Minutes Nov 2007 - Sep 2008

November 7 – 8 Face to Face meeting

Logistics Nov 7 - 8

Location
RSNA Headquarters
820 Jorie Boulevard Oak Brook, IL 60523

WebEx
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Go to https://ihe.webex.com/
Conf ID: 920 242 227
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Click on ITI Technical Meeting for today's date
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Call-in
Call-in toll-free number (US/Canada): 866-469-3239
Call-in toll number (US/Canada): 650-429-3300
Conf ID: 920 242 227

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Nearest Hotel
Marriott Residence Inn
790 Jorie Boulevard Oak Brook, IL 60523
Ph 630-571-1200
Special Rate: RSNA $139 "subject to availability"

Agenda Nov 7 - 8

The following is a tentative agenda and might be revised during the meeting. All times are rough estimates and will be changed with little notice.

Links to the detailed proposals that will be discussed during the meeting are given below in the minutes section.

November 7th, Wednesday: 8:30 a.m. to 5:30 p.m.

08:30 (.5) Continental Breakfast
09:00 (.5) Introductions/Agenda Review/Governance discussion
09:30 (2.5) First set :
              Emergency Contact Registry Query (ECON)
              Sharing Value Sets
              Cross-Entreprise Service Bus (XSB)
              Publish/Subscribe Infrastructure for XDS
12:00 (1) Lunch
01:00 (1.5) Second set :
              Asynchronous XDS.b
              Referral Request
              Extended PDQ
              Update to XDS-SD (Scanned Doc) 
                   to conform to PCC Content Profile template
02:30 (.5) White Papers :
              Cross-Community Architecture
              Sharing of Terminologies
              Policy-Driven Security and Privacy
03:00 (.5) review agenda for next day
03:30 (2) Joint meeting with PCC :
              Sharing of Terminology
              Referral Request
              On-demand queries for XDS
              Critical results
              Publish/Subscribe Infrastructure for XDS
              RFD/QED integration
              ECON Query
              XDS-SD Update
05:30 Adjourn

November 8th, Thursay: 8:30 a.m. to 3:00 p.m.

08:30 (.5) Continental Breakfast
09:00 (1) CPs critical to connectathon
10:00 (1) White papers from previous years (and followon from yesterday):
              Policy-Driven Security and Privacy
              Configuration management
              Cookbook on security section of IHE Profiles
              Template for XDS Affinity Domain Deployment Planning
11:00 (1) Discuss conclusions from discussions
          Build consensus for moving forward with lineup of profiles
          Consider alternatives to pass on to planning committee 
12:00 (1) Lunch
01:00 (1) Vote on lineup of profiles to move forward
02:00 (1) Schedule followup tcons
03:00 Adjourn

Minutes Nov 7 - 8

Governance

Link to tentative ITI Technical Committee Voting Procedures will be sent to the committee for reviewing.

The committee wants to stress that abstention is a perfectly acceptable vote especially when a member didn't have time to review the material subject of the vote before hand. It is reminded that though not counting for assessing whether a proposition is adopted, abstention counts toward quorum and maintaining voting privileges.

Webex is able to handle votes. This possibility will be investigated for T-con voting.

Emergency Contact Registry Query (ECON)

Emergency Contact Registry Query (ECON) detailed proposal

Several solid standards could be used for that profile. The detailed proposal has been edited to reflect those standards.

It is reminded that each new profile has to include risks assesment and risks mitigation. Any confidentiality issue will be adressed at that point.

The committee is stressing that Emergency Contact Registry Query profile should be about interoperability and not about how to populate an emergency contact database.

Though that profile should be small considering the number of pages, it should be assessed as a medium profile considering the amount of discussion needed to select the right standard.

Sharing Value Sets

Sharing value sets detailed proposal

In order to keep the profile simple, the scope will be limited to flat value sets. From prospective of profile development the value set shouldn't be limited but for developing and testing purpose the value set used should be an existing one.

