• GREAT NEWS ON THIS TOPIC IS THAT WE'VE NOW USED THIS PROCESS END TO END FOR THE FIRST TIME THIS CYCLE, AND SO THE OCTOBER 2021 Spanish Edition WILL CONTAIN MULTIPLE FIXES FOR ISSUES RAISED BY THE SPANISH COMMUNITY, AND REPORTED/RESOLVED THROUGH THE NEW PROCESS - thanks everyone!
  • We can therefore close this down as complete and working as expected, unless anyone has any further comments/refinements to propose?
• Presentation from Arturo
• Agreement from all Spanish Edition users who were present (Alejandra, Suzy + Alejandro) to collaborate and contribute to the refined process

• We then formalised the process and distributed the document out to all interested parties

• Arturo, Guillermo, and all others to report back on how the process is working for them?
  • October 2019 cycle worked well for Arturo + Guillermo.
  • October 2020......?   Still working well?  
    
    • finally used it for a joint discussion topic =  SECRS-4 - Getting issue details... STATUS
    • ARTURO VERY HAPPY!
    • He is now comfortable that the process works (as we have now followed it all the way through from inception to implementation with the desired results) +
    • ...that the process supports the thorough analysis and required application of these type of longer term ideas +
    • ...that it still supports the rapid and effective resolution of the large number of minor issues.
    • He is therefore happy for us to close this discussion down as having been addressed.

The short term proposal of precoordinating the numbers and measures as concepts (and therefore not changing the RF2 format) was generally well accepted, though there were concerns raised regarding the longevity of this approach, and whether or not this addresses the original target of the project (which was to allow a standardised approach across all extensions, instead of perpetuating distinct coding for different users). The other concern raised was that any solution needs to be implemented rapidly, as otherwise the various members will be forced to start/continue implementing their own solutions.

Peter G. Williams, therefore, has taken this forward in the Modelling AG and further implementation. The functionality has been rolled in to the wider discussion of enhancing SNOMED’s DL capabilities.    The Modelling AG is planning a targeted discussion on this in June 2017, and will then produce a document which would then be reviewed by the MAG at the October conference.This Proposal document will be shared when complete.

Last update from Peter was that the OWL Refset solution allows us to classify with concrete domains. The thing we’re still discussing, is how to represent that in the release. The current most popular approach suggested is to create a 2nd Inferred file ("sct2_RelationshipConcreteValues_Delta_INT_[date].txt") which contains concrete values in the destination column, rather than SCTIDs. This allows them to be added without impact to the current approach i.e. ignore it if you don’t want to use them. The new file would only contain concrete values.

At the same time, existing drugs strengths and counts expressed using concepts (which represent those same numeric values) will be inactivated.   SNOMED International will inactivate the existing strength / concentration  attributes which use concepts-as-numbers and replace them with new ones (using the same FSNs) and switch the target/value to the corresponding concrete numeric.

This enhancement will increase the analytical power of SNOMED CT through the use of numeric queries and assist with interoperability by removing the need for extension maintainers to all - separately - add concepts representing numbers in order to publish their own drug dictionaries. 

• October 2018 - Harold Solbrigto give an update on the MAG's plans? No further updates yet, check back in April 2019....

• Consultation: SNOMED International are now running a consultation around the introduction of Concrete Domains to SNOMED CT.

  I you are interested in this area, and/or wish to express an opinion on this proposed change, please read the following information and complete the feedback form if desired:

  http://www.snomed.org/news-and-events/articles/addition-concrete-domains-consultation

• Update from Peter Williams after subsequent MAG discussions - NEW MAG Proposal:
  • Concrete Domains - Community of Practice Consultation
• ANYONE HAVE ANY FEEDBACK??
  
