Vocabulary TC Meeting Minutes – Boca Raton WG

Sept 10 , 2006

Attendees:

Name Company Email

SundayQ1

Q2

Q3

Q4

Cecil Lynch UC Davis clynch@surewest.net X X X XChris Chute Mayo chute@mayo.edu X XJim Case AAVLD jtcase@ucdavis.edu X XJune Rosploch KP june.rosploch@kp.org X XRuss Hamm Mayo Hamm.Russell@mayo.edu X X XSandy Stuart KP sandra.stuart@kp.org X XSarah Ryan HL7 sarah@hl7.org X XTed Klein KCI ted@tklein.com X X X XHarry Solomon GE Harry.Solomon@med .ge.com XLloyd McKenzie HL7 Canada Lloyd@lmckenzie.com X X

Richard Thorenson

Behavioral Health Treatment and Disease

Richard.thorenson@samhsa.hhs.gov X

Francine Kitchen GE Healthcare Francine.kitchen@ge.com XRita Altamore WA DOH Rita.Altamore@doh.wa.gov X X

Paul KnappContinovation Services Inc pknapp@continovation.com X X

Stan Huff IHC/Univ of Utah stan.huff@ihc.com X X X X

Carol Mulder InfowayCmulder.infoaccess@on.aibn.com X

Sunday Q1Co chair WG meeting prep timeChair: Ted KleinScribe: Cecil Lynch

Reviewed topics for this meeting and assignments for chairing and minutes.

Lloyd noted that the OID registry needs to add a flag for OID status on the Excel and CSV outputs to identify which codes are deprecated and which are active..

Ted said that he has had comments privately that we seem to re-discussthe same topic each meting and on calls without closure by vote. He asked the question of whether we can change the process of how we tackle problems so that a few topics are carried through with focus. Stan felt that this is primarily an issue of lack of volunteer hours outside the meeting to document actions in the

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meetings. Ted noted that he is trying to push more heavily for action items to be voted on at the time of the call.

Russ noted that in templates they are using the wiki for real timeminutes documentation but they do not capture motions as well. Ted reviewed the current process using his minutes templates. Discussed the issue of permanence of minutes posted on wiki and how this should work from the view of finalizing the minutes and editing rights. Lloyd mentioned that an email should go out on the listserv if an edit is done on the wiki. Issues are not tooling related but rather it is one of the simple tasks of reviewing the minutes, contributing feedback and edits. Ted pointed out that it takes time to set up linking on a wiki and that this is an issue.

Stan feels that documentation needs to be done in the meeting even if it slows down the meeting. Everyone agrees that more work needs to be done and Cecil suggested we need to cut off discussion and take action with a result by the end of a session topic. He suggested that what we do is get the draft minutes that are done during the meeting to the co-chair responsible for posting at the end of each meeting.

Action Item: Ted will post call minutes to the HL7 website.Action Item: Ted will flesh out the Summary of Decisions Template to be used to summarize the outcome of votes and will populate the raw data with the attendance. Action Item: Cecil will take the data from Ted and post it on the Wiki.

** break for lunch **

Sunday Q2

OIDs and OID registry Chair: Cecil LynchScribe: Ted Klein

Lloyd suggests that the official registration of terminology be separate from OID registration. Stan asserted that the vocab committee agreed some time ago that all value sets would be registered. Lloyd asked what information at a minimum from the registration needs to be in the terminology service; probably less than the entire code system; this set needs to be defined.

MOTIONLloyd moves that “The HL7 vocabulary repository must store all value sets used in bindings maintained at the universal level or by affiliates. The registration (the value set content definition and identity) of these value sets is mandatory. The repository must support such registration of other value sets created for use in

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templates, etc. Registration of these other value sets is not mandatory but strongly encouraged.” Stan seconds the motion.

Discussion: Currently, the unique identifier of a value set is an OID. Currently, ‘registration’ means a public entry in the HL7 OID registry. Stan: clarifying comment: ‘value set content definition’ is an expression that can be used by a terminology server to create an enumerated list at a point in time of the defined values for the value set.Vote: 4/0/2 Motion carries.

This motion and vote will be discussed again on Tuesday afternoon in the work on Value sets and bindings, and will also be brought up in the joint MnM session on Wednesday.

