CGIT WG Minutes Orlando, FL, USA (01/2016)

HL7 Work Group MeetingOrlando, FL – January 2016

Attendees:The list is provided in the Appendix.

Adding a typed listed is tedious, given that some names are hard to read.

Monday Q1Chair: FrankScribe: NathanAttendees: 5 – see attachedQuorum: YesApprove agendaAgenda approved 4/0/0

TODO: Examine the FHIR GForge tracker, examine the open items. (Ioana) FHIR needs to assign.

Approve minutes (San Antonio, Paris, Atlanta)Motion to approve minutes by Nathan and Ioana. 4/0/0

Review and approve SWOTGoing over SWOT: http://wiki.hl7.org/index.php?title=CGIT_SWOT

Discussing the idea of creating a conformance tutorial for HL7 WGM. Probably could have something as soon as September 2016. People are interested in conformance only to get a certificate saying they are conformant.

It’s important to understand if the tool you are using can support conformance properly. Tools that can generate a document are secondary to a system that can create automatic tooling to check for conformance.

Motion to approve SWOT as it is written today by Nathan and Rob: 4/0/0

Review and approve DMPAdopted default DMP (version 4), and loaded document to file server.

Motion to adopt default DMP by Nathan and Ioana. 4/0/0

Review and approve Mission & CharterWorked on Mission and Charter.

Motion to adopt Mission and Charter as discussed today by Nathan and Ioana. 4/0/0

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Conformance facilitator: establish a fixed quarter for facilitators to attendNo progress yet.

Discuss this today with FTSD so they can bring to TSC. The issue is the facilitator list. Perhaps it needs to be by project not by workgroup. Both can make sense.

Proposal to look at Monday Q4 to use as the quarter to talk about conformance with projects and work groups.

Note from FTSD: it will be hard to find interested persons. Monday Q4 is not accepted due to conflict with most of the other WGs. We should use the facilitator round table on Thursday evening.

Monday Q2Chair: FrankScribe: NathanAttendees: 4Quorum: Yes

Follow-up action itemsAction Items:

Create Position Statement for a HL7 v2 Standalone Conformance Specification (SCS)o No progress since last WGM

Craft a new PSS for RCnLo Table discussion, want to close this project

Project 1146: is in a pre-approved state. We will come back to it later.

Projects (review) Project 1196: Terminology Quality Assurance (TQA) sponsored by Vocabulary

o Rob Snelick attends the call every two weeks Project 1146: Unified Conformance and Constraint Modeling (previously known as Refinement,

Constraint and Localization, Release 3)o On hold

Project 1097: EHR-S Functional Req Doc for Laboratory Interoperability Transactions - EHR-S Functional Profile for Laboratory

o We are not the main sponsor and we are not directly involved Project 1096: EHR-S Func Reqs Doc for Laboratory Interoperability Transactions - EHR-S Func

Reqs IG for LOIo We are co-sponsor and we are heavily involved any more

Project 1095: EHR-S Func Reqs Doc for Laboratory Interoperability Transactions - EHR-S Func Reqs IG for LRI

o We are co-sponsor and we are heavily involved any more Project 874: V2 code table versioning and alignment to V3 vocabulary model

o We are main sponsor and we are heavily involved.

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o This will be discussed on Wednesday, at least from publishing perspectiveo From project perspective Thursday Q3.

Project 763: HL7 SAIF Implementation Guideo We are just co-sponsors on it, TSC is sponsoring it. o We should talk to Ken McCaslin about this, to see what is going on with SAIFo Ioana is sending a note on behalf of CGIT

Project 737: HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 2 (US Realm)

o Not done yet, ELR will be a profile component that leverages LRI. Harmonized four specifications. All the lab ones will be harmonized.

Project 630: Develop and publish Principles & guidelines to specify the syntax for vocabulary binding in implementation guides

o Frank and Rob are actively involved on this every two weeks. Long lasting discussion with slow progress.

Close RCnL ProjectRCnL v2 is Normative. No more items to do for this. The only new work that is coming on V3 is coming from FDA. If they are interested in updating then they can take this on. But there is not enough interest to justify us going forward.

RCnL v3 is closed.

Proposal to change name of CGIT to Conformance This has already been decided.

Need to raise topic in steering division meeting today.

Note from SD: FTSD is not opposed to name change. Need to provide appropriate request.

V2 Basic Test CasesFrom agenda:

Discussion on how to define basic HL7 v2 basic test cases for verifying support for basic encoding in Chapter 2

Rob Snelick is asking what the group would like to see tested.

Discussed ideas and gave Rob a list of things that might be tested

Monday Q3Chair: FrankScribe: NathanAttendees: 4Quorum: Yes

Presentation on work being done in the US Immunization community. Nathan Bunker presented and asked for feedback. The result of the conversation is the idea that there should be separation between

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conformance requirements and functional requirements. Nathan will take this back to the community and work on this to see where it goes and will report back at the September WGM about how this idea works.

