2013-05-04 TSC WGM Minutes

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TSC Saturday meeting for 2013MayWGM in Atlanta GA USA

FOR WGM: NOTE for TSC Agenda Saturday and Sunday
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TSC WGM Agenda/Minutes

HL7 TSC Meeting Minutes

Location: Atlanta 1

Date: 2013-05-04
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
, 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
. Don Mon HL7 Board Chair (member ex officio w/ vote)
regrets Ravi Natarajan HL7 Affiliate Representative
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 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. Interim decision review since last WGM (for reference)
  4. HL7 Vitality Process (Parker) [30 minutes]
  5. Strategic Initiatives discussion

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

Q1 discussion continued

TSC Review and Planning

  1. ANSI process changes (ANSI/GOM Review Task Force Report) and GOM change proposal review
    • Closed ballot pools discussion


Q3 - Management: 1:30 pm to 3 pm

  1. Review Open Issues List
    • #2165 TSC Definition of Domain Analysis Models and Functional Profiles
    • #2400 Consolidation of approaches for submitting enhancement requests - (last update: revisit after illumination from the board on the plans for a help desk)
    • #2490 TSC Policies and Procedures review based on outcomes of ANSI audit - ANSI/GOM Review Task force recommendations
    • #2528 Awaiting Publishing response: set date as the trigger and cutoff for the Normative Edition (NE) inclusion
    • #2585 Define list of machine-processable artifacts for membership benefit
    • Project Scope Statement of Pilot SAIF ECCF-ISM as part of a Publication Request for Project Services of T3SD and cosponsored by the TSC, ArB, others TBD as they pilot, at Project Insight 996 and TSC Tracker 2599
    • Project Scope Statement of Usability Guidelines for EHR Systems at Project Insight 995 and TSC Tracker 2596 by EHR WG of SSD SD and cosponsored by CIC of DESD.
    • Informative Publication Request for HL7 Version 3 Domain Analysis Model: Preoperative Anesthesiology, Release 1 requesting name "Preoperative Anesthesiology Domain Analysis Model (DAM) R1" at Insight 731 and TSC Tracker 2606 for Anesthesia WG of DESD
    • Informative Publication Request for HL7 Version 3 Standard: Emergency Medical Services Domain Information Model, Release 1 requesting name HL7 Domain Information Model: Emergency Medical Services R1 at Project Insight 677 and TSC Tracker 2607 for CIC WG of DESD
  2. CMET Project Update (CMET)
  3. Establish TSC Nominations Committee
  4. (May) Elect TSC Representative to Nominations Committee (Per GOM Section 10.06.01)
  • TSC Project Review
    • (list 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
  • Co-sponsored projects:
    • 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
    • Maintenance project: Work Group Visibility PI# 631
  • WGH metrics review (aka do we drop or modify the Harmonization participation metric?)

Q4 - Management - 3:30 pm to 5pm


Sunday 5:15-6:30 PM Atlanta 1

  1. ArB
    • BAM Status
      • BAM Skills & Roles (Parker)
    • 'What's next for the ArB'
    • Other Topics as raised by ArB


Wednesday lunch Atlanta 1

  1. Invite "red" WG cochairs to session to discuss their WGH
  2. Project Scope Statement of Usability Guidelines for EHR Systems at Project Insight 995 and TSC Tracker 2596 by EHR WG of SSD SD and cosponsored by CIC of DESD, and endorsement of recommendation on consideration of HTTP compliance to US conformance criteria on EHRs for character set display. See HL7 TSC review of EHR Language Display
  3. TSC review of Board decisions
  4. WGM Planning - agenda setting next two WGMs - agenda links
  5. TSC Document review Schedule:
    • (May) Review TSC Three-Year Plan


