2017-09-09 TSC WGM Agenda

TSC Saturday meeting for San Diego WGM

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TSC WGM Agenda/Minutes

HL7 TSC Meeting Minutes Location: Palatine B		Date: 2017-09-09 Time: 9:00 AM
Facilitator: Ken McCaslin		Note taker(s): Anne Wizauer
Attendee	Name	Affiliation
	Calvin Beebe	HL7 SSD SD Co-Chair
x	Giorgio Cangioli	HL7 Affiliate Representative
x	Lorraine Constable	HL7 ARB Co-Chair
Regrets	Jean Duteau	HL7 Affiliate Representative
x	Freida Hall	Adhoc Member - GOM Expert
x	Russ Hamm	HL7 FTSD Co-chair
?	Stan Huff	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
x	Austin Kreisler	SSD-SD Co-chair
Regrets	Wayne Kubick	HL7 CTO (TSC member ex officio w/vote)
x	Ken McCaslin (Chair)
x	Anne Wizauer (scribe, non-voting)	HL7 HQ
x	Melva Peters	HL7 DESD Co-Chair
x	John Roberts	HL7 DESD Co-chair
Regrets	Andy Stechishin	HL7 T3SD Co-Chair
x	Sandra Stuart	HL7 T3SD Co-Chair
x	Pat Van Dyke	HL7 Board Chair (member ex officio w/ vote)
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)

1. Additions to, and acceptance of, agenda
2. TSC Chair Election open online reminder
3. HL7 Board Strategic Initiatives (Pat)
4. Essentialism
   • M&C Reviews

Q2 - 11 am to 12:30 pm

1. Essentialism (continued)

Q3 - 1:30 pm to 3 pm

1. FHIR Normative ballot issues
2. Ballot reconciliation sync project (Austin)
3. SGB update

Q4 - 3:30 pm to 5pm

1. Architecture and Tooling: preview Wayne's report
2. TSC Chair election results
3. Confirmation of CDAMG candidates

Sunday evening Agenda Topics

1. ArB
2. BAM
3. FHIR
   • SGB review of FHIR ballot level issues (resources that moved from draft in ballot to STU in publication) - Paul
   • FHIR naming issues - Calvin
4. Co-branding of standards

Wednesday lunch

1. Meet with GOC re: Considered for Future Use ballot disposition
2. Issues from Monday's Steering Division Meetings
3. HL7 Product roadmap

   (September) Review TSC SWOT

Minutes/Conclusions Reached:

Q1 - 9 am to 10:30 am

1. Roll Call and Introduction of visitors (including declaration of interests)
   • Pat Van Dyke here
   • Wayne not here until tomorrow night

1. Additions to, and acceptance of, agenda
   • Agenda accepted

1. TSC Chair Election open online reminder
   • Ken confirms that everyone got the instructional email
2. HL7 Board Strategic Initiatives (Pat)
   • Pat presents strategic plan and goals from the Board. Categories include: 1) Enhance Image; 2) Organizational Vitality; 3) FHIR as Primary Standard; 4) Support HL7 Standards. Mission: To provide standards that empower global health data interoperability. Vision: A world in which everyone can securely access and use the right health data when and where they need it. Pat describes the thought process behind the development of each category. Group reviews objectives associated with each strategy.
     • Enhanced image: Expand image/perception from standards to solutions – Immediate (I). Improve relevance with key target audiences globally and establish/strengthen relationships with key stakeholders (Midterm – M). Enhance value of standards to target audiences globally (Later – L)
     • Organizational vitality: Protect existing revenue sources (I). Increase revenue from new partners and stakeholders (M). Pursue new revenue streams (L). Giorgio asks if internationalization could make an impact. Pat agrees that we need a more global focus and need to find more ways to engage the affiliates.
     • FHIR as Primary Standard: Ensure that the community at large understands that FHIR Is an HL7 product (I). Increase understanding of FHIR usage and value of usage worldwide (I). Demonstrate the value of FHIR in enabling interoperability (M). Ensure resources are most effectively focused to enhance FHIR (M).
     • Support HL7 Standards: Establish a strategic tooling plan to support the standards lifecycle (I). Increase efficiency and effectiveness of process and updating current standards (M). Improve accessibility (M). Lorraine notes that there is much work to be done with tooling.
     • Next need to establish actions for each of these, starting with the immediate goals. Ken wants the TSC to digest this and anticipate that there may be questions on Monday night. Pat notes that the full plan will include all details including responsibility assignments; this is a snapshot. Lorraine thanks Pat and the Board for their work on this.

