ITI Agenda 2017-2018

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November 2017 F2F – Technical Profile Kick-Off Meeting, 15–16 November 2017

This 2-day meeting is focused on a review of the detailed profile proposals, and selection of work items for the 2016/2017 year based on committee resources and technical readiness.

Meeting Location
RSNA Building, Oak Brook, IL
WebEx information for this meeting is
Meeting Number: 927 055 967
Password: Ask Jeremiah Myers (jmyers@himss.org)
Link: TBD
Support material
Profile proposals and other support information may be found in the meeting folder

Agenda & Minutes

All times listed are tentative, and may be revised during the meeting—refresh often.

Wednesday, 15 November, 2017

Day 1: Wednesday, 15 November, 2017
Time

Oak Brook (CST, UTC−06:00)

Leads Activity Notes
8:30 am–9:00 am — Breakfast —
9:00 am–9:30 am Elliot/Mauro Introductions and Agenda Review
9:30 am–10:45 am
10:45 am–11:00 am — Morning Break —
11:00 am–12:30 am
12:30 am–1:30 pm — Lunch —
1:30 pm–3:15 pm
3:15 pm–3:30 pm — Afternoon Break —
3:30 pm–4:45 pm
4:45 pm–5:00 pm Elliot/Mauro Wrap-up, homework, agenda updates

Thursday, 16 November, 2017

Day 2: Thursday, 16 November, 2017
Time

Oak Brook (CST, UTC−06:00)

Leads Activity Notes
8:30 am–9:00 am — Breakfast —
9:00 am–10:45 am
10:45 am–11:00 am — Morning Break —
11:00 am–12:30 am
12:30 am–1:30 pm — Lunch —
1:30 pm–3:15 pm
3:15 pm–3:30 pm — Afternoon Break —
3:30 pm–4:45 pm
4:45 pm–5:00 pm Elliot/Mauro Wrap-up, homework, agenda updates No homework assigned.

Day 1, Wednesday, November 16th, 2016.

Activity Leads Time Minute
Breakfast 8:30AM – 9:00AM
Introduction -( Agenda Review , Round table introduction, Discussion on voting process, sponsor communications, formalize which are authors commitments: wiki updates , f2f participation, identification of editors/primary authors…) Elliot / Mauro 9:00AM – 10:00AM Participants: Ben Levy (Corepoint) Elliot Silver (McKesson) Karen Witting (Ready Computing) John Moherke (Moherke Research) Charles Parisot (GE Healthcare) Nader Cheaib (Asip Sanitè) Matt Blackmon (?) Kirsten Boyd (HIMSS) Lynn Felhoper (ITI Technical Manager) Tarik Idris (ICW) Joe Lamy (AEGIS.net) Eric Heflin (THSA) Fabio Buti (DEDALUS) Bill Majurski (NIST) Ken Meyer (Merge/IBM) Luke Duncan (Intrahealth) Chris Melo (Philips) Gregorio Canal (Arsenal.IT), Rob Horn (AGFA Healthcare), Mauro Zanardini (Arsenal.IT).

Minute: Round table introduction of attendees. Agenda has been reviewed. No changes to the agenda has been applied.

Voting procedure: we will try to reach consensus. After consensus reached we will move a motion and people can vote the motion. The Tech cmte agreed that the Vote casted by ITI tech is intended to propose to the planning what we can address. Planning Cmte will revise recommendation made by the Tech Cmte (during the joint meeting) and will accept or reject taking in consideration prioritization and tech cmte capacities.

Elliot presented some slides related to IHE's Patent disclosure policies. If someone needs more info about this topic, should ask IHE secretariat.

Mauro listed profile authors commitments in order to reach an agreement within the cmte. Profile authors are asked to create wiki page after TI publication. Wiki can be used to track activities of sub-work groups, and this is approach is strongly suggested by co-chairs.

Sharing platform for not patient centric documents Gregorio Canal / Mauro 10:00AM – 10:35AM Gregorio presented some slides related to the detailed proposal. It has been suggested to keep search separated from retrieve. The cmte would clearly identify the scope of the profile in order to keep the proposal small. it is suggested to take in consideration use-cases that are based on document's sharing and not other type of files. In order to have an efficient search mechanism, we should identify each metadata. We should classify the type of the document but there are additional metadata that will be important: Confidentiality, Integrity. In fact access control is needed and in scope for the profile (probably can be more focused on content creation instead of content disclosure).

The cmte would identify categories of documents that can be managed using this profile: documents that do not contain PHI and document that do not contain PI.