This motion implies three separate questions that must be answered/clarified:1. These value sets must be centrally maintained; how should this be done

and where should it be housed and what tooling should be used?2. What is the required metadata for a value set to enable this process?3. How are these value sets referenced in HL7 specifications and

implementation guides?

Cecil went through the new wizard-based OID registry interface.Lloyd made some requests to show the active OIDs and all OIDs in the various lists for output. We worked on some improved wording on the screen when an OID is generated.

Sunday Q3Vocabulary facilitator’s orientation, LexGrid tooling use for facilitators Chair: Ted KleinScribe: Stan Huff

Introductions

Brief Facilitator’s Responsibilities description by Ted Klein

Harmonization Tools – Russ Hamm1. Russ Hamm demonstrated new software to support creation of proposal

for submission of vocabulary to RIM Harmonization.2. Comments from the demo:

a. The “Refresh” button for the current database should be “Revert” or “Restore”.

b. Francine Kitchen – what is the process of how the XML file gets exported for submission to HL7 Harmonization. This needs to be determined by joint agreement between MnM and Vocabulary.

c. It would be good to have documentation.

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d. It would be good to have a “Submit to HL7 Harmonization” button that would send the XML file to HL7 headquarters if the person was connected to the internet.

e. Francine Kitchen agrees to write the “Vocabulary Submission to the HL7 Harmonization Process Guide for Dummies”, if Russ will agree to explain and demonstrate the process to her.

f. June Rosploch agrees to test the user guide if Francine writes it.

** break for afternoon **

Sunday Q4 16 Points documentChair: Ted KleinScribe: Stan Huff

Meeting convened at 3:50 p.m.

The current version of the “16 Points Document” has been posted to the Vocabulary part of the HL7 Wikihttp://www.hl7.org/library/committees/vocab%5Cpnp/Facilitators16PointDocumentv509%2Exls

Ted provided a brief background of the purpose of the 16 Point Document Eventually become a “How to Guide” for vocabulary facilitators Represents tasks that vocabulary facilitators would be expected to

perform

Jim Case noted that the most common tasks that come up in RIM Harmonization are:

Definition of domains and sub domains Addition of value sets Modification and/or reorganization of value sets

The group spent time discussing and providing detailed suggests for point 16, “Use of standard vocabularies”. See latest draft of document from Ted Klein.

It was noted that, as a group, we are having a difficult time making progress on this document. Ted suggested that we might take some time on each conference call to work on a specific item. Cecil suggested that this might be an ideal task to progress via the Wiki. The document could be posted to the Wiki

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and anyone that had time or interest could add to the content. The consensus of the group was that we should progress the document via the Wiki.

Meeting adjourned at 5:05 p.m.

Sept 11, 2006

Attendees:

Name Company Email

MondayQ1

Q2

Q3

Q4

Bob Bishop VHA Robert.Bishop2@med.va.govCecil Lynch UC Davis clynch@surewest.net X XChris Chute Mayo chute@mayo.edu X X

Christine Bester GPIchristine.bester@gpinformatics.com

Ganesh Singh Oracle ganesh.singh@oracle.comHarold Solbrig Mayo Solbrig.Harold@mayo.eduJim Case AAVLD jtcase@ucdavis.eduJune Rosploch KP june.rosploch@kp.orgKathleen Connor Fox Systems kathleen.connor@foxsys.comLee Coller Oracle Lee.Coller@oracle.comLen Gallagher NIST lgallagher@nist.govMead Walker dmead@comcast.netPavla Frazier NCI/MSD frazierp@mail.nih.govRobert Grant robert.b.grant@gov.bc.caRuss Hamm Mayo Hamm.Russell@mayo.eduSandy Stuart KP sandra.stuart@kp.orgSarah Glamm Epic sglamm@epicsystems.comSarah Ryan HL7 sarah@hl7.orgTed Klein KCI ted@tklein.com XPeter MacIsaac peter@macisaacinformatics.orgRobert Hausam Theradoc 5 ausam.hausam@theradoc .com Harry Solomon GE Harry.Solomon@med .ge.com