• The MAG have only received formal feedback (via the online form - I know some of you commented direct on the page!) from ONE person so far, so can we please make a point of providing some feedback on this ASAP - even if it's just to say that you're in complete agreement? Thanks!
• We should also be issuing advice to downstream users of the drug model to avoid using the current concepts as numbers as they will soon be disappearing - can we please have confirmation of who knows that they have users impacted by this, and that they'll provide the advice immediately?
• Can anyone foresee any impact (negative or positive) on the Release(s)? NO
  
  
  • Does the introduction of a second inferred file present any risk of confusion, etc?
    • NO
  • Are there any perceived restrictions around the use of concrete domains in inferred format?
    • NO
  • Should the new inferred file take exactly the same format as the current file?
    • Current proposal removes the DestinationID field completely and replaces it with the new "Value" field
    • But in theory, we could just hold the Values in the existing DestinationID field, if there's a strong business case for people to need the same format as the existing Inferred file? (hard coding of field names in import systems, etc)
    • NO, THE NEW FORMAT IS ACCEPTABLE
  • Will the inactivation of the existing concepts containing drugs strengths/counts cause anyone problems?
    • NO, BUT
    • MORE COMMS NEEDED TO WANR PEOPLE THEY'LL BE INACTIVATED
      • EVERYONE HAPPY THAT COMMS HAVE BEEN SUFFICIENT??
      • Neither happy or not - we'll send out some advanced comms to the usual suspects shortly... Andrew Atkinson
  • Are they any users, for example, for currently use these concepts, who are unable to switch to the new approach?
    • YES plenty, so we just need to continue to ensure this is an OPTIONAL file (to consume, it must be mandatory to include in the Release package)
  • April 2020 - Any further feedback? (especially from any further updates from MAG plans)
    • YES - the new question is whether or not we actually NEED to inactivate all previous concepts, or if (as we are only changing one attribute) we can leave them active and just update the attributes?
    • Question sent to MAG
    • Jim also kindly agreed to ask Editorial AG in meeting on 6th April...
      • ANSWER - yes, these concepts will necessarily be inactivated - is everyone on board with this?
    •  
  • OCTOBER 2020 - Discuss everything in the URGENT: CONCRETE DOMAINS Consultation proposal -
    • in particular all impacts to RF2 package + naming conventions, etc:
      • SNOMED International Proposal for Representing Concrete Domains in RF2
        • File naming convention / package location:
          • "SnomedCT_InternationalRF2_Production_20210731T120000Z/Full/Terminology/      sct2_RelationshipConcreteValues_Full_INT_20210731.txt"
        •  
      • 4.2.6 Concrete Value File Specification
        • Generally, rules and behaviour of the Concrete Value file is identical to that of the Relationship file
        • DestinationId column replaced with a value column
        • An additional column has been provide for a comparison operator, but this must - for now - be set to the equals sign in all cases.
        • IMMUTABLE fields:  sourceId, typeId, value, relationshipGroup,  characteristicTypeId , modifierId 
        •  
      • Initial Questions:
        • Concrete Domains RF2 Impact Analysis - The planned impact will be (likely to increase in Jan 2021)
          • We will inactivate the existing strength / concentration  attributes which use concepts-as-numbers and replace them with new ones (using the same FSNs) and switch the target/value to the corresponding concrete numeric
            • 28,218 inactivations of current Relationship records
            • 28,218 new Relationship records in the new Concrete Domains file
          • There will be an equivalent change in the stated view, but since OWL is already capable of supporting concrete values, this will only result in changes within the OWL expressions:
            • 13515 OWL Axioms are likely to change in the OWLExpression file 
          • MAG Confirmed yesterday that we cannot use true/false instead of 1/0 for booleans, due to the lack of EL support for this!
          •  They are suggesting the use of concepts 31874001 |True (qualifier value)| and 64100000 |False (qualifier value)| as an alternative. 
            • 2020-10-05 & 08 Full MAG Meeting (Conf call) 
            • New proposal will be posted here:
              • Re: SNOMED International Proposal for Representing Concrete Domains in RF2
          •  
    • Either confirm no issues or provide feedback urgently, as we are in the middle of developing the Tech Preview for Jan 2021 as we speak....   TRAG agreed to provide feedback asap if anything is required...
•  
• URGENT: CONCRETE DOMAINS WILL BE INCLUDED IN THE JULY 2021 INTERNATIONAL EDITION RELEASE FOR THE FIRST TIME
• We therefore now need any final feedback to be submitted immediately, as the feedback window closed last week on 15th April!!
  • We will therefore be proceeding with the Production release as of next week, so this is the last call for feedback of any kind! 
  • February 2021 SNOMED CT International Edition Concrete Domains Technical Preview feedback
• NO FURTHER FEEDBACK
  • (other than potentially Michael Lawley who has just tried to access the Tech Preview and can't - Matt sending it to him now, and Michael Lawley to provide any feedback urgently this week)
• Therefore at the end of this week we will close this topic down and progress with the Production release as part of the July 2021 International Edition...
• Released on July 2021 as planned - any feedback?
• If not we can close this topic down...