The cmte identified two tech approaches that could address the problem: extension of XDS.b and a profiling of FHIR documentReference resource. DocumentReference could be the right solution and provides search metadata that already address confidentiality, integrity and content classification. Some ITI members posted out that there are some other RESTful solution. If we choose RESTfull i twill be easy to formalize metadata. OMA protocol can be a solution, maybe more stable. The cmte agreed on limiting the proposal to: documents that do not convey personal identifiable data, and related to 3 use-cases presented. Access control is part of the scope, in particular for creation. Tarik suggested that we should add a use-case in which we stress the role of the creation that can be done by many system (multiple creators). During the profiling we should take in consideration compatibility with XDS, it will be a profile complementary to XDS.

Patient-centric Data-element Location Service Charles 10:35am – 11:50am

Charles presented the detailed proposal. A list of use-cases of interested are described. Charles confirmed that the mapping bewteew CDA and FHIR is out of scope for this profile. In scope to move from XDS to this profile alowing the following usecase: give me all immunization and give me immunization in this docs (data element that will be taken in consideration are well defined in QED profile).

QED is a profile of interest because, we would create a light weight version of that profile (we will try to align this work with HL7 Argonaut initiative) in order to provide to a Data Element Consumer actor to access data element using a RESTful query.

Breakdown of tasks:

  • Produce a normative supplement that will cover chaining of transactions (ITI-18 , ITI-43 , RECON , mQED) in order to define the workflow to collect data (the profile will use the aggregator capability on the automatic side from RECON and not the part that requires human actions to reconciliate the content ).
  • Define a light weight QED transaction. This document will be drafted by ITI. However it will be owned by PCC (The cmte should grant that this process is accepted by all the co-chairs). If something needs to be revised we will give the ball to PCC asking them to fix it via CP. There are concerns in the ITI tech about the skills needed to work on the QED transaction. Charles will try to engage PCC members and other useful technicians is needed.


BREAK 11:50AM - 11:55AM
Remove Documents from XDS Repository Ken 11:55AM - 12:30AM Ken Mayer presented the detailed proposal. The proposal is well understood from the cmte because it has been a discussion topic for many years. There are concerns about the approach taken for the deletion: the doc administrator shall send a delete request to the registry (to delete metadata) and after that it has to send a delete request to the Rep or should be the Registry that will delete docs from Repository? The best solution still need to be designed.

Administrator should be defined as a separate actor that can be grouped with other actors in order to fit different use-cases or patterns. The Cmte is confident that the size and the scope of the profile allow to successfully produce the desired output.

LUNCH 12:30pm – 1:30pm
mobile HPD/CSD Luke/Carl/Eric 1:30am – 2:15am Luke presented in collaboration with Eric the detailed proposal. The intent of the proposal is to create a mobile/FHIR profile that covers all the use-cases defined in HPD/CSD. There are some use-cases that are not needed.The cmte asks editors to narrow down the set of use-cases. Take the CSD/HPD list of use-cases as starting point, but not bound to satisfy all them. The technical Cmte do need to identify a complete scope (The primary use.cases are identified and highland in the detailed proposal). The mapping to the original soap versions of the profile is not in scope (it is not part of the main needs). This profile will be Independedent from HPD/CSD.
Start Assessment of proposals: Evaluation Matrix completion and Discussions about new work-items Elliot/Mauro 2:15pm – 2:45pm Profile are sized in order to identify the effort needed for the drafting and for the review of profiles themselves.
MUST DO n°1: Maintenance (general) Lynn 2:45pm – 3:15pm Lynn proposed a new apporach to address CP’s and a change in the scheduling (1 hour per week). Thee different scheduling are discussed. The cmte think that to take a decision on the scheduling it is needed to reach out the availabilities of main CP contributors.
MUST DO n°2: FHIR Updates John 3:15pm – 3:45pm John aligned the cmte about the publication time line of STU3 HL7 FHIR standard. The STU3 will be published at the end of March.

The cmte analyzed the various profile based on FHIR, to identify the approach to take in addressing the update:

MHD: pretty much no changes due to STU3. There is a need to update just the base urls. This can be done in parallel to STU3 comment reconciliation and can be done via normal CP process. The goal is to be able to test in the European CAT the actual version of MHD plus a balloted and approved CP that moves it in STU3. No additional publication cycle needed.

PDQm: no many changes Update only base urls and can be done via normal CP process. It will follow the same approach of MHD.

ATNA: some editorial changes but not technical big changes. The urgency for this profile is lower so it will be fixed during the spring via a normal CP process.

Profiles that need discussion:

mACM: small work-item. Changes are not big. But there are conceptual changes that we need to agree on.

PIXm: re-evaluate the solution (small size).

The cmte should allocate some time for those profiles starting from the February meeting.

Break 3:45pm – 4:00pm
Joint meeting with QRPH , PCC, RAD:

1. Domains Report about work items selected for the new cycle.

2. In the context of FUNC profile in RAD and exploring what existing methods might exist to help deal with:

  • When patient identifies a doctor, but doctor's name is ambigious, what are recommendations for resolving ambiguity
  • When patient cannnot recall, what tools are available to help. E.g., "it was a cancer doctor at iowa general hospital"
  • We give up when patient can't answer or hasn't had a doctor for many years.