Jane Curryjanecurry@healthinfostrategies.com X

Lloyd McKenzie HL7 Canada Lloyd@lmckenzie.com

Richard Thorenson

Behavioral Health Treatment and Disease

Richard.thorenson@samhsa.hhs.gov

Francine Kitchen GE Healthcare Francine.kitchen@ge.comRita Altamore WA DOH Rita.Altamore@doh.wa.gov

Paul KnappContinovation Services Inc pknapp@continovation.com

Stan Huff IHC/Univ of Utah stan.huff@ihc.com X

Carol Mulder InfowayCmulder.infoaccess@on.aibn.com

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Rob McClure Apelon mcclure@apelon.com X

Andrew PerryClinical Information Consultancy andrew@clininfo.co.uk X

Davera Gabriel davera@ucdavis.edu XIan Townend Ian.townend@cfh.nhs.uk XGeraldine Wade gwade@pol.net XJohn Kilbourne kilbourj@mail.nih.gov XTim Williams twillia@cap.org XMike Lincoln Michael.lincoln@va.gov XDan Russler Dan.russler@oracle.com XBob DavisMark Schaffarman

Q3

Code/Value Split discussion, and prep for MnM joint on this topicChair: Ted KleinScribe: Stan Huff

1. David Markwell has requested that we not discuss the code-value split today because he is teaching a tutorial this quarter. We will take time today to introduce code-value split, but we will discuss again on Tuesday Q2, and then in the joint MnM session on Wednesday Q1 and Q2.

2. Commenced reviewing the document sent out by David Markwell.

(RepresentingClinicalFindingsWithHL7v3andSNOMED CT 20080830.doc)

a. Chris Chute noted that this argument is a little like putting gummie worms into two square boxes. We could solve this by resolving one or more representation against an “uber” model like the “detailed clinical modeling” work that is going on.

b. Dan contends that using “qualifiers” in David’s examples represent arbitrary code-value splits, which we are presumably trying to avoid. What we are arguing about is whether concepts that are represented within “qualifier” could be represented equally well in a different part of the information model. Question and answers must be preserved.

3. No decisions were made. No votes were taken.

Q4Marital Status convergence project (Bob Davis) Binding of specific Code Systems to a Realm (Francine Kitchen)Discussion of the HL7/CEN/ISO 13606/v3 harmonization proposal (Mark

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Shafarman)Proposal for discourse type in Language (Davera Gabriel)Chair: Ted KleinScribe: Chris Chute

Bob Davis presented Marital Status Hierarchy Beta versionBackground of multiple, conflicting lists among standards organizations.Much term overlap.X12 and HL7 approached CDC to be keeper of common listsSubsequent activity on HL7 vocab lists, VA, SNOMED other stakeholdersCurrent draft is synthesis of many sources and comments

Question as to whether this is intended for legal, epidemiologic, or other use cases. The analogy came up with gender: administrative gender, genomic gender, etc.

In the process of cross-pollinating with multiple HL7 WG, patient administration.

The project was well received. Recognizing that value-set machinery might finesse the use-case or message specific refinements such as “legal marriages in FL.”

Binding in RealmsFrancine Kitchen

FM wanted to bind industry standard elements to vocabulary. Harmonization asserted that this task should be brought back to vocabulary. Long discussion suggested that Harmonization did not understand that this was an instance of a request to bind in the representative realm.

This should be resolved in M&M facilitator’s round table on Thursday.

Davera GabrielDiscourse Types

First effort to investigate spoken languages: ISO 639-2, however some might be missing.Review OLAD types, (academic linguists community). Another discussion outlined the benefits of Ethnolog.

The recommendation is that three due diligence items be pursued:1. pursue the IP issues surrounding OLAD lists, specifically user fees if any

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2. explore whether it’s feasible to create an HL7 discourse extension to 639-2 to accommodate discourse types not being found there, e.g. ASL, Spanish sign, etc.

3. touch base with PA

13606/v2 HarmonizationMark Shafarman

History of the HL7/CEN and now the HL7/CEN/ISO discussions. Some HL7 standards (RIM, CTS, etc) are now ISO.

Scope of 13606 – patient record data. If this become ISO, it would be unfortunate if not aligned with HL7. Tightly coupled with OpenEHR, in fact part 2 of 13606 is archetypes.

Early success appears likely with CDA-R2.

