5 other ISO-certification platforms. The UG would not be US Realm-specific but HL7 standard specific.
   • TSC Role: Advance tooling and product families for management of machine-processable artifacts. With three month advance for members, how to permit committee review of pre-publication material other than ballot sites.
4. Governance Group reports
   • TRAC (Pat) (30 minutes) - Pat shows a slide show
   • Overview of TRAC process
     • Critical Risks
       • Woody notes that engaging with negative balloters early in the process is a different risk.
       • Calvin notes that the number of normative ballots is one per product, risk ID 25 metrics. Should use "final" ballot or review the metric. Draft for Comment is not a "ballot". Balloting guidance has been out for a while, but what Mead has heard is 'push it through' and not 'put in the work up front and get it right the first time'.
     • Formal risk analysis of board motions risk description discussed. Pre-publication materials distribution risk vs. current issue. Material uploaded to the website even listed as members-only can be changed by a cochairs to become public. Perhaps we change that to make the members-only default and the switch can only be flipped by staff.
   • We will continue to bring these back to the TSC.
     • John Roberts suggested we cycle these back to the WGs for consideration in their SWOTs.
     • Melva suggests we identify what level this risk relates to, Lorraine adds the appropriate governance level in the BAM might be the terms of reference. Freida notes feedback to the GOM revisions.

Recessed at 12:35 PM

Q3 - Governance continued: 1:30 pm to ? pm

1. TSC Messages for the week - defer to end - 15 mins
2. High Priority Issues
   • Issue - IHE Balloting - Form a task force?
     • Project did not pass in DESD. The TSC took it over and then deferred attention to it. Need project to define the process, at more rigorous levels than draft for comment. IHE ballot and cycles don't match with HL7. OOC ballots cost staff resources so if they routinely will not meet deadlines we need to resolve it, notes Woody. Like the S&I Framework, they are developing outside and bringing it in, notes Lorraine. Freida notes they profile some HL7 standards however. Austin notes that we need a process for reviewing content that gets thrown over the wall for HL7 to put through our process. This type of content review may fall back to the ArB to see how such work fits into the HL7.
     • Extensive discussion ensued. Guidance to external organizations on bringing externally developed Implementation Guides (GOM section 18) needed; definition of implementation guides is already being assigned to another group. US Realm Task Force relationships management also a component.
     • ArB setup their content review group quickly to start looking at SDC and FAD, though Lorraine is concerned with the volunteer bandwidth to make that happen.
     • IHE is probably more a task for the US Realm Task Force.
   • Issue - Making final "draft" versions of standards available for work group QA review
     • Problem is that this content is close enough to final that posting this publicly (wiki or hl7 website) may violate new 90 day members on availability policy
     • Need a mechanism to make available for QA review while restricting access to HL7 members only
     • Discussed under risk assessment/TRAC for ongoing risk. Current issue is versions of standards published as standalone documents on WG web pages, virtually complete pending final approval by WG prior to HL7 publication. This doesn't really apply to V3 standards but those things that can be published as documents. Ken finds the membership benefit of first 90 days' access behooves us to create a place for pre-publication staging. Andy cautions we must evaluate what it will cost to do, versus what it will cost us not to do. Mead asks if it's just education to the cochairs? Some cochairs are still pushing to keep it public.
     • John Quinn notes there are two models to SDOs, one that all is free but you pay to develop the standards. The second is you pay for access to the standard. We have moved to the first model, but we have not yet committed to the location to draw the line, at what point do you only allow members to participate even with the early contributions to a standard. Ron notes the difference between consumer and contributor. What's missing is that the development of such-and-such a standard needed by S&I or ONC should be 'assigned' to a particular SDO and they direct interested parties to go over to that organization to work on it.
     • Ken feels we need to draw the line to differentiate the member benefits. Ballot package and preparation needs to be secure, and anything past the ballot package goes to a members-only area. Lorraine notes how WGs post development all over the place. Austin notes that some organizations do HL7 development internally and hand over final product for publishing.
     • Jean notes that non-members need to know when they contribute on a phone call, they have no effect until final publication.
     • Ken suggests we shoot for January to get the requirements and planning done, aiming for May to have policy instantiated and technology implemented. John Q suggests we socialize the concept and/or request endorsement from the Executive Committee and Board for the policy aspects of this approach, acknowledging there may be GOM changes. Austin will work on taking this to the Board; Calvin suggests we offer this as the operationalization of the 90 day advance window.
     • Motion: Ken moves the TSC recommend to the EC that by January we come up with an implementation strategy that locks up the preproduction content so that only staff can unlock it and it be accessible by members-only. John Q seconds. Vote: unanimously approved.
   • Governance (reprised)- FGB (Ron) - slide show
     • Discussion of period from DSTU to Normative and reticence of implementers to keep DSTU features and US Government regulation citing DSTU. Need to bring organizations into vested interests in management and governance if they are implementing.
     • FMG may have to create structured function areas within FMG; education, connectathon, versioning, liaison management. Product features and rubric in product director currently held by FMG review. Different skillsets will be required. Calvin notes that the education focus should not be duplicated or diluted. Jean notes that this product management group would have served V3 well. Functional expertise and subject domain expertise have collected together in different ways in other groups in HL7, e.g. Patient Care, Publishing, etc. Calvin notes we need to get ahead of this organic formation which will conflict with our consistency efforts, and make the forecast of the structure needed.
     • In addition to the other areas, the work with FHIR methodology needs separate attention.
     • Calvin asks about application of SAIF Framework and will this be done for V2? Common use cases for V2 implementations and FHIR implementations would be worth looking at. Solving common business problems using the framework may emerge in the ballot comments. Lorraine noted that a requirement for SAIF has been identified in non-healthcare space governmental RFP. Ron notes the Canadian finance authority has used it also and it was reflected in updates to their website.
     • Jean notes concern with the rush to ballot. The one-cycle passage in opposition to the 'sniff test' for readiness are in conflict is cited by Lorraine. Jean notes that the WG involvement has been lacking, noting Patient Care - Lorraine adds they have wanted to create content faster than the WG can produce. Core group took over PC area so the WG disengaged - a significant risk.
     • Ron notes the break point is needed, and very clearly drawn, between the breakneck pace of development and the pause for feedback during DSTU.