Supporting Documents

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) none present
  2. Additions to, and acceptance of, agenda:
    • John recounts the announcement by Austin of non-intent to renew TSC Chair eligibility. The amount of time needed to commit to the role was discussed. Funding, volunteer availability, other topics need to be addressed with the CEO and the Board. Refer to nomination committee discussion.
  3. Interim decision review since last WGM (for reference)
    • 19 projects, 14 publication requests, and 8 normative ballot notifications (just since instituted at the last WGM)
    • 1 ballot, 2 errata, 2 Work Group Formation/Dissolution, 4 withdrawals, 5 Strategic issues for a total of 57 issues closed this cycle.
  4. HL7 Vitality Process
    • Slide show by Ron Parker
    • John notes that ability to adapt to major organizational change that has just been implemented is of great importance. Austin notes that a change of this magnitude should have ripples or a cascade of vitality assessment throughout the organization.
    • Of note is that a trigger means that you check an assessment but does not require change be made.
    • Discussion ensued on how one can avoid being "jerked around". Having a vitality process may ease this.
    • Vitality Governance Process: Identify -> Assess -> Plan Refresh->Approve->Communicate
    • Calvin notes that our governance topics are all vitality assessment triggers, and should they automatically address those five processes? What does refresh mean? Examination of some element of governance, management or methodology to determine if change is required. Layers of the onion and the level at which the TSC uses these concepts as a checklist for addressing the governance issues. Austin adds the Product Lines will also need to set up these processes, e.g. FHIR.
  5. Strategic Initiatives discussion
    • Strategic_Initiatives_TSC_Dashboard
    • Requirements Traceability - rollout of SAIF and its ECCF are the milestones.
      • Calvin notes that it's still a framework. CDA IG product family requirements traceability and maps from domain committees mapping into their RIM 3 space in order to use a subset of the model for use case requirements. They need traceability infrastructure to do so. SAIF tells us how to do it but not how. Need to engineer exactly what we're going to do.
      • Ron notes we need conformity assessment for artifacts for how well they conform to an existing asset. Need to also address 'what we're solving for'. Catalog of mappings also needed. We have engineering requirements for strategic tooling.
      • Austin notes that cross artifact consistency is in the red. This dashboard is a trigger for our vitality processes.
      • Calvin notes that such engineering would allow for Domains refined to RMIMs which constrain further, and that constraint can leave elements off, we constrain to a CDA context instead of a message model for right hand of the CDA RIM, converting element names that are customized back into the RIM names. They have two customized names in CDA space. Would like to be able to trace from DAMs, ballot comments, enhancement requests.
      • Austin suggests line item ballot negatives might be a measure, though Woody cautions that depends on a very picky voter. Line items across all ballots might work for Product Ballot quality. Calvin suggests the responses from the committee might also be mined. Of concerned is the ballots that pass with zero negatives though the material is of poor quality. What if you look at a subset of comments, not just wording e.g AS or AT Calvin suggests. Andy refers to other comments that suggest a rewrite of a document for considerations of other content areas should be considered. Austin suggests we get statistics from Publishing across multiple types of ballots to just see if there are statistics that can be identified. Tasking someone to do the work is the issue. Concern is the differentiation over whether the product was poorly written versus the topic was hard.
      • Woody can produce the QA reports for V3 but what do we do for V2.x.
      • Andy suggests you look at what happens after dispositions.
      • Can we develop a process to scrape data from the last dozen ballots. Understanding of the balloters as well as the cochairs affects the product in ballot.
      • Cochair standings with attendance at calls and meetings further discussed.
      • We have a huge dataset to mine. When you post your reconciliation spreadsheet, since reconciliation has to be done in a year, you run a macro to tally and enter that into some tracking. Need to choose documents from a previous cycle for which the dispositions have been completed. Woody notes if you just choose six then 'Rochester MN' will work on them for an automation. Calvin also notes that another group should review the same six with subjective Likert scale (5 point score) on what their quality is. Austin signs up for the subjective group, as does Mead and Jean. Do you measure on the first ballot cycle or if they go to a third cycle for example- Austin et al will identify which ballot cycle they will evaluate the reconciliation package from. Also, should be release 1 as compared to RIM R5. Ideally need to use a group of 2.x IG, CDA IG, V3 standard, DAM, EHR FP , the EHR-S FM and a Service (e.g. RLUS).
      • What does it mean to be "ready". If ballot passed with no comment is it ready to publish in its final form. E.g. if the developer recognizes they missed something and decided to negative-ballot themselves. Is it readiness for publishing for their consumers.