1. Essentialism
   • All WGs went through and looked at their M&C and edited to make them more precise. SD cochairs went through a checklist to analyze the WGs.
     • DESD: Melva reviews spreadsheet of WGs. RCRIM and BRIDG have merged. Anesthesia is pulling up their britches and getting their act together. PHER changed their name to Public Health.
       • Attachments – name should be updated to better reflect. Potential scope overlap with other WGs in DESD. Like to meet at X12 rather than at WGMs. Ken notes the political issues between WGs – has heard reports that WGs are not open to collaboration at times. Seems to not reflect the collaborative nature of HL7. Need to find a balance. Ken would like TSC to consider knocking down some of these barriers to participation. Some WGs are project teams instead of administrative filters. ONC work within OO is an example of good process. Melva notes that people have brought forward things to Pharmacy that they want to work on but Pharmacy doesn’t have the bandwidth, so then they shop it around and it appears in another WG. Issue with US focus vs. International focus.
       • BR&R: Collaborating with 12 WGs, which is problematic. Have scope overlap with Pharmacy and are not engaging with Pharmacy the way they should. John notes they have a focused relationship with fewer than 12 WGs – some relationships are more casual. Floyd notes that the definition of collaborative WG is likely viewed differently by each WG and should be clarified. Lorraine states that on top of it, they’re not always collaborating where they should be collaborating. Austin notes that if a WG has a high number of collaborating WGs, they could be a potential candidate for being a product family – especially in the case of EHR. WG health is higher than their functional behavior. Would there be a metric that would measure their issue? One issue is PSS management and cochair SD tasks. Could be a measure of the SD cochairs evaluation the WG cochair performance.
       • CBCC: Needs a new name. Name does not match scope. Potential overlap with other WGs in DESD and other SDs. They seem to focus on privacy and consent. Ken proposes that they should be part of FTSD.
         • PL: Look at better communication regarding WG changes, name changes, dissolutions, etc.
         • PL: Look at WG Health metric for co-chair effectiveness with SD co-chair evaluation aspect
         • PL: Need cochairs to provide member education on proper behaviors.
         • PL: Look at Attachments WG’s international involvement
       • Clinical Genomics: List 9 collaborating WGs. Not in their current M&C but they list them on the website. May need to be part of a different SD.
       • CIC: Name isn’t meaningful. Collaborating WGs not documented on M&C but website lists 9. Potential overlap with other WGs in DESD. Ken asks if they’re more of a User Group that helps facilitate projects? John agrees. Lorraine notes a lot of overlap with what CIMI is doing, Discussion over failures of other user group formations. Lorraine: It will be interesting to see what happens as they start working with CIMI.
         • PL: Address idea of building User Group steering division; User groups would be resource sources and SMEs
       • CQI: Collaborate with 13 groups. Potential scope overlap with other WGs. Discussion over potentially merging with CDS. Could be a clash due to different working styles/politics. Tony states that we need to educate members as well. Sandy notes individual or corporate interests cause clashes; need leadership to avoid that.
       • Emergency Care: Okay
       • Devices: May need to be in another SD; FTSD or SSD-SD
       • Learning Health Systems: Not clear what they’re doing. Should be a User Group. They don’t document collaborations. Are working on a DAM. Ken explains that he sees User Groups as people focused on a particular aspect of healthcare who provide resources to WGs. Calvin: The domain experts are the ones who are the source of the requirements. Ken notes that eye care people came to HL7 and he asked them to be mentored by OO. They want to create messages but they don’t have the experience. They are really a User Group with a whole lot of expertise but probably shouldn’t be a separate WG. Lorraine states they sound more like clinical advisory groups. Melva states that she doesn’t want to sit in a user group, hoping that someone with technical knowledge reaches out. Need to be more clear if it’s a user group/focus group SD.
       • Patient Care – good. Mission is very broad with scope overlaps.
       • Pharmacy – good
       • PHER – name changed to Public Health
     • Reviewed Calvin’s relationship diagram that shows a formal relationship between WGs via projects. Created it using Gephi, a free open-source tool.
       • Calvin will send Gephi file to Anne
     • FTSD
       • AID: Will be taking a motion to dissolve at this WGM. Have always thought of themselves as a User Group. SD cochairs will discuss with them. There remains a need for their function.
       • ITS: Looking at renaming, but it may be impossible to come up with something succinct that describes what they do.