Recessed 3:33 PM

Q4 - Management - 3:30 pm to 5pm

Convened 3:51 PM

1. TSC Review and Planning
   • (Sept) Review and confirm ORC liaison assignment - Melva is our current ORC liaison, and is willing to continue
2. Management Reports
   • CTO/Tooling Report (John Quinn)
     • John reviews a slide show on the results of the Conformance Testing and Certification Surveys
     • Ken comments that in the lab industry they have to perform their own conformance testing every 2 years for CLIA so HL7 conformance testing would not be useful to them. LOI and LRI conformance has to be done by each vendor anyway, but the EHR side would be interested. It was suggested to have a UG on conformance testing.
3. TSC Messages for the week - defer to end - 15 mins
   • International Council vs. Co-chairs dinner relevance to US Realm project issues
   • General session (time limited to 5 minutes)

Adjourned 4:53 PM

Deferred agenda items

1. • US Realm Task Force
2. (45 mins) Review Open Issues List
3. TSC Project Review

   TSC-Sponsored projects

   • HL7 Product Line Architecture PI# 916
   • HL7 BAM (Business Architecture Model) PI# 915
   • Risk Assessment and Governance for HL7 Architecture Program PI# 901
   • FHIR DSTU Ballot PI# 891
   • TSC Governance System for HL7 Business Architecture PI# 890
   • HL7 Strategic Initiatives Dashboard Project PI# 799
   • SAIF Pilot Coordination PI# 764
   • HL7 SAIF Implementation Guide PI# 763
   • SAIF Architecture Program PI# 751

   TSC Co-sponsored projects:

   • Extend DSTU comments site functionality to informative and normative PI 1032
   • Pilot SAIF ECCF SFM in publication request (on hold) PI 996
   • WGM Room Assignment Project 2013 PI# 944
   • Interoperability Resources for Healthcare (IR4H) Methodology Design PI# 809
   • Preparation of SAIF Book for Informative Ballot PI# 807
   • EHR System Function and Information Model (EHR-S FIM) PI# 688

   TSC Three-year planning projects

   • FHIR Program PI 883 next milestone date currently 2013May...
   • Maintenance project: Work Group Visibility
4. Next WGM Planning - next two WGMs - agenda links
   • 2014Jan TSC Saturday meeting Jan 18, 2014 to Jan 24, 2014 - San Antonio, TX
   • 2014May TSC Saturday meeting May 4, 2014 to May 9, 2014 - Phoenix, AZ

Architecture and Tooling:

1. BAM
   • Enacting Steering Division review of projects; specificity of project scope vs ballot artifact
     • vitality triggers by time-based (aging) or event-based (NIB)

Actions (Include Owner, Action Item, and due date) .

Next Meeting/Preliminary Agenda Items .