Recess at 10:44 AM

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

Reconvene 11:04 AM

  1. Q1 discussion continued

    • Project Scope Statement of Pilot SAIF ECCF-ISM as part of a Publication Request for Project Services of T3SD and cosponsored by the TSC, ArB, others TBD as they pilot, at Project Insight 996 and TSC Tracker 2599
      • Lloyd's concerns via email reviewed
      • Woody notes that there's a threat implied that if the ISM is unsatisfactory it will not be published. Austin states that WGs are not expected to change their publication material but add the ISM matrix. The project team would look at matrices across products to see if there are commonalities.
      • The pilot groups would use a special form; what the final form would be is unknown.
      • What risks does this mitigate, Lloyd asks? This activity is a proxy for mitigation of a risk for continuity of artifacts. The answer is really what risk(s) does the ISM mitigate. We need to figure out how to populate it. Risk is that SAIF is not adopted by HL7. Need to figure out how the artifacts map to SAIF ECCF so that we can apply SAIF to the organization. Lloyd asks if SAIF is useful to the organization. Discussion of the organization's commitment to SAIF discussed. Calvin notes the relationship between domain contents and the artifacts. Calvin notes they proposed models to IHE that Keith had mapped from domains back to the RIM. They are missing the mapping to act.classes - we're missing that in our artifacts.
      • Need to assert in the PSS that it may not be a process change but need to figure out what the process should be. Change to not include new process definition.
      • Architecture will come out after we do these types of analyses.
      • Need to send back to Project Services to see if they agree with the scope changes.
      • Calvin moves approval conditional on Project Services' acceptance, seconded by Pat. Unanimously approved.
      • SAIF CD DSTU feedback incorporated into PSS. DSTU ends May 2014 but may need to be extended.
    • Cross-artifact consistency - on agenda Q3.
  2. TSC Review and Planning
    • ANSI process changes (ANSI/GOM Review Task Force Report) and GOM change proposal review
      • Jean reports the process for review has been educational and productive. There are more of the ANSI auditors' comments still to go through so the calls will continue. They need to bring recommendations to Karen on their recommendations, including the interpretation of the GOM for quorum by membership in the ballot pools WRT the recent ITS ballot. The discussion with Karen on item 3 is Acceptance of the proposed ballot reconciliation package will be based on the consensus majority vote (including abstentions). Austin notes that at some point we may have to expand the term work groups to include product groups. Pat notes that in EHR the HL7 members get to vote, so membership is a consideration then. Suggestion also that multiple sub-groups may be formed to review multiple comments for draft reconciliation.
    • Closed ballot pools discussion included speculation on ANSI's opinion on casting votes versus counting quorum including abstention. The balance of the pool is checked by Don as was recommended after the ANSI audit prior to the most recent one. Limiting the scope of the ballot comments has also reduced the ballot pools.
      • Freida suggests that you might be prompted when voting to abstain that if you wished to withdraw from the ballot. This may affect the balance of the pool, and you want to allow the voter to remain eligible for subsequent closed pools.
      • Motion: Calvin moves the TSC recommend a GOM change to remove closed ballot pools, and all pools remain open. Jean seconds. Tony is concerned with the one (stubborn) negative that goes to reconciliation. Calvin accepts clarification to the motion that this does not apply to recirculation ballots. Jean accepts. Task force will deal with the technical details.
      • Vote: unanimously approved.
      • Freida further reviews an auditor recommendation on 14.08.01 and suggests a statement that the GOM does not require line-item votes on dispositions
      • Tony points out that voting is not required on dispositions according to the ANSI auditor. The ANSI/GOM task force is not choosing to explore this, but to continue to expect the WG to vote on the dispositions as well as a package.
      • Still need to review the TSC interpretation policy.