Monday Q4Chair: RobScribe: NathanAttendees: 3Quorum: Yes

Test Data CategorizationsFrom agenda:

Testing associated to specific test cases. Need to review the categories.

Discussing testing and which has the responsibility to filter data, is it the sender or the receiver? A lot of discussion between Rob Snelick and Frank Oemig. No resolution yet on the issue of how to enforce contracts and expectations through the profile.

Co-Chair MeetingConsidering change to DSTU to Standard for Trial Use to help reduce confusion outside HL7. Want to move standard as the primary name.

Moving TSC guidance out to HL7.org to make it more visible to membership.

Standards Governance Board has been put together.

Some discussion about when to create Project Scope Statement. Fielding questions about PSS.

Harmonization OverviewThis is an update of a regular harmonization of the CDA RIM. This is important for those who set standards for HL7 v3. The next cycle is being planned, everything is going on schedule.

Vocab Items for WGs. V2 table content cleanup continues. Looking at process proposals for unified terminology governance.

Project OfficeDave Hamill has been focused on several ONC grant funded projects:

* Enhancing C-CDA Implementation, awarded to Duteau Design. There was a connect-a-thon.

* C-CDA companion guide, awarded to Duteau Design.

* Enhance HL7's Testing Infrastructure, will be providing update in September

FHIRShowing graphic of who is hitting HAPI server, a lot of traffic around the world. 126 people registered for Connect-a-thon. FHIR's interest continues to grow.

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Looking at either a 2.1 or 3.0 version freeze on Mar 13 or Jul 17. Talking about improvements to the build process.

Process Improvement (PIC)Visibility has been low lately, so they sent out a survey. They confirmed there was low interest in PIC.

* TODO Need to check on 3-year plan

OtherNew chair is Pat Van Dyke.

Implementer Certification Market Survey update from Austin KryslerHL7 will be sending out a survey to see if people are interested in providing professional certifications or not. Will be a large investment for HL7 so they need to know if they should proceed or not.

The question was how this might be different than current certificates that are being issued. This will be more broadly at a person's experience in the implementation space and there will be an exam. Will entail a continuing education requirement. Must more than just passing the exam.

What is the difference between certification of product lines vs certification of professional?

FTSD NotesRename CGIT to Conformance

Action Needed: send Charter to FTSD

Discuss Facilitators Quarter

FTSD will raise at TSC lunch to float by SD

Tuesday Q1Chair: Rob SnelickScribe: Nathan BunkerAttendees: 11 – see attachedQuorum: Yes

Today we are covering testing tools. Only one group came to show their tools. We have Aegis here to discuss their tool.

Discussion about how Connectathon track is not a full test case. The FHIR Connectathon has testing tracks. Aegis is showing us these tracks. Aegis is explaining how Connectathon test cases work. Now they are showing how this looks in their Touchstone tool. The test scripts are written in XML and are FHIR resources. Richard is currently writing the XML directly but in the future a tool may be built to help with writing these test cases.

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Richard showed how the test looks when run. Mario said that after Connectathon the testing continues. Frank made the comment that IHE does minimal testing in preparation for a demo, but it’s not full testing. Mario agreed and said that there is no negative testing, so there is a need for testing system to be in the middle to break messages so we can see what happens. Mario says they are working to slowly increase the number of tests at each connectathon so that they will be gradually accepted and used.

The other issue is when the resource or standard is not well defined. As tests are written these problems are determined.

Ioana makes the comment that the best and first use case for FHIR, at least in the US, seems to be query. So this should be the major focus in testing. But in further discussion the group said that FHIR will be increasingly used as an internal API for EHR systems as they are looking for rest interfaces to connect different parts of their system together.

The level of testing and maturity of FHIR is increasing. Now to increase the FHIR Maturity Metric Level (FMM) the resource has to have test cases defined and it has to go to the Connectathon.

We can work on creating use cases for immunizations and work on it for the next WGM. Nathan can work with Richard Ettema from Aegis on this.

Action: Create a quarter for FHIR Conformance

Discussion about how the description of the test cases can be made more generic so that it can be applied to FHIR, V2, V3, etc.

Tuesday Q2 Chair: IoanaScribe: Nathan BunkerAttendees: 7Quorum: Yes

Agenda:

Discussion of Strategy for Conformance in FHIR, V3, etc.

o Discuss strategy to provide input to FHIR on conformance.o Discuss generic conformance format that may be applicable to any HL7 product line.

A question about how FHIR testing is currently connected to new implementation guides. Richard Ettema is showing this URL: http://hl7-fhir.github.io/daf/daf.html

The assertions are currently not very testable. Looking at D.0.3.1. Need to have a tool bag that the tester can use to pick standard options.

