CIC PSS: Breast Cancer Modeling

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Return to Domain Experts Electronic Voting Summaries

Please vote on the PSS for the CIC WG. Enter your name and WG along with your vote. 1 vote per WG. Poll open until March 5, 2018.

Link to PSS: Link to PSS

PBS Metrics: Green

  • Summary -
    • Number of participants: 12
    • Most popular option: Affirmative
    • Votes in favor: 11
    • Comments: 2
    • Non-participating work groups counted as abstaining solely for the purpose of counting quorum

Vote and Comments

' Affirmative Negative (with comments) Abstain
Melva Peters (Pharm) OK
Russ Leftwich (LHS) OK
Floyd Eisenberg (CQI) OK
Ed Helton (BRIDG) OK
Kevin Power (Clinical Genomics) OK
Erin Holt (PH) OK
Durwin Day (AWG) OK
John Walsh (Anesth) OK
Jim McClay (EC) X
Suzanne Gonzales Webb (CBCP) OK
Mitra Rocca (CIC) OK
John Garguilo (Devices) OK
Count 11 1 0
Comments:
  • Jim McClay (EC): This extremely broad project should be creating specific artifacts not a sweeping, we're going to do everything statement. I suggest starting with a breast cancer domain analysis model to organize the artifacts. Also, the diagnosis of breast cancer is made by pathologists examining tissue specimens. There is no mention of anatomic pathology modeling in this PSS. HL7 should require individual PSS for each type of artifact proposed.
    • Response: [Rute Martins] Regarding scope and individual artifacts: While the project does have an ambitious scope, our approach is incremental and iterative. For example, as our first artifact, we intend to ballot a FHIR implementation guide, including logical models and FHIR profiles, with a focus on breast cancer staging. We expect the scope to broaden, but our intent is to bring content to the community in an incremental, fast iterating approach. The PSS states the work products of this project are logical models, FHIR Profiles, FHIR Extensions and Implementation Guides. We believe it is common for projects to submit a single PSSs covering a range of artifacts. In fact, the PSS template allows for a single PSS to cover the creation of a wide range of products (see section 4).
    • Response: Regarding stakeholders: We agree anatomic pathology is of paramount importance in the context of breast cancer. As stated in the PSS, we intend to “collaboratively define logical models relevant to diagnosis, Treatment and Research for Breast Cancer”. There are a range of disciplines that are critical for breast cancer, including radiology and radiation therapy, among others, which are not exhaustively listed in the PSS. We attempted to identify the wide range of stakeholders under section 6c, where we specifically listed the College of American Pathologists (CAP), among other organizations, as named stakeholders.
  • Suzanne Gonzales Webb (CPCP): Under 3f - Cancer Interoperability Group is mentioned. Is this an HL7 WG? I don't remember seeing one.
    • Response: [Rute Martins/Richard Esmond] The Cancer Interoperability Group is an informal group. It was determined that because CIC exists, it was unnecessary to for a new HL7 workgroup, but instead to work through CIC. We all realize that this is somewhat of a new model for content creation, but one which many parties are interested in determining if it can be used to scale the development of FHIR Profiles outside of the small confines of existing HL7 resources.

The Cancer Interoperability team has meetings with the various clinical communities and then authors provisional content which we will then review and package for ballot through CIC. It is, for practical purposes, the project team. We are in the process of adding Cancer Interoperability project meetings to CIC’s official calendar.

  • Additional Response (Richard Esmond):
    • Over the last nine months several different teams discovered that they were working on overlapping FHIR Profiling projects related to cancer. Obviously this would have been a very counterproductive situation, where many different unaligned sets of FHIR Profiles created competing options. So, to the joy of all, we have pulled together an informal group of many dozen different clinical subject matter experts, plus the support of seven different medical professional societies, plus the support of HL7 and IHE.
    • It was determined that because CIC exists, it was unnecessary to for a new HL7 workgroup, but instead to work through CIC. So the Cancer-Interoperability team has meetings with the various clinical communities and then authors provisional content which we will then review and package for ballot through CIC.
    • We all realize that this is somewhat of a new model for content creation, but one which many parties are interested in determining if it can be used to scale the development of FHIR Profiles outside of the small confines of existing HL7 resources.
    • With this first ballot, we intend to carefully monitor what processes work well, and which we might consider adapting. But this first ballot offer is actually quite modest in size, so it should provide a good opportunity to trial some of these new ideas.