ITI Agenda October 2025 F2F: Difference between revisions

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== Work Item Proposals Discussed ==
== Work Item Proposals Discussed ==


=== 1) MHD on FHIR R5 (parallel to R4) ===
=== MHD FHIR R5 ===
; Goal
'''Goal.''' Provide an MHD on FHIR R5 track in parallel to today’s normative MHD on FHIR R4 This will not deprecate R4. This is funded/sponsored by IHE-Europe.
* Provide an MHD-on-FHIR R5 track in parallel to today’s normative MHD on FHIR R4. This does not deprecate R4.


; Positioning / Fragmentation Concern
; Editorial/Packaging approach
* Creating an R5 line effectively introduces two MHD profiles (R4 and R5).
* Create a versioned branch of the MHD repo for the R5 work.
* R4 remains the normative version and is the line presented and tested at IHE Connectathons.
* Publish as a new major line with a suffix (e.g., 5.0.0-R5) so it’s clearly not replacing the 4.x line; R4 remains the recommended publication. And the version tested at connectathons
* The R5 line will be presented as a segment targeted to regions operating under EHDS needs (e.g., EU projectathons), without signaling a global migration.
* IHE normally avoids multiple simultaneously-published versions; this plan intentionally carves out a method to keep both visible until a future convergence (likely at FHIR R6).
* Packaging, branching, version suffixes, and page placement will be refined in Technical Committee meetings.


; Editorial/Packaging Approach
; Technical notes
* Maintain a versioned branch of the MHD repository for the R5 work.
* Many sections of MHD don’t change; the big changes are in DocumentReference.
* Publish as a separate major line with a clear suffix (for example, “-R5”) to avoid confusion with the 4.x line.
* AuditEvent: profile directly for R5 (not strictly via BALP), keeping consistent with a future BALP upgrade.
* Dependencies: PDQm should be fine (normative resources); FormatCode is vocabulary (version-agnostic); IUA is version-agnostic; MHDS update is out of scope.


; Technical Notes
'''Timeline:''' Europe/EHDS would like a TI as early as Dec 2025; recognize this stresses normal governance. Aim to get as close as feasible.
* Most of MHD is unchanged; the largest delta is in DocumentReference.
* AuditEvent will be profiled directly for R5, with future alignment to BALP as appropriate.
* Dependencies expected to remain stable or version-agnostic; MHDS update is out of scope.


; Implementation Guidance
'''Actors/options:''' Ensure both Source and Responder variants are supported where relevant; keep options tightly scoped and testable.
* Support both Source and Responder options where relevant.
* Keep options tightly scoped and testable.
* Treat the R5 line as suitable for national/regional extensions and EHDS events while avoiding pressure on global sites to switch.
* Running two live lines increases maintenance; keep diffs minimal and document precise deltas.


=== 2) Full-Text Search for Document Sharing ===
'''National/Regional use:''' Treat R5 line as suitable for national extensions and European projectathons (EHDS) while avoiding pressure on global sites to switch.
; Goal
* Add server-side cross-document full-text search to IHE Document Sharing so clinicians can find relevant unstructured documents (e.g., PDFs) without opening each one.


; Scope / Positioning
'''Maintenance risk:''' Running two live lines (R4 & R5) adds overhead; keep diffs minimal and document precise deltas.
* Complements existing metadata/structured queries (XDS/MHD, mXDE, QEDm).
 
* Limit scope to MHD unstructured content search; leave structured extraction to existing profiles.
'''Future:''' Expect broad convergence at FHIR R6; the R5 branching/packaging pattern will inform how to run dual lines for other profiles later.
* Define minimal, testable options (query parameters, response fields, snippet behavior, ranking hints).
 
=== Full-Text Search for Document Sharing ===
'''Goal.''' Add server-side cross-document full-text search to IHE Document Sharing so clinicians can find relevant unstructured documents (e.g., PDFs) without opening each one.
 
; Key takeaways from discussion
* Complements existing metadata and structured-data queries (XDS/MHD, mXDE, QEDm).
* Scope is limited to MHD unstructured content search; leave structured extraction to existin


== Consensus ==
== Consensus ==

Revision as of 09:51, 10 October 2025

This 4-days meeting is to move forward all the current work items in the continuous development cycle. The [ITI Project Planning Board]

Meeting Location - Virtual

Google Meet information for this meeting is:

Join the Meeting Here


Agenda & Minutes

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

Monday, 06 October 2025

Day 1: Monday, 06 October 2025
Time

Virtual (CST, UTC−06:00)

Leads Activity Notes
8:30 am–9:00 am Luke / Oliver / Steve

Participants: Luke Duncan, Alessia Favero, Chris Melo, John Moehrke, Matt Blackmon, Oliver Egger, Ritika Rawlani, Steve Nichols, Carl Leitner, Spencer LaGesse, Diletta Babato Minutes:

  • Goals:
    • VHL - continuing
    • XCDR - continuing
    • Sex & gender - published with CP Integration
    • De-identification Handbook - continuing
9:00 am–10:30 am Ritika / Carl Verifiable Health Links
11:00 am–12:00 pm Vassil XCDR Endpoint Addressing
  • Reviewed work item
  • CP has been started and will upload to Incoming.
1:00 pm–3:00 pm Luke / Oliver Github Maintenance
  • Reviewed pull requests and new issues across github repos