Outline of 13606 RMIM presented, strong beginnings for meaningful harmonization. Future work for this harmonization will fall to TC, including this one.

Meeting adjourned at 5:12 p.m.

Sept 12, 2006

Name Company Email

MondayQ1

Q2

Q3

Q4

Bob Bishop VHA Robert.Bishop2@med.va.govCecil Lynch UC Davis clynch@surewest.net X X XChris Chute Mayo chute@mayo.edu X X

Christine Bester GPIchristine.bester@gpinformatics.com

Ganesh Singh Oracle ganesh.singh@oracle.comHarold Solbrig Mayo Solbrig.Harold@mayo.eduJim Case AAVLD jtcase@ucdavis.eduJune Rosploch KP june.rosploch@kp.orgKathleen Connor Fox Systems kathleen.connor@foxsys.comLee Coller Oracle Lee.Coller@oracle.comLen Gallagher NIST lgallagher@nist.govMead Walker dmead@comcast.netPavla Frazier NCI/MSD frazierp@mail.nih.govRobert Grant robert.b.grant@gov.bc.caRuss Hamm Mayo Hamm.Russell@mayo.edu XSandy Stuart KP sandra.stuart@kp.orgSarah Glamm Epic sglamm@epicsystems.com

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Sarah Ryan HL7 sarah@hl7.org XTed Klein KCI ted@tklein.com X X XPeter MacIsaac peter@macisaacinformatics.orgRobert Hausam Theradoc robert.hausam@theradoc .com XHarry Solomon GE Harry.Solomon@med .ge.com

Jane Curryjanecurry@healthinfostrategies.com X X

Lloyd McKenzie HL7 Canada Lloyd@lmckenzie.com

Richard Thorenson

Behavioral Health Treatment and Disease

Richard.thorenson@samhsa .hhs. gov

Francine Kitchen GE Healthcare Francine.kitchen@ge .com Rita Altamore WA DOH Rita.Altamore@doh .wa.gov

Paul KnappContinovation Services Inc pknapp@continovation.com

Stan Huff IHC/Univ of Utah stan.huff@ihc .com X

Carol Mulder InfowayCmulder.infoaccess@on .aibn.co m

Rob McClure Apelon mcclure@apelon.com X X

Andrew PerryClinical Information Consultancy andrew@clininfo.co.uk X

Davera Gabriel davera@ucdavis.edu XIan Townend Ian.townend@cfh.nhs.ukGeraldine Wade gwade@pol.net X XJohn Kilbourne kilbourj@mail.nih.gov X XTim Williams twillia@cap.org XMike Lincoln Michael.lincoln@va.govDan Russler Dan.russler@oracle .com Bob DavisMark SchaffarmanEd Hammond X XHeather Grain h.grain@latrobe.edu.au X XJim Campbell Campbell@unmc.edu X XGaby Jewell XSkirmantas Kligys Skirmantas.kligys@oracle .com XTom Oniki XRichard Franck IBM XMax Walker Max.walker@dhs.vic.gov.au X

Q1CD data type changes: post coordination, original text, translations, code representation in value sets, etc.Administrative items: conference call schedule, San Diego meeting scheduleChair: Chris ChuteScribe: Stan Huff

Attendance: See sign up sheet

1. Discussion of the definition and use of Translation as part of Concept Descriptor data type definition.

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Motion by Cecil Lynch to: Change the definition of translation of Concept Descriptor in the data type definition to read: translation is a set of other CDs that each translate this CD into equivalent codes within the same code system or into corresponding concepts from other code systems.

Use cases:ISO 639 versus 2 character country codes, legacy codes for old SNOMED and Read Codes for SNOMED CT codes.SNOMED codes and legacy lab local codesSNOMED pre-coordinated codes in an extension and the equivalent post-coordinated expressionAscending bilateral paralysis -

In favor – 14, Negative – 0, Abstain – 2

2. There is an inconsistency in the definition of translation with the CE data type. In one place translation is SET<CD> and in the second instance is SET<CE>. The intent is that the definition in both places should be SET<CD>.

3. It was asserted that people should be reminded that coded data types can be further constrained in implementation guides to meet business needs.

There was discussion that we should consider changing the definition of translations in CE to be SET<CE> or SET<CV> rather than SET<CD>. No action was taken.

