2015-05-09 TSC WGM Agenda

TSC Saturday meeting for Paris WGM

Guests are asked to make alternate arrangements for the noon meal, or respect the opportunity for TSC members to dine first as the food provided is for elected TSC members and invited guests noted on the agenda

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TSC WGM Agenda/Minutes

HL7 TSC Meeting Minutes Location: Labo 02		Date: 2015-05-09 Time: 9:00a - 5:00p
Facilitator: Ken McCaslin		Note taker(s): Anne Wizauer
Attendee	Name	Affiliation
x	Calvin Beebe	HL7 SSD SD Co-Chair
Regrets	Woody Beeler	HL7 FTSD Co-Chair
x	Giorgio Cangioli	HL7 Affiliate Representative
x	Lorraine Constable	HL7 ARB Vice Chair
x	Jean Duteau	HL7 Affiliate Representative
Regrets	Freida Hall	HL7 TSS SD Co-Chair
	Stan Huff	HL7 Board Chair (member ex officio w/ vote)
	Chuck Jaffe	HL7 CEO (member ex officio w/o vote)
x	Tony Julian	HL7 ARB Chair
	Paul Knapp	HL7 FTSD Co-Chair
x	Ken McCaslin (Chair)
x	Anne Wizauer(scribe, non-voting)	HL7 HQ
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
	Andy Stechishin	HL7 T3SD Co-Chair
x	Pat Van Dyke	HL7 SSD SD 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. View of the France Healthcare Space (Nicolas Canu - France HL7 Chair)
4. Link to Interim decision review since last WGM
5. Strategic Initiatives discussion
6. HL7 Quality Plan
7. US Realm Task Force Update/Mission and Charter Review (Paul, Ed, Austin)

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

TSC Review and Planning

1. (45 mins) Review Open Issues List
2. Next WGM Planning - next two WGMs - agenda links
3. Review TSC Three-Year Plan
4. Review TSC Communications Plan - how are we doing against it?
   • Maintenance project: Work Group Visibility
5. Review work on Multi-Year Planning
6. HL7 Standards Governance Board and FMG/FGB discussion
7. HL7Registry for FHIR and other standards

Q3 - Governance continued: 1:30 pm to 3 pm

1. HL7 Standards Governance Board and FMG/FGB (Paul/Lorraine)
2. Multi-year plan review (Ken)
3. University Internship Review (Ken)
4. TSC Project Review
5. Strategic Initiative Review (Ken)

Q4 - Management - 3:30 pm to 5pm

1. Guest Speaker
   • Stan Huff (HL7 Board Chair) CIMI
2. Review of GOM naming convention for publishing
3. Architecture and Tooling:
   • Tooling

Minutes

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. View of the France Healthcare Space (Nicolas Canu - France HL7 Chair)
   • Nicolas Canu presented on healthcare in France from HL7 perspective. Focus on two projects: 1) Parmaceutical record and DMP, or “Dossier Medical Personnel.” Uses HL7 CDA and IHE XDS. Deployment is moving slowly and is considered stuck. FHIR is seen as a good thing to decrease complexity, which will increase adoption. However, it must be adopted carefully to avoid problems. Overview of Interop Sante organization’s strengths, weaknesses, and tools. A universal value set editor is needed. Urgent need is user interface for editing translation in European languages of en-US display names. Questions remain over the role of HL7 affiliates in the FHIR ecosystem; working on tooling independently or with partners such as IHE? There is not currently a European market, but there are European projects. There could be movement toward a European FHIR ecosystem. In the European future, there are two examples: EMA/IDMP and Snomed CT. Discussion over hiding complexities behind APIs.
   • Giorgio discussed cross-border care. Began by describing the varying definitions of “Europe,” which is defined by a variety of concepts – European Union, geographical area, states under other agreements, etc. This creates complexity in healthcare. Health is a national responsibility for each nation with a national level, regional level and organizational level. There is a pan-European level that is working toward rights of patients to have cross-border healthcare. Discussion over how it is being implemented and the challenges being faced. Trillium Bridge accomplishments are many, including bi-directional exchange of patient summaries, etc. However, the transformation process is not sustainable. Working on how to converge towards a harmonized international standard.
4. Link to Interim decision review since last WGM
5. Strategic Initiatives discussion
   • Ken and Rick Haddorf are working on 1-3-6 year plan. Felt that 6 years would cover the amount of time a WG would need to focus on issues. Will be bringing a draft to TSC for review before September. Melva mentions that discussion in TRAC has been concern about introducing new process; education should be done on current process. Ken states that the tool has not yet been decided upon but there is understanding that if the tool is Gforge, there would be education. Right now the conversation is about process. Tools support the process, not define it. Training for new tools can increase effort. Tony brings up difficulty in standardization of processes. Melva asks if we could look at some things that are working well for some WGs who manage to keep up. Pat describes the varying discussions on TRAC with potentially renaming the three year plan. Lorraine suggests we need an organization-wide SWOT. Discussion over Project Insight and using it more effectively.
6. HL7 Quality Plan
7. US Realm Task Force Update/Mission and Charter Review (Paul, Ed, Austin)
   • Paul present to go over USR-TSC proposed Mission and Charter. Modified from TSC M&C. Group agrees that we should name it something different as it is confusing to include TSC in the name. Ken suggests removing the word “specific” from “US Realm specific needs” mentioned in the mission section; group agrees. Group reviews composition section: There should be an ArB rep and the ability to add other members as required to represent external stakeholders (for example, ONC representative). Ken suggests saying that 3 or 4 ad-hoc members may be proposed as necessary that are annual appointments. Discussion over how that would work given that it will be a board committee. Would we have a problem getting people from each SD? Discussion over finding young people to mentor in these roles rather than relying on existing co-chairs. Conversation on process and tracking US Realm approvals.

