ITI Agenda 2020-2021 July 2021 F2F

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This 5-days meeting is to move forward all the current work items in the continuous development cycle.

Meeting Location
Virtual Face to Face
Zoom information for this meeting is
Meeting Number: 954 8428 1157
Password: N/A
Support material
Profile proposals and other support information may be found in the google drive

Agenda & Minutes

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

Agenda for ITI, PCC, and QRPH for the week can be found here

Monday, 19th July, 2021

Day 1: Monday, 19 July, 2021

Virtual (CDT, UTC−05:00)

Leads Activity Notes
8:00 am–8:30 am
  • Luke / John / Oliver

Participants: John Moehrke, Sarah Bell, Lynn Felhofer, Martin Smock, Olivia Bellamou-Huet, Steve Nichols, Oliver Egger, Ben Levy, Spencer LaGesse, Joe Lamy, Vassil Peytchev, David Pyke, Mick Talley, Chris Melo, Didi Davis


  • Week's Goals
    • PIXm: to Public Comment
    • mCSD Whitepaper: to Public Comment
    • MHD: Determine outputs (CPs, Whitepaper, etc.)
    • HTML Publication: review backlog of issues
    • PDQm IG: to Public Comment
    • CP Processing
    • Need lots of time to review work items this week.

8:30 am–10:00 am Oliver PIXm Feed


  • reviewed changes since last call
    • audit event/examples
    • Open Issues
    • added ITI-104 feed transaction
    • delete operation
    • added examples based on query transaction from connectathon
  • discussion points
    • discussed resolve duplicate section
      • will add body content to the examples
  • discussed single source actor per domain
  • compared to v2 patient requirements
  • reviewed Appendix E and inclusion of E.3 which is still in TI
  • discussed targetId in PIXm query

10:00 am–11:00 am David PDQm IG Review


  • reviewed work on IG conversion
  • discussed appendix M
  • further review/edits/cleanup happening today.

12:00 pm–1:00 pm Joe MHD to a Federation


  • Issue 142 was created to track progress
  • topics for this week
    • address IHE endpoints in FHIR directories
    • profile HCID for discovering in mCSD
    • representing business hierarchies vs. routing hierarchies and allowing them to be independent
    • publish updated matrix
      • look at if/how it's usable for push and pull

Tuesday, 20th July, 2021

Day 2: Tuesday, 20 July, 2021

Virtual (CDT, UTC−05:00)

Leads Activity Notes
8:00 am–9:00 am Oliver PIXm Feed

Participants: John, Sarah, Oliver, Olivia, Martin, Lynn, Spencer, Steve

  • Added body to examples
  • clarified patient identifier domain and linked to PIX
  • reviewed index page content
  • reviewed security considerations on transaction
  • Open Issues
9:00 am–10:00 am Luke / Richard / Nathan mCSD Whitepaper


  • Spent time on read through
  • Add content on using for authorization by linking practitioner/role and organization.
    • add to 2.2 use case
  • look at FHIR security and privacy tutorial for content
  • reviewed intro text
  • issue added and typos and fixes were sent as a pull request
10:00 am–11:00 am Sarah / Lynn / Luke / John CP Processing / maintenance


  • Reviewed 1256 - moving to ballot
  • Reviewed 1259 - will update text for review at next session
  • reviewed resurrected CPs
12:00 pm–1:00 pm John HTML Publication


1:00 pm–2:00 pm John / Luke Using FHIR IG


Wednesday, 21th July, 2021

Day 3: Wednesday, 21 July, 2021

Virtual (CDT, UTC−05:00)

Leads Activity Notes
8:00 am–9:00am John / Luke Using FHIR IG

Participants: Sarah, Oliver, John, Steve, Martin, Mick, Joe, Spencer, Lynn, Ben, Richard, Luke

9:00 am–11:00am Joe MHD to a Federation


  • Walked through Carequality and other examples
    • Idea: Pair "kind of" relationship with reference
    • There may be a lot of things coming in R5 -- we need to pass needs to them
    • OrganizationAffiliation?
    • Organization is FMF3 -- breaking changes are encouraged
  • This work item: If the federation matters to the consuming system, then this is what we are focusing on
  • Don't need one architecture; can have different ones
    • Can document examples in white paper like App E
  • Need diagrams! Structural and behavioral
  • Example of XCA targeted routing of request being done in CeQ
    • Not quite clear yet if/how this is being done
    • Tried to think through a use of AAID, but doesn't make sense
    • Because CeQ doesn't allow multiple matches in XCPD
  • XCPD targeting
    • Receiver device id = HCID
    • We could unconstrain OtherIDsScopingOrganization to allow it to be specified in XCPD request
      • They would supply AAID
      • The would need to know deployment mapping between AAIDs/HCIDs/Orgs
  • Why target on request? Why not just filter results?
    • In some cases, might need to send more selective requests (privacy reason - the request itself is giving info)
    • Committee thinks this UC is legit
  • VhDir seems to be evolving to handle quite a bit
    • Maybe mCSD could end up deriving from VhDir with minimal work
    • Maybe a work item
  • Actions
    • Look into R5 work and zulip for multi-org
    • Ask CeQ why is it so important to target edge systems for XCPD and XCA?
      • Why can't you just filter locally?
    • Find out more detail of XCA targeting
    • Think about a better def of HCID
12:00 pm–1:00pm Luke / Richard / Nathan mCSD Whitepaper