HPD doesn't solve it directly but may be able to help.

3. Patient-centric Data-element Location Service: This proposal relies on PCC profiles. In addition to that the aim of this proposal is to identify a platform that can be further specialized by IHE clinical domains in order to provide a mapping between contents inside a document and content in a FHIR resource.

- 4:00PM - 5:30PM

Participants:

John Stamm (Epic) Chris Melo (Philips) Charles Parisot (GE) Nader Cheaib (ASIP Sante) Mauro Zanardini (Arsenal IT) Elliot Silver (McKesson) Gila Pyke (Cognaissance) Ben Levy (Corepoint) Amit Popat (Epic) Thierry Dart (ASIP) Andrea Fourquet Joe Lamy (SSA) Emma Jones (Allscripts) Denise Downing (ORN) Jeremiah Myers (HIMSS) Celina Roth (HIMSS) Luke Duncan (Intrahealth) Ann Diamond (ACOG) Thom Kuhn (American College of Physicians) Daniel Berezeanu (Ready Computing) Didi Davis (Sequoia) George Cole (Allscripts) John Moehrke Ken Meyer (Merge) Lori Fourquet (e-HealthSign) Lynn Felhofer (IHE Tech Project Manager) Rob Horn (AGFA) Vassil Peytchev (EPIC) Eric Heflin (THSA) Nichole Drye-Mayo (RSNA) Matt Blackman (E-health Exchange) Lauren Lemieux (ACOG) Ioana Singureanu (VA) Kristen Boyd (HIMSS)


  • QRPH Update:
    • 2 new proposals:
      • MRFD – RFD on FHIR.
      • PDMP (prescription drug monitoring) – query for opiod prescriptions for patients.
    • 2 large revisions
      • ADX revisions – remove constraints implementers had challenges with
      • Family Planning rev 2 with feedback from Connectathon
    • Additional revisions
      • Healthy Weight, Birth & Fetal Death (potentially including FHIR), VRDR
    • General theme: first cycle with in-depth FHIR profiling.
    • Planning items: CDISC white paper, EHDI quality metrics whitepaper
    • CP maintenance completion
    • Dedicated effort to move profiles to FT
  • PCC Update:
    • New work items
      • 360 closed loop profile
      • Closed loop white paper – EHDI Careplan
        • Includes Referral order linking and dynamic care planning
      • Patient Registration Content profile
      • Discharge to EMS profile (CDA or FHIR based)
      • Medical Devices:
        • Implementation Guide for Cross-paradigm medical device interoperability.
        • Point-of-care medical device manager (FHIR-based)
        • Remote Patient Monitoring (existing profile, adding FHIR option)
      • Care team management profile (FHIR-based)
      • Patient-centric data element location service.
  • ITI
    • 4 new work items
      • Non-patient centric documents
      • Patient-centric data element location service.
      • XDS Delete Document
      • Mobile CSD/HPD
    • Ongoing maintenance
    • FHIR-specific maintenance
  • Follow-up from previous meeting:
    • Workflow authors and implements webinars/workshops now complete, recorded, and available on the IHE website. Thanks to Chris Pauer for outstanding effort.
    • Discussed how to write up FHIR-based profiles.
  • Patient-centric Data-element Location Service
    • Charles gave an overview of the profile
    • PCC will discuss Thursday AM and report back to ITI.
  • CP to Cancer profile
    • From Celina
    • QRPH has existing cancer reporting profile that is being considered for FT.
    • Implementation in US and Europe registries is different due to national extensions.
    • Whole implementation guide would replace the profile in the US.
    • CP should create a volume 4 national extension identifying the high-level differences between the international profile and the CDC-defined version. Identify what will be tested in the US-realm.
    • Refer further work to IHE-USA.
  • Formal process for National committee involvement
    • Untapped resource
    • Unaware of Domain committee activities
    • DCC issue?
    • Identify liaison?
    • Brainstorming session Thursday at lunch.
  • IHE Social Media Presence
    • Andrea will be presenting to ITI Thursday at Lunch.
  • IHE relationship with HL7 regarding profiles on FHIR
    • What is the relationship with HL7 and FHIR.org?
    • What kind of organizational support do we need?
  • Action items:
    • Amit to follow-up with Chris Carr on IHE News.


The action items document can be found in the FTP site at: ftp://ftp.ihe.net/IT_Infrastructure/iheitiyr15-2017-2018/Technical_Cmte/NovemberF2F/F2F_material/Joint%20meeting%20ITI-PCC-QRPH_20161116%20action%20items.docx

Day 2, Thursday, November 17th, 2016.