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

TSC Review and Planning

1. (45 mins) Review Open Issues List
2. Next WGM Planning - next two WGMs - agenda links
   • Will be doing more intentional planning for next WGMs. We’ll also be putting more agendas out to be more prepared for discussions. In September we’ll be doing final approval of naming conventions.
3. Review TSC Three-Year Plan
   • Once Ken/Rick Haddorf get the 1-3-6 year plan comfortable, they’d like to pilot it with the TSC. Exercise will be done in the TSC so we can look at it and get comfortable with it before socializing it with co-chairs. Melva is happy to put pharmacy as a pilot group. Paul asks if the multi-year planning will affect groups below from groups above. Discussion that the six years is in reference to ballots. Real planning goes on in the 1-3 year space. TSC rollout won’t really reflect how the WGs will use it. Suggestion to add some more time in to introducing this process. John Q. brings up the hidden financial cost element.
   • SGB: Paul reviews purpose of and plan for SGB. Goes over diagram of structure. Describes options for FGB transition to SGB. Shared a draft plan created by Austin to solve some of FGB’s stated issue with dissolving the FGB and replacing immediately with SGB. Calvin expresses concern that it seems to open a door for continued FHIR governance operations. Ken hopes the transition plan will solve that problem. Paul is concerned that you can’t close the loop with the transition plan. Should we add piece that puts an expiration date on the created governance committee/task force? The default would be that it disappears, but if it is needed it could continue. This idea will be reviewed with FGB tomorrow. Patrick Lloyd and Mary Kay present for discussion after lunch. Mary Kay notes that we truly need to provide education regarding management, methodology, and governance, and asks how we keep track of the proposed waiver. Paul notes that SGB should determine that.