Q2 - 11 am to 12:30 pm

1. Essentialism (continued)
   • FTSD (continued)
     • CIMI: Should move to SSD-SD.
       • PL: Look at CIMI scope creep and how they work with domain groups. They believe they are taking over the clinical model space.
     • MnM: Has problems independent of this discussion.
       • PL: Look at how the GOM identifies MnM as the methodology group for the entire organization.
       • ACTION: SGB to look at scope/charter between WG and product management on tomorrow’s agenda and bring back to TSC on Wednesday
     • InM: Melva notes that they may need a name change to better describe what the group does. Paul isn’t sure that will work; need to list their business topics.
       • Discussion over Collaborating WG evaluation on the FTSD spreadsheet as it is done differently than how DESD did it. FTSD’s notes how many WGs within the SD that the WGs are collaborating with.
     • SOA: Doing better from an administrative perspective.
     • Templates: Why aren’t they in the same SD as Structured Docs? Austin: Structured Documents may now be a candidate for moving to FTSD.
       • PL: Determine what WG collaboration means in terms of this review
   • SSD-SD
     • Arden is a product family that exists within a WG, but it works.
     • CDS: Arden is a subset of CDS’ scope. Issues with CDS are with scope/charter parking lot item.
     • Clinical Statement: Their standard is mature and activity has decreased. May be a candidate for merger, possibly with OO or Structured Docs. They do belong in SSD-SD.
     • EHR: May be a product family.
       • PL: Evaluate whether or not EHR should be a product family.
       • PL: Evaluate tooling support for EHR
     • Imaging Integration: Is like both a domain committee and HSI. May be a User Group? They do own standards. Are they in the right SD? No active projects, but they’re working on FHIR. Should probably be in DESD.
     • Financial Management: Should probably be in DESD. DESD should perhaps split into administrative domains and clinical domains.
     • Structured Documents: May need to move to SSD-SD. Has been doing governance, management, and methodology for CDA. Need to proceed with formalizing the CDAMG to solve one of these issues. Will make these changes as part of standing up the CDA product family rather than as part of Essentialism. Ken states that Structured Docs should go ahead with their M&C changes as a result.
     • PA: Consider moving to DESD. May need to change name; one suggestion is Personnel Management, Logistics and Scheduling.
     • Mobile Health: Consider moving to FTSD
   • T3SD
     • International Mentoring does not collaborate.
     • Melva’s notes: Education should not be a WG. Should be an advisory council with member participation/cochairs. EST should also be advisory. Discussion over whether advisory is the right term. Lorraine disagrees with the EST evaluation. Ken states that none of these are really WGs as we typically define them. Discussion over what they are. Paul notes that all of these committees involve volunteers, budgets, and HQ. Freida notes that some were originally board committees that got lumped together in this group. Lorraine: It bridges HQ and volunteers – it is organizational plumbing. Ken: Education, Project, Services, Publishing and EST are a combination of staff and volunteers, which makes them different. DMPs are different because staff gets a vote. Melva notes that International Mentoring should be under the International Council. Group agrees. Pat: HSI and International Mentoring are the outliers in this group. The other 5 are of the same ilk and can stay as they are.
       • HSI: All three cochairs are resigning but they didn’t want to dissolve. Will be discussing the future of the group this week on Tuesday. If they remain, do they belong in T3SD? If we create an Interest Group SD, they would belong there. They do want to create standards, though, which the interest groups can’t do. HSI, however, wasn’t ever supposed to create standards which is why we put in T3SD.