** break **

Q2

Code/Value SplitChair: Chris Chute Scribe: Ted Klein

Continuation of the discussion from yesterdayWhat role do Templates, Archetypes, etc. have, if any, in recommending solutions to this problem? How much desire is there to change or extend the 2-box model rather than defining how to shoehorn the Findings examples into the 2-box models (Act.code/Act.value)

There is a particular need in Patient Care to support both consistency and the explicit information in a ‘question’ to support care plans. Many ways to

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represent terminology exist, but we want a simple and consistent means of doing this.

The original model is that the ‘code’ contains what was done, and the ‘value’ is what resulted. This caused an arbitrary split for those items that just seem to exist, and are noted without anything other than the activity of recording them being done. David asks if we can resolve the issue of whether or not the code fundamentally informs what is in the value consistently.

We discussed how the current split is defined in the RIM. Dan asserts that going to a single-box model with the semantics in code violates the consistency of care plan even if you use a separate Act and ActRelationship (‘fulfills’) makes an inconsistent model.

Cecil asserts that there is a need that the representation of a concept within the same mood should be done the same way.

We had a straw vote from Chris on whether the test done and whether it was done is a separate Act from the result. Overwhelming yes. Another straw vote from Dan whether within a single instance of the UML object you cannot have both the test and the result. Overwhelming: of course you can.

David’s question in a case where the result is complete in itself is it appropriate to include the question in the same instance as the complete answer. We had almost ½ and ½ yes and no.

** break **

Q3

Vocabulary Items DefinitionsChair: Ted KleinScribe: Cecil Lynch

Russ Hamm presented the initial attempt at taking definitions and descriptions of attributes and values sets in different places and put it into a summary.

Values sets

Sub value sets were brought up and defined by Stan. This is different than a nested value set. Rob asked why the sub value set was needed. Ted explained that the message can be constrained to narrow the set of codes to a subset for a particular use case and this is a sub value set. Does not have to be of a single semantic type.

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Value sets can be made up of codes from different code systems and may contain other value sets.

The same value set may be statically or dynamically defined and each concept must have a distinct meaning from other concepts in the same value set.Every attribute has a domain. Can then create sub domains and value sets under that domain. A sub value set can be made. Ted mentioned that others might define that as a sub-domain that then has a value set that is bound. If you have a single message type and want to change value sets then it goes through a domain.

Stan states that there are 2 kinds of bindings:

1) to attribute in static model2) to support runtime binding of a value set to a specific domain and a specific realm

Stan will define this further.

Big discussion about whether to carry the domain when binding the value set. Stan says it is not necessary to do this because the domain is implied.Rob mentioned that value sets in HL7 are treated differently than out of coding systems like LOINC. This allows a concept from a value set to be used out of context since the values sets are not explicitly defined unless they are bound to a domain. If this is changed, then there will be conflicts in HL7. Ted argues that the context of meaning is supplied at the instance of the message.

Russ will define attributes of value sets in a UML diagram and include it in his documents.

Discussed the difference between container concepts (abstract and non-selectable) and member concepts (concrete and selectable). Maybe there should always be a label for a container that is an abstract concept.

Adjourn for the day at 5:20PM.

Sept 14, 2006

Name Company EmailMonday

Q Q Q Q

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1 2 3 4Cecil Lynch UC Davis clynch@surewest.net X X X XLen Gallagher NIST lgallagher@nist.gov XRuss Hamm Mayo Hamm.Russell@mayo.edu X XTed Klein KCI ted@tklein.com X X X X