  • Discussed VhDir relation to mCSD
    • Will look at differences between VhDir, mCSD, and DaVinci
  • expand authorization section
  • reviewed issues/comments
  • look at access control whitepaper
  • explain jurisdiction/facility type
  • rework intro a bit
  • add primary image from mCSD concepts
1:00 pm–3:00pm Sarah / Lynn / Luke / John CP Processing / maintenance


  • reviewed 1259 - moved to completed
  • reviewed 1225 integration
  • discussed process for integration
  • reviewed resurrected CPs

3:00 pm–5:00pm All Joint Domain Meeting


Thursday, 22th July, 2021

Day 4: Thursday, 22 July, 2021

Virtual (CDT, UTC−05:00)

Leads Activity Notes
8:00 am–9:30 am Oliver PIXm Feed

Participants: Sarah, Martin, John, Oliver, Matt Blackmon, Olivia, Spencer, Lynn, Ben, Steve, Joe, Richard


  • Integrated final text CPs
  • reviewed other changes
    • reviewed new use case, will add back in previous ones
  • reviewed github and open issues
    • discussed how duplicates are handled
    • discussed single source actor for a domain
    • differences between 104 and 93

9:30 am–10:00 am John HTML Publication


  • Reviewed top note that appears regarding PDF vs. HTML precedence.
  • Reviewed release tags for publication

10:00 am–11:00 am Joe MHD to a Federation


  • Talked through FHIR-12342
  • One value set or complementary codes?
  • Original list was sparse because some cases didn't make a big difference to client side
  • Need to support 2 endpoints for query vs. retrieve
  • If we were to break out extensions
    • Endpoint.connectionType = ihe-xca
    • ihe-actor-transaction-option = XCA-RespGateway-Query-async
      • Allow options to be combined
  • We would create an IHE codesystem for any extra codes
  • Creating extension can be mCSD, but the vocabulary should be managed elsewhere
    • Standalone IG like FormatCode
    • Can revise more freely
    • Merge with FormatCode?
      • Only if we rename the original IG

12:00 pm–1:00 pm Luke / Richard / Nathan
  • mCSD Whitepaper
  • PDQm


  • mCSD
    • Reviewed minor updates
    • Will continue to revise based on comments
  • PDQm

Friday, 23rd July, 2021

Day 5: Friday, 23 July, 2021

Virtual (CDT, UTC−05:00)

Leads Activity Notes
8:00 am–9:00 am John / Luke
  • Joint Planning/Tech
    • assessment of current work items
    • new work items selection


Minutes: Sarah, Ben, John, Matt, Lynn, Steve, Spencer, Oliver, Olivia, Chris, Richard, Luke


  • What went well? Things we should keep doing.
 * GitHub - pull-requests and issues --
 * CP integration using GitHub 
 * Moving CP process to Sarah has worked very well.
 * Abandonment CP process
  • What did not go well? Things we should stop doing.
 * CP integration - viewing changes when GitHub diff is used (html)
   * so integrate change, and look at it in -- compare to -- ACTION: Lynn, update process
 * CP handling when the initial issue is reported in github issue is not clear.

* currently, when issue requires ballot, replicating these into the WORD CP process. (aka do not ballot pull-requests)

 * GitHub is harder to use for "redline" changes? Small things like spelling, punctuation, 
   * possibly during face-to-face when last review is requested, a redlining branch that everyone cooperates on, and editor has last editing

* Luke potential solution using feedback links in the IG, that appear on right, and auto populate the form with the spec and header.

 * committee review of the IG publisher output is not obvious or smooth. 
   * people overloaded?

* people don't know what to do? * people are not comfortable with reviewing IG format?

 * Virtual is now engaging everyone as fully  as physical meetings
 * some TI supplements are not progressing, when we think they are useful.

* might need to do the Abandonment process for some old Supplements

 * legacy profiles do not have expert readily available.
  • Public-Comment process
 * Good idea provided by Ben to include the header number in the issue title 
 * Good idea more consistency to using tags
 * Bad: when commenter submits by spreadsheet or form, not a clear process to move these into issues

9:00 am–10:00 am Oliver PIXm Feed



10:00 am–11:00 am Luke / John
  • HTML Publication (if needed)
  • MHD to a Federation
  • Decisions on PDQm, mCSD Whitepaper, PIXm Feed
  • T-Con scheduling
  • AOB
  • Closing


  • Oliva motioned to accept PIXm to public comment, Ben seconded, motion passed
  • John motioned to accept PDQm to public comment, Ben seconded, motion passed
  • Luke motioned to accept mCSD Whitepaper to public comment, Richard seconded, motion passed
  • Scheduled public comment planning review on Sep 17 at 9 CDT