Now looking at: http://hl7-fhir.github.io/daf/patient-daf.html

Looking at scenarios. Drilling down to US Core. Looking at test script for search.

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The next step is to read the structured data for the resource and build automatic assertions for the test case.

Talking about work being done with Death Reporting as an example of how to deal with creating guides in different standards. The issue is that there are mismatches in how the conformance constructs are named and described. In essentials they are the same, but they are not done in the same way.

Need to align the products. ONC would like the conformance rules to be expressed the same. Maybe FHIR is an opportunity to create definitions that we can all reuse.

Looking at http://wiki.hl7.org/index.php?title=Unified_Conformance_Guidance This wiki page was updated with changes based on conversation. Refer to page for synopsis of conversation.

CGIT Wednesday Q3Chair: Frank OemigScribe: Nathan BunkerAttendees: 14 – see attachmentQuorum: YesAgenda

Joint session with FHIR, Vocab, Templates

FHIR discussions

Implementation Guide Conformance Rules

Discussing Agenda for Meeting

FHIR has taken an existing guide for FHIR and see how well it could fit in the format we had last time. We can talk about the major issues that were encountered. Kai had wanted to do it for CDA but didn’t have time to do it. Ewout can show what he has done.

Conformance rules FHIR has discussed and it is part of FHIR. The issue of what are allowed constraints has been discussed. We have found a few points where the specification was missing details. Trying to keep a list of issues that we find as we work on the tooling. FHIR has added an implementer’s checklist, and this is very valuable.

Ewout worked on the Lab Order implementation guide and tried to push it into the format that was discussed last time.

CGIT has made some progress on the conformance document, but we are waiting for something before continuing. Rob should have a paper to review in May to look at for a tutorial on conformance. We tend to have a generic conformance tutorial applicable to all standards.

Governance Board has changed, instead of product specific ones there will now be a common board. The FHIR Governance Board will disappear. Will be replaced by something new and it will report to Governance Board. But that is not going to be discussed here. There needs to be tighter integration

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between conformance concepts. FHIR does have data type flavors, they look like subtypes of the primatives.

Question, Richard is here, put on the agenda to discuss that testing is part of the implementation guide. More related to the implementation guide than as part of it.

No open tracker items to discuss. All conformance resources are frozen, except Test Case and Implementation Guide. Maybe there are new ones that CGIT should look at on the conference calls. Need to have people on CGIT list to look at Test Case and Implementation Guide resource.

Ewout will present on ConformanceWe were not sure how the technical artifacts and use cases be linked. Package contents (one per interaction or a group of interactions?) There is usually a focus class/object that is the starting point for use cases. The US Lab was chosen because it was the “worse” one out there, the most badly structured. It’s very complicated structure.

Now Ewout is showing the document he created.

Created shorter headings than was in the original document Not everything that was discussed is in here There were three central parts that were found in the lab report:

o Laboratory Ordero Laboratory Reporto Laboratory Report to Public Health

The source of truth: http://hl7.org/fhir/iglist.htmlo Open USLAB IGo Original done by Eric Haas

The FHIR expression is the least well structured, just a big table of contents with no organizing principle.

o This is a derivative work from the original. o The original is here: http://www.hl7.org/implement/standards/product_brief.cfm?

product_id=279o There are actually 4 guides that these separate intoo Skip details of the guide for now, but focus on how this was translated into FHIR

Contains, what was expected, works very wello Purposeo Audienceo Conventionso Use Caseso Actors

High level uses cases with actors grouped under. But it was split into three use cases. Profiles seem to align with the “focal classes” mentioned above. Then you can click and see the constraints that flow from the test case. The Implementation dropdown ties together the first drop down with the second down drop

down.

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The term “profile” is overloaded. In this case we mean FHIR resource profile, and not V2 and V3 profile. This might need to rename if used across other products.

There is an element of behavior, the transaction, and the data that needs to be transmitted. There are different levels, the lowest is transaction. Several transactions are grouped together as a use case.

Profile is probably not a good work to use. Talking about how these are named in different standards. Profile is way overused and needs to be renamed to something else. Group is discussing what to name this. No consensus, next time we will talk and get a better term.

There is no tab for value sets. Under the registry tab everything is there. It is an artefact list. Talking about the different kinds of supported. Currently there is a wide category for

“supported”. Very lightweight type of support: reproducing support, send in and get it back. But this is different than being able to know what it means and print it out on a printer in a specific place.

Next time, or in between, we can look at a CDA implementation guide. Links to value sets, how should that be done? Links to templates, how should this be done?

How is this information maintained? How is linked to other stuff? Combination of technical profiles, which are generated and some are hand written.

Discussing the details of how to work with HL7 v3 in context of this new proposed process. How public can we make this preliminary thing? Ewout and his team will finish their 2015

Atlanta Implementation Guide Section Inventory document and put screenshots of what they have done to publish the document.