Spreadsheet available here: ftp://ftp.ihe.net/IT_Infrastructure/iheitiyr15-2017-2018/Technical_Cmte/NovemberF2F/2016_TechnicalCommittee_prioritization_review_v02.xls

Activity Leads Time Minute
Breakfast 8:30AM – 9:00AM
Agenda Review / Residual Discussion / Eventually review the matrix


Elliot / Mauro 9:00AM – 10:00AM

Participants: Luke Duncan (intraHealth), Joey Lamy (SSA) , Nader Cheaib (ASIP Sante), Mauro Zanardini (Arsenal IT) , Ben Levy (Corepoint), Lynn Felhofer (IHE), Eric Heflin (THSA) , Fabio Buti (Dedalus), Ken Meyer (IBM/merge), John Moherke (Moherke Research), Karima Blounquard, Mick Talley, Kirsten Boyd (HIMSS), Silver Elliot (McKesson)

Minute: The Agenda has been reviewed, and residual open topics are analyzed for each profile:

-breakdown pf tasks for the Patient-centric Data-element Location Service: an agreement is subscribed between ITI and PCC domains:

1. IHE-ITI has coordinated with IHE-PCC and reached the following agreement:

  • PCC will decide:
    • the profile “packaging” (distinct profile or integrated into QED, possibly retire QED), update existing supplement.
    • the core set of “resources” that align with QED, FHIR stability and Argonaut work, plus PCC member input)
    • the query parameters in Volume 2.
  • PCC work needed:
    • 2 hours face to face time in Feb, April and 4 hours in July, plus one 2 hour t-con in March, May, June (between face to face meetings).
  • ITI editor work needed:
    • develop a TI version for the PCC framework (7 pages Vol.1-same as current QED and 10 pages Vol.2-down from 35 pages for current QED).
    • account for the above decision points” (See 1 above).
    • Reference “QED on FHIR profile” as PCC supplement in ITI profile.
  • Approval and Ownership - The QED on FHIR TI profile:
    • once developed by ITI editor, to be reviewed by ITI for technical “touch points” between resources and documents
    • to be submitted to PCC for overall approval in July.
    • to be handed over to PCC in August 2017 as PCC supplement

2. concerns about use-cases that need to be covered by CSD/HPD has been risen: Luke and Eric presented the new list of use-cases

Continuation of Assessment of proposals: Evaluation Matrix, completion discussions, reach agreement on new workitems. Elliot/Mauro 10:00AM - 10:45AM

The cmte continued to complete the spreadsheet with EVALUATION MATRIX. The intent is to quantify work-load in order evaluate if all the 4 new work-items can be accepted. It seemed manageable, but the cmte asked the co-chairs after each f2f to analyze if the time spent in each proposal is alligned with estimation and will identitfy potential risks.

Another key point is to identify Mentors for larger proposal that have to keep the editors on track.

Ben moved the motion to accept all the 4 new work-items. Charles seconded, no objection, Rob Horn abstains.

Completed evaluation matrix: ftp://ftp.ihe.net/IT_Infrastructure/iheitiyr15-2017-2018/Technical_Cmte/NovemberF2F/2016_TechnicalCommittee_prioritization_review_v02.xls

Break 10:45AM - 11:00AM
Joint meeting with Planning: Vote Results Elliot / Mauro 11:00AM – 11:30AM

The joint ITI PC/TC meeting was called to order. Our domain sponsor took roll and determined that a quorum of voting members was present. The ITI felt it could perform all work items for the items sent by ITI PT to ITI TC for evaluation this cycle. As per ITI TC, the estimated capacity of the ITI TC is equal to the estimated work load for the items sent to ITI TC for evaluation this cycle. The joint workgroup explored ways to reduce workload. No substantial ways were identified. A discussion occured about cutting a work item, and the members seemed to feel that was not necessary. Two optimizations were identified:

1) Sequence the Document Delete work item first, to reduce the overhead of managing it the entire cycle, and

2) holding more tcons before the F2F meetings to increase F2F meeting efficiency

It was thought that this may help some, but potentially not enough to provide for a buffer for unexpected work load problems. The group discussed careful management of the work items to keep scope realistic for this cycle.

Motion by Eric H to approve the work items from ITI TC, with guidance to move the Document Delete forward in the schedule if possible, and for ITI TC to carefully manage scope. Karen W seconded the motion. No discussion ensued. No objections and no abstentions were raised. Motion carried. Meeting adjourned.


All were thanked for their help and for the successful meeting!

Schedule tons Elliot / Mauro 11:30AM-12:30PM Tcons has been scheduled and webbed invitation will be sent the next week.
Social LUNCH with Andrea Garay (RSNA) (for people that need to leave …) 12:30 – 13:30
Open-discussion about Social Media and IHE Andrea Garay (RSNA) 13:30 - 14:30
ADJURN 14:30
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