Jane Curryjanecurry@healthinfostrategies.com X X

Stan Huff IHC/Univ of Utah stan.huff@ihc .com X X X X

Carol Mulder InfowayCmulder.infoaccess@on .aibn.co m X X

Rob McClure Apelon mcclure@apelon.com XIan Townend Ian.townend@cfh.nhs.uk XGeraldine Wade gwade@pol.net X X X XJohn Kilbourne kilbourj@mail.nih.gov X X XTim Williams twillia@cap.org X X XMike Lincoln Michael.lincoln@va.gov X X XDan Russler Dan.russler@oracle .com Heather Grain h.grain@latrobe .edu.au X X X XTom Oniki X XRichard Franck IBM XLee Min Lau 3M leeminlau@mmm.com X X XJaqui Parker Jaqui.parker@thomson .com X X XKasey Poon 3M kpoon@mmm.com X X XShaun Shakib 3M scshakib@mmm.com X X X XBetsy Smith FDA Elizabeth.smith@fda.hhs.gov X XRob Hallowell Robert.hallowell@siemens.com XJohn Hatem Oracle John.hatem@oracle.com XKathy Giannangelo AHIMA Kathy.giannangelo@ahima.org X X XBhavana Patel InfoWay bpatel@infoway-inforoute.ca X XDoris McGinness SNOMED dmcginn@cap.org X XGarry Cruickshank InfoWay g.cruickshanck@sympatico.ca XAni Vallabuanem Epic ani@epicsystems.com XHugh Glover Blue Wave Hugh-glover@bluewave.com X

Tom OnikiIntermountain Healthcare Tom.oniki@intermountainmail.org X X

Chenjian Che 3M cche@mmm.com X X

Brian Levy Health LanguageBrian.levy@brian.levy@healthlangage.com X X

Nancy Orvis DOD XStefan Baumann Novartis Stefan.baumann@novartis.com X

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Q1

Joint with Pharmacy (vocab hosting) Routes discussionChair: Ted KleinScribe: Cecil Lynch

Introductions

The Routes are a mix of procedures and routes that need more than one value set. Rob Hallowell presented the efforts of the sub-team that reviewed this from pharmacy. They presented a proposal to rename "Routes of administration" to "Administrations for Medicinal Substances". No motion or vote taken.

There was a question about how this fit in to the HL7 NLM contract and Stan Huff said this is a part of the process and is under the current scope for the RFP.

The derivation of the spreadsheet presented was discussed in relation to the UK effort over dose syntax and those definitions and Hugh explained that the UK effort was not specific to the UK. The definitions were done as vocab definitions but not as RIM definitions. Stan pointed out that there is a domain name and a RIM attribute name that are separate and need to be harmonized. Ted asked if this effort involves reviewing the RIM to make sure their was alignment to the vocabulary review. Everyone agreed this was needed and was the goal. There was notation that the RIM definition respected that the individual related attributes of routeCode, approachSiteCode, and methodCode are interrelated and need to be in synch. Rob McClure pointed out that this complex area may be under the purview of vocab to build and maintain this terminology because of the lack of appropriate structure and content in other areas.

In a decomposition analysis of Routes they found:

RouteAnatomical siteMethod (as related to body)Dosage formMethod (as related to dosage form)DeviceTiming

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Used for

Suggested to remove dosage form, device and used for and align the vocabulary to the RIM attributes. The sub team review has completed thier analysis and now asks for vocab guidance.

There was debate as to whether the decomposition required both a terminology and information model or was all just a terminology model.

Hugh mentioned that there are types of administration involved in substance administration such as radiation and that we might need a child domain of Medicine Administration under Route of Administration and that route would include items that were not medicines.

Motion by Stan Huff:

1. We complete and review the spreadsheet and make corrections where appropriate and the scope is the set of things you want to say for medicinal substances.

2. We create value sets that include the precoordinate part and all decomposed parts of the current RoutesOFAdministration.

3. We review and make changes to the RIM model to align the value sets to the RIM attributes.

4. The completed spreadsheet will be published as an informative part of the ballot.

5. We will prepare value set bindings for harmonization for the Representative Realm.

6. Documentation will be prepared to accompany the spreadsheet in the informative ballot.

7. The spreadsheet and a draft document will be prepared by the next work group and prepare the vocabulary harmonization proposal.

Rob McClure seconds.

19 for0 abstain 0 against

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Q2

US Realm DiscussionChair: Cecil LynchScribe: Stan Huff

Attendance: See sign up sheet

1. Stan summarized progress of the NLM CHI terminology contract.RFP response just closed.2. Stan described the purpose of having a US Realm specific session during

this quarter.3. Discussion: As a work item, the Vocabulary TC needs to understand the

end-to-end process relating to realm specific value set bindings, including capture of the bindings, recording, reviewing, approval, and publication.

Motion by Ted Klein:

The policy for US realm specific vocabulary assignments is:

1. A realm has the authority to adopt realm wide binding for a specific value set or vocabulary domain in a specific message.