The profile will be based on simple HL7 CTS transactions (a stable and well known standard). Even though a version 2 of CTS is under development, one of the requirement of CTS 2 is compatibility with CTS.

After scoping down, the profile is evaluated as a medium profile.

Cross-Entreprise Service Bus (XSB)

Cross-Entreprise Service Bus (XSB) detailed proposal

After discussion of the use cases, it has been agreed that the profile be move forth as a white paper. Upon white paper completion, next step will be decided on (depending on the technical scope, it could be as light as a CP to appendix V)

The white paper should be renamed to better reflect its scope.

Publish/Subscribe Infrastructure for XDS

Publish/Subscribe Infrastructure for XDS detailed proposal

After discussion, it appears that there isn't a stable standard on which to base that profile.

Considering the need for publish/subscribe infrastructure for XDS, it is proposed to work normatively on the content part of a publish/subscribe service and informatively on the standard that can be used to implement those services.

The subject could be handle as a new direction instead of a profile. Work on publish/subscribe (including demonstration) should then be handle by a group of people in parallel of committee work. Progresses will be presented during face to face meetings but no vote will be called.

The co-chairs will ask the sponsors for support of that new direction.

Asynchronous XDS.b

Asynchronous XDS.b detailed proposal

Discussed standards in support of one request and multiple aysnchronous responses. WS-Enumeration may support this but is not a stable standard, only a member submission. Probably will need to scope to one request/one response support until standards are available. Concern that we not create lots of options on the functionality as we adopt newly available standards. Will require evaluation of security in an asynchronous environment. Expected mainly to be a Vol. 1 update to describe the option and Vol. 2 data which refers to WS-I Basic Profile and addresses security concerns. Assessed as Small - 10 pages. Author will be supplied by Microsoft, a name will be provided within the next four weeks.

Referral Request

Referral Request detailed proposal

Several options in terms of describing this as multiple profiles or options. Standards are clear, although choice between HL7V2.5 and HL7V3 will be complicated as there is no clear winner. Estimated as large, 100 page profile or set of profiles.

Extended PDQ

Extended PDQ detailed proposal

Discussion regarding whether to support all attribute fields in HL7 V2.5 Chap. 3 or just a subset of the fields. General feeling is to support a subset and the original submission specified a good subset. But should be re-evaluated as part of profile development.

Requires changes to PIX, PDQ, PAM, PIX V3, PDQ V3. Include in this update to PIX the adoption of the HL7v2.5 PAM Patient Identity Feed. Currently PIX is all v2.5 based except the patient identity feed which is a back level of HL7v2(.3?).

This changes touches a lot of profiles, but each change is very small. Judge it as medium because of the significance to multiple profiles and coordination involved.

Update XDS-SD to PCC template

Concern with cross-domain maintenance of wiki and published document. Will need attention from PCC. Work on this could inform the planned Guide PCC will work on. Also need to consider BPPC. Small or medium, depending on support from PCC and need for ITI discussion time to resolve issues.

White Paper : Cross-Community Architecture

Cross-Community Architecture White Paper detailed proposal

Discussion of including multiple points of view. Charles to help get attention from US and other country national initiatives. Judged as largish white paper.

White Paper : Sharing of Terminologies

Terminology Sharing White Paper detailed proposal

Christel Daniel presented Terminology Presentation

Discussion of scope - consider scoping down to a roadmap only, describing the next steps after the 2008 profile.

White Paper : Policy-Driven Security and Privacy

See section on "whitepapers from previous years"

Joint PCC&ITI Discussion

• Sharing of Terminology

Considering the scope of the "share value set" profile, no specific concern is voiced by PCC on the subject.
PCC will review the profile.

• RFD/QED integration

After discussion on the RFD profile and its use with content profile, further work on the subject will be handle through future T-con between ITI and PCC.

• Referral Orders

PCC is intersted in that profile as a potential underlying profile for critical results.