Dion McMurtrie

Michael Lawley

We have now identified more use cases for this proposal, as the new automated MDRS validation picks up what appear at first to be false positives, but which are actually valid failures due to the historical shortcomings of the MDRS format.

• We therefore need to discuss and agree an approach that allows us to both express the correct moduleDependencies + the new module composition (to express which modules comprise the Edition package, for URI + validation purposes).
• This should then be used to properly validate the MDRS and moduleDependencies within the Edition and Extension packages.
• There was a lot of feedback on the original proposal - however in this meeting we should:
• a) Ask Dion/Michael to walk through the proposal in person to ensure that everyone's on the same page (and remembers the original discussions)
• b) Answer the feedback (plus any new feedback in light of new situations and/or use cases)
• c) Agree what the final proposal should be, and what are the next steps we need to take in order to get it signed off (MAG, design authority, etc?)
• Michael, Dion and Reuben were going to create the Australian version as an example, in order to include that in Michael's updated version of the proposal document - did this happen?
  • New proposal for representing the ECRS information in the .JSON Metadata file will be kindly brought to the table by Dion + Michael tomorrow, for further review
    • This will include an example of how the INT Edition might look...
•  
• As part of the discussions on this topic, we need to decide what to do about the transitivity of dependencies in the MDRS - Linda will kindly present the background and options to discuss... 
  • Initial discussion were had on 18th October 2021, leading to a provisional decision that the best course of action might be to:
    • State that transitivity is the primary method, but that
    • Explicit statement of all moduleDependencies (even though that could be inferred through their transitive inclusion) would remain an option in all cases, to be used whenever the transitive dependencies would lead to potential confusion or conflict, for example in the case where two different components (eg. ICD-10 map + IPS refset) of an Edition (eg. Pangea Edition) were themselves dependent on two different versions of the same product (eg. the July 2021 INT Edition + the October 2021 INT Edition respectively).  In this case the MDRS in the Edition which incorporates the modules would explicitly state the dependencies of all it's constituent modules, and therefore resolve the conflict that would otherwise have arisen -
      • so in this example, the  Pangea Edition would explicitly state that both ICD-10 + IPS modules were dependent on the October 2021 INT Edition
        • NB  the curator of the Pangea Edition would first be responsible for testing and confirming that the ICD-10 maps (which were implicitly dependent on the July 2021 INT Edition rather than October) worked cleanly with the October 2021 release as well, before publishing the Pangea Edition.
  • However, the one drawback raised in response to this option was that we need a strong use case to warrant changing the RF2 spec.  So we need to decide if we're happy that the use cases in the proposal are strong enough for that (ie) 
    1. Resolving issues with pre-existing Editions that did not originally spec out the URI with this in the mind
    2. Enabling more comprehensive targeted automated validation of the MDRS files
       1. This is currently not possible without resolving the transitivity question, and 
       2. The imminent transition to Frequent Delivery brings this to the forefront of our current considerations, as without the necessary breadth in the automated validation, we cannot guarantee the quality of the monthly releases.
  • FINAL DECISIONS:
    • a)  We will use the new JSON data on Package Composition to resolve the issues with the false positive results in the current MDRS RVF assertions, by having the assertions check the new JSON data to confirm whether or not the modules that are not explicitly called out in the packages' MDRS file (as its an extension or similar), or that have conflicting versions.
    • b)  We will use the new .JSON data to allow correct resolution of URI's
    • c)  We will NOT change the RF2 spec to move to transitive dependencies in the MDRS. 
      • 5.2.4.2 Module Dependency Reference Set - currently states 

        "Dependencies are not transitive and this means that dependencies cannot be inferred from a chain of dependencies. If module-A depends on module-B and module-B depends on module-C, the dependency of module-A on module-C must still be stated explicitly."