2. A sub-realm authorized by a realm as having responsibility and authority for vocabulary bindings in specific messages within the scope of the sub-realm should declare bindings that are either the same value set declared by the realm or a sub-value set thereof.

3. If a value set is to be declared by a sub-realm that is not a sub-value set of a realms declaration then the sub-realm may do so only with explicit approval of the realm for the use in a specific context.

4. All realm and sub-realm bindings will be registered in a publicly available HL7 resource.

second

11 for1 abstain0 negative

Q3

CTS 2 Update - support for resolution of value set content at a point in time (Russ and Jane) - EHR functional model terminology section (Joanne and Stan)

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Chair: StanScribe: Ted

Agenda item: Support for value set content resolution at a point in time

This ties directly into the issue of how the versioning is represented in value set property definitions, and the whole issue of value set binding.

Discussion of the requirements for this resolution and versioning; review of the binding issues from the joint MnM meeting about binding.

There are enumeration and intension for definition of value set content. These mechanisms are orthogonal to the binding type static vs. dynamic.

Lots of discussion

Motion Ted Klein:

Ted moves that we use effective date mechanisms for versioning in value sets and binding mechanisms. Mike Lincoln seconds. There seems to be at least one terminology in the UK where multiple versions are active in the same effective time range. Stan described that it can be validated correctly by the records or messages or applications that use such things, they must identify a specific set. It does not matter in dynamic binding. Lee Min calls the question.

Vote: 17/0/0 Motion carries.

Agenda item: EHR functional model vocabulary section (Joanne Larsen)

Joann could not make the meeting so this item was differed.

Agenda item: CTS-2 reportConference calls will be scheduled starting in about 2 weeks to continue with CTS-2. Very little has been done since the May meeting.

Q4

Joint with ConformanceChair: Ted KleinScribe: Cecil Lynch

Conformance Reconciliation: John Lyons

Discussion of Vocabulary Domain definition for the conformance ballot:

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Vocabulary Domain current definition

“An HL7 Vocabulary Domain is a named category of like concepts (semantic type) that will be bound to one or more coded elements.*Vocabulary domains exist because we want to constrain the intent of the coded element while deferring the association of the element to a specific coded terminology until later in the message development process. Thus, vocabulary domains are independent of any specific vocabulary or code system.Domains are universal in nature (independent of any realm). A domain name should never contain any reference to a specific realm. Vocabulary domains are proposed as part of the HL7 standards development process and are approved by the RIM harmonization process. Any conflicts in proposed domains are resolved by the RIM harmonization process.A vocabulary domain is documented by specifying a name, a narrative description, and three or more examples of concepts that are members of the category.”

It was decided that a more intent driven definition was needed in the conformance document. This is specified in section 2.5.1 of the conformance document.

There was suggestion that the narrative definition might be better as a list of attributes of what a domain is and what it is not.

There was a long discussion of what the defined text of a sub-domain was.

Working definition;” For purposes of Conformance a vocabulary domain acts as a place holder to enable the constraint process to later bind a value set to an attribute. The allowed semantic space attribute for an attribute’s values can be constrained by defining a sub domain which is a portion of the semantic space of the parent vocabulary domain and binding the attribute to the sub domain.”

Len moves to accept the above definition and John Lyons seconds

16 in favor 2 abstained0 negatives

Ted suggested the following refined definitions:

A value space is a restricted semantic space whose extent is restricted by the values in that space.

An attribute space is a value space defined by the values permitted in that attribute.

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There was much discussion and clarification regarding constraint of value sets and the realm specialization process.

Leave the vocabulary domain that is bound to the child attribute the same as the vocabulary domain that is bound to the attribute in the parent model.

Constrain the allowed semantic space of the child attribute by binding it to a sub domain that represents a portion of the semantic space of the parent vocabulary domain. If the parent domain is non-realm-specializable, then the child domain will also be non-realm-specializable.

Stan moved to accept the above (first 2 bullets of this section of 2.5.1)Mike seconded the motion.

14 in favor0 against1 abstention

Motion passes

The committees will explore the potential for continuation of the discussions by teleconference

Meeting was adjourned at 5:07 PM

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