Recessed 12:30 PM

Q3 - Management: 1:30 pm to 3 pm

Reconvened 1:38 PM

  1. Review Open Issues List
    • #2165 TSC Definition of Domain Analysis Models and Functional Profiles
      • Ron notes the ArB has yet to address this. Woody clarifies that a profile as a constraint against a model. The EHR-S FM functional profiles are a stretch to this definition.
    • #2400 Consolidation of approaches for submitting enhancement requests - (last update: revisit after illumination from the board on the plans for a help desk)
      • many ways of doing it today - through ballot, DSTU comments, 2.x request database, CPM and ClinStmt have their own requests, Tooling uses GForge, etc. GForge is a very specific tool, e.g functions as a square-headed (Robertson) screwdriver. HingX is a repository but does not process enhancement requests. Freida suggests we ask WGs to document how they entertain enhancement requests in their DMP. Woody suggests a simple solution in listserves. Calvin notes the SDWG uses the HL7 web site and they have nearly full ballot reconciliation-type functionality. See http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=81. Some groups use wiki. Woody notes we could use this behind any of our standards not just DSTU. Andy notes that SDWG came to Tooling to find out what was available and evaluate fitness for purpose.
      • Austin would like to see this become a project to develop this. Disposition of comments may be different with different lines.
      • Motion: Calvin moves we extend the dstucomments site functionality to normative and informative standards as well as the DSTUs. Ron seconds. Need to work out details for standards that are only published in the Normative edition. Pat clarifies this does not extend to comment-only ballots. Implicit in this is that the comments against standards need to be reviewed by steward WGs. Gives us a place to hear feedback on implementation. May want to link this to the product brief page. This will need a project with Electronic Services to implement.
      • Vote: Unanimously approved. Action item: Pat will draft the PSS and have Calvin review it.
    • #2490 TSC Policies and Procedures review based on outcomes of ANSI audit - ANSI/GOM Review Task force recommendations - discussed earlier
    • #2528 Awaiting Publishing response: set date as the trigger and cutoff for the Normative Edition (NE) inclusion - this may be appearing in the Publishing calendar. Woody will find the decision and report for the tracker.
    • #2585 Define list of machine-processable artifacts for membership benefit
      • TSC needs to work with Marketing on this. What is the proposal for how this relates to the effort with the Board and the hiring of Ticia. TSC produced a list, but as part of standing up product lines need to identify which aspects of each product line will be reserved for members-only.
    • Project Scope Statement of Pilot SAIF ECCF-ISM as part of a Publication Request for Project Services of T3SD and cosponsored by the TSC, ArB, others TBD as they pilot, at Project Insight 996 and TSC Tracker 2599 reviewed earlier
    • Project Scope Statement of Usability Guidelines for EHR Systems at Project Insight 995 and TSC Tracker 2596 by EHR WG of SSD SD and cosponsored by CIC of DESD.
      • Question was raised whether this was an appropriate activity for HL7 to pursue. Calvin notes the Board chair addressed this as a new opportunity to develop membership.
      • Pat notes usability will happen somewhere and there needs to be a standard about it.
      • Ron notes from a vitality process then you identify what skillsets and resources are needed to support.
      • Is this a manifestation of a Board request? Mead offers that the is concerned over whether this is a volunteer project. Ron adds will this be related to our status as an ANSI standards developer.
      • Woody refutes that existing usability guidelines truly exist, therefore this is not a workable premise. Jean notes that usability is highly constrained to situation-based guidelines and a particular environment.
      • Don Mon was approached at AMIA conference. Usability is important as building implementation for "Meaningful Use", which implies US Realm but the project listed UV Realm. The proposers are not here to discuss the project.
      • Ron notes risk to organization especially with UV Realm is significant. This is not related to data content standards for patient safety.
      • UV Realm project will not meet Oct 2013 deadlines for MU. Woody directs attention to http://www.healthcareusability.com. How will they assert that the EHR-S FM spec and profiles have a role in the proposed User Centered Design (UCD) process, where NIST needs to certify.
      • Presumption is that work has already begun. Pat notes Weds Q3/Q4 is dedicated to this project with others flying in to work on it.
      • Pat will invite Don to attend Wednesday lunch and discuss the project. As a Board initiative it may have merit but as a project by the Working Group may not pass. We may suspend disbelief in its appropriateness in order to allow the project team to conduct its meta-analysis and literature review to see if a standard is even feasible. Though the EHR-S FM is not about data exchange/interoperability, and it was also new ground when it arrived on the scene, we need a new product definition for it. (Box is not checked)
      • Austin will speak to the red flag groups, AP, ChildHealth, and HealthCareDevices separately and use the time on Wednesday's agenda for Don.
    • Referred to discussion Informative Publication Request for HL7 Version 3 Domain Analysis Model: Preoperative Anesthesiology, Release 1 requesting name "Preoperative Anesthesiology Domain Analysis Model (DAM) R1" at Insight 731 and TSC Tracker 2606 for Anesthesia WG of DESD - Andy notes that the ballot on these items was some time ago, are they allowed to be published? ITS has had publication held up for age issues. However, these are informative and not normative. They may have not realized they needed to submit request for publication to be included in NE. Mead seconds and Woody seconds approval, unanimously approved.
    • Referred to discussion Informative Publication Request for HL7 Version 3 Standard: Emergency Medical Services Domain Information Model, Release 1 requesting name HL7 Domain Information Model: Emergency Medical Services R1 at Project Insight 677 and TSC Tracker 2607 for CIC WG of DESD. Woody moves and Calvin seconds.
      • Mead suggests we may want to extend the publication deadlines for informative or provide justification why the WG took so long; Woody agrees that we definitely should for DSTU. Even though we are not required to meet ANSI deadlines for DSTU or Informative it may be good for HL7 to track it and the TSC to expect requests for extension. Unanimously approved.
    • Calvin moves to extend notification process reserved for normative ballots for publication within a year. TSC proposed GOM change for needing justification after 10 months. GOM has not yet been published to know if the TSC suggestion was approved so will defer this motion.
  2. Establish TSC Nominations Committee - Pat, Jean, Andy, Tony, Melva.
  3. (May) Elect TSC Representative to Nominations Committee (Per GOM Section 10.06.01) - Melva volunteers

Recessed 3:06 PM


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