      • Despite this being a valid theoretical stance (as dependencies are inherently transitive), the weight of historical data across all products for the past many years means that introducing a new approach whereby all dependencies are assumed to be transitive unless there's a problem and are therefore stated, could result in confusion when taken in the context of all previous releases where stated dependencies are NOT only there if there's a problem!   We will therefore continue to review this use case in future TRAG meetings, to see if the case for changing the spec becomes strong enough to warrant a change to all our products, plus a change that runs contrary to all historical releases.
    • New planned changes to .JSON metadata file:  Update to the .JSON file metadata - addition of "Package Composition" data

Dion McMurtrie

• Dion to Present current status + plan...
• Comments and feedback welcomed...
  • Plenty of feedback and so further discussions required as we move through the project...
• The main feedback for the past few months has been the RVF failures for the new MDRS assertions, which appear at first glance to be false positives.  However, they have been proven to be valid failures, as long as you consider that the MDRS format itself is (and has always been) inherently flawed.
• The closure of this topic is therefore dependent on the outcome of the discussions on the Proposal for a complimentary file to the MDRS - the "ECRS" ("Edition Composition Reference Set")
  • If this concludes that we need to change the MDRS, then this RVF topic can be closed down.
  • If, however, we decide to retain the MDRS format, then we need to revisit these RVF assertions...
• We need to use the new planned changes to .JSON metadata file:  Update to the .JSON file metadata - addition of "Package Composition" data in order to fix the RVF assertions and remove the false positives...
  • FRI-169 - Getting issue details... STATUS

If you could please review before the TRAG meeting and provide any feedback that would be great?  We can then discuss any issues in the next TRAG meeting in October.

This needs to be signed off at this business meeting, as once approved we'll be:

a)  Pushing early warning comms out to the community to advise of the upcoming changes to the MedDRA map format in April 2022 + 

b)  Moving ahead with preparations and build of the new MedDRA maps

So please speak now if you have any concerns at all!

• Issues raised?
  • Whether we should instead create generic parent concepts for the new Correlation Types (ie)
    • Instead of replacing the existing correlation concepts, we would add generic parents which would be used for the new Map refsets (that are "something else TO Snomed"), but leave the existing "Snomed TO something else" concepts in place as their children, in order to prevent the entire community from having to re-publish all of their maps as a result of the existing Correlation concepts having to be inactivated:
      • PARENTS:
      • <sctId> |Source to SNOMED CT target map correlation value|
      • <sctId> |Broad to narrow map from map source to SNOMED CT target|
      • <sctId> |Exact match map from map source to SNOMED CT target|
      • <sctId> |Narrow to broad map from map source to SNOMED CT target|
      • <sctId> |Partial overlap between map source and SNOMED CT target|
      • <sctId> |Map source not mappable to SNOMED CT|
      • <sctId> |Map source to SNOMED CT target correlation not specified|
      • CHILDREN:
      • 447247004 |SNOMED CT source to target map correlation value|
      • 447559001 |Broad to narrow map from SNOMED CT source to map target|
      • 447557004 |Exact match map from SNOMED CT source to map target|
      • 447558009 |Narrow to broad map from SNOMED CT source to map target|
      • 447560006 |Partial overlap between SNOMED CT source and map target|
      • 447556008 |SNOMED CT source not mappable to target coding scheme|
      • 447561005 |SNOMED CT source to map target correlation not specified|
      •  
  •  
  • This proposal was signed off, ready to take to the MAG on 20/10/2021...
•  
• HOWEVER, WE'RE STILL MISSING THE IDENTIFICATION OF THE ACTUAL MAP PRODUCT ITSELF, AND THE VERSION OF THAT ENTITY
  • (eg) "ICNP version Jan 2019" should exist as metadata somewhere within the ICNP map product package...
  • + possibly even the direct URI?
  • SUGGESTION IS TO USE THE JSON FILE FOR THIS - Andrew Atkinson  to take this forward in the Metadata working group...
  •  
•  ANOTHER DISCUSSION POINT FOR THE JSON FILE:
  • Are the "DeltaToDate" and "DeltaFromDate" fields in the JSON file now misleading in the new world of Frequent Delivery where we have no Delta files in the INT package itself?!
    • "deltaFromDate" : "20210930",
      "deltaToDate" : "20211031",
      