Q3 - 1:30 pm to 3 pm

1. Essentialism, continued
   • T3SD, continued
     • Process Improvement Committee: Question over appropriateness for T3SD. Should they be advisory? Tony notes overlap between ARB, PIC, and Project Services. ARB looks at architecture, project services looks at implementing the architecture, and PIC looks at improving the architecture. Austin asks if they should be merged into ARB? Sandy: We need to define what a WG needs to be, a liaison group, etc. What is the function or artifact that will come out of that group? PIC does updates to the cochair handbook. Lorraine: Still value in separating design and implementation. Perhaps they should review their scopes against each other. Tony states we should have someone reviewing data and workflow, and someone else instantiating that. People try to design FHIR resources who are over their head because they don’t understand basic IT and data design, and we’ve also got a lot of people here who are great at that, who have no idea how to provide medical care.
       • PL: Review scope of ARB, PIC, and Project Services against each other for boundaries
     • Publishing: Austin - V2 publishing is now also the V2 management group, which is causing logistical problems. May need to formally separate out the V2 management group. Leave publishing as it is, and take out the hat of V2 management from the WG.
       • Discussion over where the management groups go…should there be a management group SD? Paul: Not sure what they would meet about. Calvin: We may need to refactor the TSC. Ken: When we had one group we hung it off TSC, but now that there are multiple groups, is that still right? Perhaps we have cochairs that represent them at the TSC. Austin: We could dissolve DESD and SSD-SD, and reconstitute administrative domains and clinical domains. A couple could also go to infrastructure. Reviewed Waye’s TSC structure slide from May. Interest Group is the appropriate name for what we’ve been calling User Group so far today. Paul: If we had a product management committee that they all belong to, they could then have two reps on TSC. Interest Groups could also have two reps on TSC. Ken: What about a Product Management Board? Paul: It may not be a board because boards are appointed, but we could say that they elect their own. Austin adds that we should have a Product Methodology Board. ARB is methodology, and then we add PIC and Project Services to that board. Melva draws how it would look: TSC on top. Second row: Product Management (CDAMG, FMG, CIMI-MG, V2-M); Governance (SGB); Methodology (ARB, PIC, PS). Third row: Steering Divisions (proposed: Clinical Domains, Administrative Domains, Infrastructure, Functional Support, Interest Groups). Need participation from each in the TSC. CTO appoints ARB cochairs based on recommendation from ARB. SGB is recommended by CTO to TSC. Cochairs of the management groups are appointed and cochairs are elected by the group. Should we be consistent across the board on how people are appointed? General agreement.
         • ACTION: Ken and Melva will slot in the WGs to this potential structure for review.
       • Discussion over communication/timelines for implementation.
2. FHIR Normative ballot issues
   • We had the R3 publication go out with anomalies between what levels artifacts were balloted vs. published at. Product director was asked to provide explanation. SGB reviewed the statement; statement only covered 2 of the 25 resources that were published differently than balloted (balloted draft, published STU). Paul went through and looked at getting dates on which the WGs approved the resources to be STU. Half of them have dates around the date of publication as opposed to when it went to ballot. Some were approved after publication. Some said they intended it to be STU but didn’t vote. Issue is physical and political. Materials are out there and published. The cost of not going forward exceeds that of pulling it back. Need to document what occurred and take our lesson from that. The exercise will further identify that this is a management issue, not a governance issue. The policies are in place but weren’t followed. No precept changes need to be made; policies need to be followed. TSC approved the publication before the final materials were ready. We did change our policy to state that we need time to review before publication occurs. SGB will recommend that there needs to be formally reporting of WG decisions to ballot at a certain level for FHIR. This happens on the NIB for other things but FHIR is different. Calvin: Do we need to establish a precept of how the NIB is used? So each committee would have to do a NIB for their FHIR Material. Lorraine: Current process is management groups don’t see the NIB. There was a NIB for FHIR as a whole stating they were doing a ballot that FMG submitted. Ken: First thing is that a single WG is responsible for the NIB, so if there are multiple cosponsors, they don’t manage or control it. But in FHIR the management group is responsible, as well as V2. The problem is when it is an aggregate good, such as in the case of FHIR. Ken wonders if we should use the V3 model. Calvin: Another possibility is to create a custom FHIR NIB listing the resources and approval dates of their intended level.
     • SGB will confirm the necessary steps that the different bodies need to do going forward. TSC needs to endorse that communicate to the management groups that they must do these things. Melva asserts that WGs are confused by the FHIR process.
3. SGB update
   • • Anne to add link to slides here