1. Review TSC Communications Plan - how are we doing against it?
   • Maintenance project: Work Group Visibility
2. Review work on Multi-Year Planning
3. HL7 Standards Governance Board and FMG/FGB discussion
4. HL7Registry for FHIR and other standards
   • RFP development process stalled without the creation of the RFP. Furore is actually producing a registry now. Discussion over a registry vs. a repository. Ken wonders how validation happens on Furore’s website – can we ballot an artifact on someone else’s website? How important is it that HL7 be involved in the registry? Issue is a higher priority than the attention it is being given by FHIR. The trademark infringement issue: the requirements as they stand are a big gold-plated and have not been put in context. Calvin states that in order to be within the rule, they have to change how they represent the product. Discussion over the difference between a repository and a registry. Registries keep track of things in a relevant way. Andy states the appropriate question is if the maintenance and registration of our standards is key to our organization. Mary Kay states that a revenue making product would be both a registry and repository. Registry should be curated – Andy. What are the questions we need to ask to further this conversation and idea? So the project was put on hold. EST does not wish to be the driving factor to dictate how it should be built. Paul states that we need to figure out what the organization would like to do. Group feels that this is a board issue that is strategic in nature. Calvin states the questions: 1) is there a violation of our trademark in the Furore registry? 2) is there value to HL7 to be doing this? Ken brings up the OID registry. At some point the Board decided to charge for OID registration. What’s to keep Furore from doing the same thing? Nothing. We could have THE registry with our trademark. It is a business proposition with money flowing both ways, potentially. Ken summarizes that this needs to be reviewed with the Board. John will add it to the CTO report with the expectation that the Board help with some guiding principles. Will take it up with the EC/Chuck first. The concern regarding the trademark issue should be brought to the EC as well. For future consideration, we need to determine how to handle balloting material that is not curated on HL7 sites. No enforceable consistency on external site. Must conform to ANSI rules. Referencing external materials – we need to make sure they’re following ANSI rules. Will be reviewed in TRAC on the first call after the WGM and on the TSC agenda for the last Monday in June (June 29th).
   • New PSS-lite will be announced at the co-chair dinner. ===Q3 - Governance continued: 1:30 pm to 3 pm===
5. HL7 Standards Governance Board and FMG/FGB (Paul/Lorraine)
6. Multi-year plan review (Ken)
7. University Internship Review (Ken)
   • Ken is getting feedback that we don’t want an internship program. Calvin asks if the intern could give more specifics about the feedback he is receiving? Ken states it is a timing issue with trimesters, but people aren’t realizing that it is not current projects that interns would be working on. Melva and Lorraine stated that he is not necessarily framing the project well or in the correct context. Ken will do some guidance with him. Jean mentions timing as being a valid issue for many of their projects when they attempted to engage students. Ken states this would be a graduate level student focusing on healthcare and we could be very specific and the full 16 weeks would be dedicated to our project. Lorraine asks if they would participate in conference calls? Ken states that perhaps they would come every four weeks to provide an update. Professors have to approve the projects to ensure alignment with coursework.

1. TSC Project Review
2. Strategic Initiative Review (Ken)

Q4 - Management - 3:30 pm to 5pm

1. Guest Speaker
   • Stan Huff (HL7 Board Chair) CIMI: CIMI originated in the same meeting as FHIR originated in. CIMI is a community of interest – the Clinical Information Modeling Initiative. It produces detailed clinical information models to improve interoperability. The model shows the structure of data with bindings to terminology that contains a LOINC code, a unit of measure, and qualifiers. It shows a logical containment structure of data and constraints that provide links to terminology. Uses formal bindings of the models to standard coded terminology. Repository is open to everyone and models are licensed free for use at no cost. There are around 600 models viewable in a variety of source codes. Working to move a lot of the Intermountain content into CIMI content.
   • Goal of CIMI is to create plug and play interoperability. There are a variety of challenges including divergent FHIR profiles (DAF, QICore), leaf level FHIR profiles needed, observation profiles and FHIR common data element resources being used to do the same thing, and lack of clinical review of FHIR profiles.
   • CIMI is proposing that, in the future, CIMI models will be translated by FHIR resources to create HSPC-approved HL7 FHIR profiles. CIMI has the potential to add value to the FHIR profiles because it contains rich data content.
   • Discussion over realm-specificity, followed by units for LOINC codes.
   • CIMI started at an HL7 meeting back when the standard was not free, and the vision was always to have CIMI be free. CIMI is still looking for a home, which may end up being Hl7. CIMI may petition to be a WG. Andy states that it seems like a foundational technology.
   • Next steps in CIMI camp; not for the TSC yet. Will go to Chuck and the board next for discussion. TSC welcome to bring questions/concerns to Stan anytime.
2. Review of GOM naming convention for publishing: Will discuss in September
3. Architecture and Tooling:
   • Tooling – Andy: No clear vision of budget. Andy reviewed strategy presentation slide deck with group. Need for revenue generation. Listed policy implications such as considering a fundraising body and technical management/support services resources. Question regarding tutorial on ballot desktop – will be forthcoming. Highlighted tooling volunteer liaison program. Need far more volunteer toolsmiths to support strategic initiative for external tooling. Discussion of OHT, a new potential stakeholder – potentially disruptive. EST wants to develop and internal architecture.
   • Went over strategic plan goals from tooling strategy document. Discussion over the FHIR hosting issue success when we brought everyone together to work collaboratively. Issue is having the strategy and then operationalizing the strategy with progress that is measurable.

Sunday evening Agenda Topics

1. ArB
2. BAM
3. FHIR

Tuesday lunch

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:

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

Next Meeting/Preliminary Agenda Items .