  •  
  • FINAL DECISIONS:
    • Agreed that these fields should ONLY be available in packages with Delta files
    • Monthly International Releases going forward, should instead just have:
      • EffectiveTime
      • PreviousPublishedPackage (that the current release is based upon)
      • Any retracted releases + their replacements

• The consensus so far is that we should keep the RefsetDescriptor records themselves active, which has been the precedent for all cases in RF2 history so far, with the exception of the Non-human refset which was physically removed from the International Edition package.
• The UKTC and others have previously requested these RefsetDescriptor records to be inactivated ( ISRS-112 - Getting issue details... STATUS , etc) - for consistency purposes, but the corollary of this is that the refset structure itself (which the refsetDescriptor describes) remains valid and active, despite the refset itself having been inactivated.
• TRAG TO DISCUSS AND AGREE BEST SOLUTION...
  • Then propose an addition to the TIG to provide clear guidance on this for all users...
  • AGREED:
    • Happy to leave the RefsetDescriptor Active for all normal circumstances
    • If we're removing the Refset entirely from the Extension/Edition, we should 
      • a) if it's just for space or something, then leave refsetDescriptor record in place
      • b) if it's for CRITICAL INCIDENTS ONLY (and even then only certain subsets of this - most likely only legal issues), we'll remove RefsetDescriptor completely
    •  
    • Matt Cordell  to write up and send to all of us for review.... confirmed on 20/04/2021 that Matt will write this up and present to the TRAG in future meetings
      • we will then incorporate the new conventions into the TIG and other documentation in order to ensure consistent approaches for all users going forward...
      • Matt has written this up now for review:
      • https://docs.google.com/document/d/1c4HcqhRs0OC_uDG_R8ZTPc44HzVjKBK3lrmB1iCSPoU/edit?usp=sharing
      • Matt to present and discuss...
      •  
    • FINAL DECISIONS:
      • Matt Presented - no contentious points, so Matt is ready to take this proposal further...
      •  

• This is out most important topic for this week - we're currently in the development phase for all of the dependent work, so any questions about this, or issues to be raised must be done immediately if they are to be taken into account for the transition!
• Introduction + HIGH LEVEL walk through of current Proposal...
  • (not enough time for a full detailed walk through, so if you could please read through it in advance and be ready with any questions that would be great?)
  •  
  • SNOMED International Frequent Delivery public proposal - Technical detail 
    
  •  
• APRIL 2021 - Confirm requirements are now complete and sufficient to successfully make the move to Continuous Delivery...
•  
• October 2021:
• We are now in the trial period, whereby we're generating and validating "soft launch" monthly releases.
• So far the progress has been good, with the main focus on:
  • Ensuring that the automated validation scope covers as many scenarios as possible
  • Confirming that the new authoring process is working, and that the content team have the support they require in order to complete the new gateways.
  • Verify that no issues are making it through to the Release cycle (which is now only a few days long)
    • Anything that does needs to be added into the automated validation suite
  • Timing the end to end process to ensure that the timings are refined enough to hit the much shorter deadlines.
  •  
• The initial soft launch releases have been sent to various stakeholders in the community for review
  • SO FAR NO FEEDBACK!! (positive or otherwise!)
    • Please respond asap...
  • PLEASE VOLUNTEER if you believe that you can help out with these validation efforts
    • It is in your own best interests to help ensure that the quality of the monthly releases is as high as possible
      • Although we will have the ability to release fixes to issues in the next monthly release, it still means re-importing the updated release into your systems!
•  

RVF has now been open sourced to allow people to contribute towards it more easily, so that Implementation issues can be reverse engineered into the assertions. All of the NRC validation systems should remain separate, in order to ensure as great a coverage across the board as possible.