Talking about vocabulary bindings. The value set meta data tells us about the meta data, and this is very important to understand what to do. It is valuable from a readability point-of-view to reference this. This should go on the registry.

Talking about how it would be best to navigate to different sections in the report. Best to have the top level bundle in the list and not every item. Then you look inside the resources in that bundle and you can see the details.

The other question is what supported means.

CGIT Wednesday Q4Chair: Frank OemigScribe: Nathan BunkerAttendees: 13 – see attachmentQuorum: Yes

Talking about the naming of the third category on the top. Proposing to call the section “Components”. After some discussion it seems like it would work for now. In V2 there are some of the same headings. What is the closest thing to “components” in HL7 v2. Is this in scope? If this is only for FHIR then “Profile” it could remain named this way. Will try to rename to generic name for now and see how far we can go.

Must SupportDiscussion about what “must support” means. Might vary according to interaction.

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Richard has some questions about test scripts. Now that we have an implementation guide were we have references to the definitions, we could generate initial test scripts and generate assertions.

Talking about FHIRPath, which is like XPath but optimized for FHIR. We have a history at making new things which we don’t want to do. But we like this and haven’t found anything else that would work.

Question about if test scripts go with or are just referenced by implementation guide. Had a long discussion about this in Atlanta last time. Any artifacts that you can automatically generate can be part of the implementation guide as artifacts that you can use in context free situations. But specific test cases with specific data would be separate. The test script would reference the IG.

Discussion is complete for this WGM. We will pick it up again in May.

Notes from Michel: Heading "Profiles" => overloaded; rename to "Components" Contains high-level entries Each entry describes a list of all the artefacts (profiles / templates / segments) related to a

specific interaction Each entry provides links to (possibly many) detail pages for each artefact

- Rendering – specific renderings for FHIR, CDA, … - Kai & Ewout/Michel – write down a skeleton document that can serve as a

checklist/starting point - Valueset bindings – currently listed below individual components; Kai: also list all

of these under heading “Registries” - Next HL7 WGM – only on Q3, not Q4 - MustSupport - must be clearly defined

Ewout: where to put this in the guide? Kai: meaning of Must Support can differ inbetween interactions => explain this on interaction pages under heading “Implementation”

- Richard Ettema: now we can generate TestScripts from the computable ImplementationGuide resource

Rob: may/would also require additional (complex) tests, outside of the scope of the IG Via a connector inbetween Simplifier (registry) and TouchStone (test engine)

Publish IG on Simplifier Connector signals TouchStone TouchStone generate TestScripts TouchStone publishes the generated TestScripts back to Simplifier (along with the IG)

Vocab, with CGIT and InM joining: Thursday Q1Chair: Ted KleinScribe: Heather GrainAttendees:Quorum: Yes

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Something to discuss that concerns all three groups.

Does InM have specific items: No

Does CGIT have any additional items: No

Vocabulary will now be subjected to quality measures. There is now a form for V2 tables request. It will come through harmonization. Then it will end up eventually with Frank Oemig to put in his database. Outstanding issue with InM for a very long time. Updating the examples in v2.9 where fields have not been updated and they are wrong. Tony, what do we want to do about this? It has been at the bottom of our priority list. What is the target for v2.9? They are looking to target May ballot cycle, so very soon. Tony says he can tackle the Chapter 2 examples. They are in all 20 chapters, should we ask the work groups? But Vocab will still have to review what is done. The chapter authors need to update the examples.

Propose a motion: Vocab joint with Conformance notify chapter editors that editors of the chapter need to update their examples to ensure they are accurate in preparation for HL7 v2.9. Motion carried: 9/0/0

Talked about get rid of 2+ values has been tabled. We want to get the conformance model to a pure data model and not conflate with data types. Work to move CNE/CWE will be done not prior 2+, i.e. not 2.9. This is something that will done later.

HL7 v2+, Frank can provide a URL to show what we currently have.

Made a schedule for the InM calls. Binding Syntax and the Tables calls. TQA is also a joint project. The tables calls will resume at the same time as the main.

Thursday at 3pm EDT, beginning on the 28th of January. This is okay for Conformance? Yes. Binding Semantics on Tuesday 2pm EDT, starting this coming Tuesday. Meeting for an hour. Quality Assurance will be Monday, February 8th. Alternates every other week.

Do we want to have this joint quarter in Montreal? Conformance, yes. Continued discuss when to meet for the next WGM.

Meeting with Vocab – Thursday Q2Chair: Ted KleinScribe: Heather GrainAttendees:Quorum: Yes

Group discussing binding syntax. The wiki always has everything. http://wiki.hl7.org/index.php?title=Binding_Syntax#Current_Working_Material

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Attendance Sheets

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