Tuesday, 07 October 2025

Day 2: Tuesday, 07 October 2025
Time

Virtual (CST, UTC−06:00)

Leads Activity Notes
8:30 am–10:30 am Ritika / Carl VHL

Participants: Luke, Spencer, Carl, Ritika, Alessia, Diletta, Oliver, Daniel Berezeanu ,Matt

11:00 am–12:00 pm Luke / Oliver Github Maintenance
  • Reviewed and accepted pull requests
1:00 pm–3:00 pm Luke / Oliver CP Integration
  • Reviewed all pending pull requests for CP Integration for 2025
3:00 am–4:00 pm Matt / Daniel Connectathon Discussion
3:00 pm–5:00 pm tbd

Wednesday, 08 October 2025

Day 3: Wednesday, 08 October 2025
Time

Virtual (CST, UTC−06:00)

Leads Activity Notes
11:00 am–12:00pm Vassil XCDR Endpoint Addressing

Participants: Luke, Oliver, Matt, Alessia, Spencer, Diletta, Steve, Vassil

  • Reviewed CP and proposed changes
  • Will have recurring meeting starting Nov 6 at 10 CT
1:00 pm–3:00pm Oliver CP Maintenance
  • Reviewed Incoming CPs
3:00 pm–5:00pm all Joint ITI/PCC/QRPH

Thursday, 09 October 2025

Day 4: Thursday, 09 October 2025
Time

Virtual (CST, UTC−06:00)

Leads Activity Notes
8:30 am–10:30am Alain De-Identification Handbook
11:00 am–1:00 pm Steve / Luke / Oliver ITI Tech/Planning

Attendees

  • Steve Nichols – GE HealthCare, Planning co-chair
  • Andrea Fourquet – eHealthSign
  • Lori Fourquet – eHealthSign
  • Andreas Klingler – Siemens
  • Chris Melo – Philips
  • Diletta Babato – Arsenàl.IT
  • Gudrun Liß – IHE Germany
  • John Moehrke – IHE Europe
  • Luke Duncan – Path, Planning co-chair
  • Oliver Egger – ahdis ag
  • Raik Kuhlisch – gematik
  • Spencer LaGesse – Epic
  • Matt Blackmon – Sequoia
  • Michael Onken – gematik
  • Martin Rosner – Philips
  • Vivi Hen – gematik

Work Item Proposals Discussed

MHD FHIR R5

Goal. Provide an MHD on FHIR R5 track in parallel to today’s normative MHD on FHIR R4 This will not deprecate R4. This is funded/sponsored by IHE-Europe.

Editorial/Packaging approach
  • Create a versioned branch of the MHD repo for the R5 work.
  • Publish as a new major line with a suffix (e.g., 5.0.0-R5) so it’s clearly not replacing the 4.x line; R4 remains the recommended publication. And the version tested at connectathons
  • IHE normally avoids multiple simultaneously-published versions; this plan intentionally carves out a method to keep both visible until a future convergence (likely at FHIR R6).
Technical notes
  • Many sections of MHD don’t change; the big changes are in DocumentReference.
  • AuditEvent: profile directly for R5 (not strictly via BALP), keeping consistent with a future BALP upgrade.
  • Dependencies: PDQm should be fine (normative resources); FormatCode is vocabulary (version-agnostic); IUA is version-agnostic; MHDS update is out of scope.

Timeline: Europe/EHDS would like a TI as early as Dec 2025; recognize this stresses normal governance. Aim to get as close as feasible.

Actors/options: Ensure both Source and Responder variants are supported where relevant; keep options tightly scoped and testable.

National/Regional use: Treat R5 line as suitable for national extensions and European projectathons (EHDS) while avoiding pressure on global sites to switch.

Maintenance risk: Running two live lines (R4 & R5) adds overhead; keep diffs minimal and document precise deltas.

Future: Expect broad convergence at FHIR R6; the R5 branching/packaging pattern will inform how to run dual lines for other profiles later.

Full-Text Search for Document Sharing

Goal. Add server-side cross-document full-text search to IHE Document Sharing so clinicians can find relevant unstructured documents (e.g., PDFs) without opening each one.

Key takeaways from discussion
  • Complements existing metadata and structured-data queries (XDS/MHD, mXDE, QEDm).
  • Scope is limited to MHD unstructured content search; leave structured extraction to existin

Consensus

  • Proceed with MHD-on-R5 as a parallel line; R4 remains recommended.
  • Keep MHD-R5 scope limited to what is required for R5 alignment (no net-new functionality).
  • Continue technical exploration of Full-Text Search within MHD with tight, testable options.

Action Items

  1. John Moehrke: Set up the MHD-R5 branch and seed with the initial change list (DocumentReference diffs, AuditEvent approach, examples, and a cross-reference table).
  2. gematik participants (Michael Onken, Raik Kuhlisch) and interested parties: Provide EU/EHDS projectathon expectations and testing scenarios to guide scope and timing.
  3. Full-Text Search proponents: Draft initial option text for MHD actors and propose conformance test cases.
  4. Planning/Tech co-chairs: Define publication placement/labels so R5 is findable without implying replacement of R4.