Q4 - 3:30 pm to 5pm

1. TSC Chair election results
   • Karen reports that ballot results are that Austin received the most votes in the election. Pat verified the votes.
2. Ballot reconciliation sync project (Austin)
   • Austin displays report.
     • HL7 Essential requirements govern Normative, GOM governs everything else.
     • Two reconciliation tools in use: Spreadsheet and Gforge
     • People completing reconciliation may or may not be aware of the rules governing reconciliation. Some WGs allot anyone to reconcile, others only allow cochairs.
       • Recommendations:
       • Wait and see what happens as a result of the audit.
     • Request clarification from GOC on Review ballot reconciliation requirements for WGs – can a WG ignore submitted comments, leaving them without any disposition if the ballot passes? Paul: now that we have dispositions that can be used in various circumstances, we should be able to put that in the GOM.
     • Identify one group responsible for keeping all ballot reconciliation documentation in sync with HL7 ER/GOM
     • Train/certify those doing reconciliation on the process(es) and tooling used for reconciliation.
     • Update the ballot spreadsheet to reflect the current processes. If there are multiple ballot reconciliation processes, we should have specialized versions of the spreadsheet for each different process.
     • Future ballot tooling needs to enforce that people follow the correct process for each process we have.
     • As long as we use manual ballot spreadsheet process, we need to measure conformance with the process. Verify accurate Normative reconciliation for every pub request for Normative ballots. Audit a subset of review ballots that they properly follow that process. Identify appropriate processes for correcting reconciliation issues.
     • As long as reconciliation is a manual ballot spreadsheet process, we should make accurate ballot reconciliation a WGH measure
   • Open Questions
     • Mixed balloting: FHIR is going to attempt next year. With multiple manual reconciliation processes currently in place, can we expect all WGs to get this right?
   • TSC meeting Wednesday lunch with GOC regarding Considered for Future Use for ballot disposition.
   • Could implement immediately verifying appropriate ballot reconciliation on every Normative ballot publication request. Could also remind that they must use spreadsheet or tracker – no other options currently. Paul notes that there is a project evaluating balloting with Jira and yet another emerging idea to use Github.
   • Monday night we can say that we’re noticing inappropriate dispositions for what is allowable for that type of ballot. There will be training down the road but need those doing ballot reconciliation to refresh themselves on what is allowable. Cochairs should be present for reconciliation votes and bear the responsibility for applying the rules.
   • Discussion over how to manage relationship with GOC. GOC should only be editing our changes if they are in violation of an ANSI regulation. Ken states their response should be acceptance or rejection with reason. Paul will lead the discussion on Wednesday. GOC is board appointed; what is their decision making authority? If TSC has gone through a formal process to present it as a motion, their comments should come back to us.
   • Freida notes that she will be rolling off as TSC representative on GOC and there needs to be a new one.
3. Architecture and Tooling: preview Wayne's report
   • Wayne not present
   • ACTION: Add Architecture and Tooling to TSC Parking Lot
4. Confirmation of CDAMG candidates
   • Candidates: George Dixon, Brett Marquard, Rick Geimer, Lisa Nelson, Kai Heitmann, Jean Duteau, Dale Nelson. Missing payer perspective but will add later.
     • MOTION that SGB recommends that this slate comprise the initial CDAMG: Austin/John
     • VOTE: All in favor
     • These candidates will be invited to lunch on Thursday for informal meeting.
5. TSC Code of Conduct
   • Ken asks group to consider how to add something in responsibilities regarding everyone having a voice. Floyd notes that topic is covered in the first three bullets of community requirements.
     • Floyd suggests “Collaborates effectively and respectfully.”
     • ACTION: Add discussion/feedback to next conference call.
6. Ken notes that there may be an out of cycle ballot approval request right after we go back Paul thinks FM hasn’t approved yet.
   • Paul will research the issue and report back on Wednesday.
7. Updates to PSS – Freida
   • PSS will be updating order of approval. Discussion over order.
     • Need URLs for each family management group
8. Adjourned at 4:47 pm Eastern

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