• Critical results

The key issue is to offer the ability for some one in a department to locate the contact to which critical results should be transmitted (who is the important provider to contact when a critical result is obtained for the patient).
An other important issue is the possibility to get a record of attempted contact and of successful contact. There is no auditing possibility to automatically know whether the patient has been properly informed.
Critical results workflow will be explored in a white paper by PCC.

• ECON profile dependencies on PCC profile

Pre-hospital care workflow deals with emergency contact (a folder is created to store data related to emergency). Although related, the pre-hospital care workflow and ECON can be done independently.

• XDS-SD Update to conform to PCC content profile templating

Experience sharing on how to extract wiki material and assessing how to manage evolution will be done through calls between PCC and ITI. Efforts will be done to involve LAB in order to prepare the same kind of update for XD-Lab.

• On-demand queries for XDS

There is a need for a way for a provider to ask another provider for specific documents (e.g. last 3 documents of a specific type for a patient). A related sub use-case will be added to referral order for request of record (record being considered as a set of documents).

• Publish/Subscribe Infrastructure for XDS

Concern from PCC that the direction chosen for this (new directions due to lack of standards) is a surprising choice. Expected to base this on XDS Stored Query. Explanations from ITI regarding the decision made and the issues with standards, including ebXML.

• Patient and Provider communication in the context of medical home and other things

Medical home isn't addressed within the ITI technical committee since it didn't make the cut during the ITI planning committee.
ITI technical committee does recognize the importance of the issue and will include it in the white paper on cross-community architecture. Any contribution from PCC on the subject will be greatly appreciated.

• Consent and family history change

The subject has been defered to a future tcon specific for security/privacy

CPs critical to connectathon

See November 8, 2007 CP Minutes.

White papers from previous year

• Policy-driven security and privacy (note, delayed from previous discussion)

Don volunteered to author this paper as original author (Matt Methany) has not responded to emails on the subject and has not submitted a detailed proposal. Paper will focus on policy and technology interface, how do we interact with a variety of policies? Don to organize work group to contribute to the paper.

• Configuration management

Contributions from other domains has been minimal. Agreed to convert to a wiki page and continue to encourage contributions. Will evaluate next year to determine if it is ready for something to be published.

• Cookbook on security and privacy writing profile

This paper needs to be updated with learning from its use last year and at HITSP. Manuel has agreed to own the document. After it is updated, training for ITI authors, and authors in other domains, should be developed. All domains should be encouraged to use this paper and feeding input back to the ITI committee. Update to paper should happen early in 2008 with a new version available for profile authors to use.

• Template for XDS Affinity Domain Deployment

Several changes are being made based on feedback. After changes complete Dave will distribute to ITI tech committee and state a feedback date. After review by the committee we will publish it to ihe.net.

Conclusion

Voted on adoption of committee procedures as described in: ITI Technical Committee Voting Procedures. All voted in favor of adoption.

Reviewed spreadsheet at SizingChart.xls. Calculated sizing of each entry. Determined needed to cut a small amount.

Proposal was made to pass the spreadsheet as it stands to the planning committee and ask them to determine which to cut. Concern that planning committee would just cut white papers which is possibly not the best direction from a technical standpoint.

Proposal to vote on the non-maintenance items in the spreadsheet and choose the items with the greatest number of votes. Three votes per organization.

Vote on lineup of profiles to move forward

Vote is tabulated in SizingChart.xls

Agreed to:

• Drop the XC Archictecture White Paper (lowest vote getter)
• Scale back the Referral Profile (second lowest vote getter) to be only the referral request (not the get results path).

Official documentation of this decision will be authored by co-chairs, submitted to committee for review, and then delivered to ITI Planning.

Schedule followup tcons

Nov 14th 2007: Connectathon Q&A
Jan 8th 2008: Follow up on white paper: Cookbook on security and privacy writing profile

Joint meeting with PCC: PCC technical committee co-chairs will be contacted to assess opportunity for joint T-con before march Face-to-Face meeting.

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