However, it makes sense to ensure the critical tests are included in all systems, in order to ensure that if, say, one NRC doesn't have the capacity to run Alpha/Beta testing for a certain release, we don't miss critical checks out. We are working on this in the Working Group, and also in the RVF Improvement program, where we are including the DROOLS rules, etc. These are also being incorporated into the front end input validation for the SCA.

TRAG to therefore discuss taking the Implementation Load test forward, including the potential to incorporate key rules from NRC validation systems into the RVF. So we should discuss the tests that are specific to the Implementation of vendor and affiliate systems, in order that we can facilitate the best baseline for the RVF when agreeing the generic testing functionality in the Working Group.

• Matt Cordell will promote some useful new ADHA specific rules to the RVF so we can improve the scope... report back in October 2019
• Chris Morris to do the same - get the RVF up and running and then promote any missing rules that they run locally.... report back in October 2019
•  
• THIS NEEDS TO BE CONSIDERED AS PART OF THE OVERARCHING Shared Validation Service PROJECT GROUP
• Anything we can add to the Shared Validation Service going forward?
•  

Suzy Roy Andrew Atkinson

• Plan is to ensure that the generic service is flexible enough to fail gracefully if certain extensions don't contain some of the expected files, etc.
• We should also provide a standard Manifest to show what files they should include wherever possible (even if blank)
• We'll now take this forward with the working group, using the comprehensive list of current SI assertions as the baseline:
  • RVF Assertion list 20181015.xlsx
    
• AAT sent the list out to the working group in October 2018, and requested comparison analysis results to be posted asap, with a view to being able to report back to the TRAG on proposed scope in April 2019...
•  
• Best thing is to make the RVF the central source of truth for all International validation.
• Therefore NRC's like Australia will promote all International related content to the core RVF, and only retain and run validation that is local to themselves.
• This would mean that whenever they identify a new issue, they can simply promote the new test up to us and we can run it and replicate the issue for ourselves, and therefore fix it quickly.
• It will also share the burden of maintaining the validation rules.
• Share Validation Service to address this...
•  
• Suggestion for a new RVF assertion for transitive closure loops:
  • This would be to highlight situations where through a path of is-a relationships a concept is an ancestor of itself.
  • So, when validation is run, considering the source and destination of all active inferred is-a relationships. Starting at each concept in turn and tracing from source to destination of each relevant relationship until reaching the root concept should NOT encounter the starting concept. 
  • This would have taken a long time (and a lot of processor power) in earlier incarnations of the RVF, but with auto-scaling etc now this should only take a few seconds
  • We've had some real life examples of this recently, so there is now a business case for adding this kind of assertion
  • Any objections?
  •  
• Question: can we do any automation for Modelling issues? ECL? New validation using the editorial rules in the new templates as a basis for automating modelling QA?
  • ECL the best bet - plus MRCM doing well so far - can we extend this? (Australia so far only implemented modelling validation by writing manual rules for known issues)
• What's the impact of multiple effectiveTimes in Delta files?
  • Should be negligible, Australia and US already implemented with no effect to users (despite initial complaints!)
•  
• Reports from the comparison analysis from the working group...
  • Patrick?...
  • Matt...
  • Chris...
  •  
• NEED VOLUNTEERS FOR FORMAL PROJECT GROUP NOW THAT THIS IS A DEPENDENCY FOR CONTINUOUS DELIVERY....
  • Jeremy
  • Matt
  • Dion
  • Alejandro
  • Patrick
  • Suzy
  •  
  • THIS ALSO NEEDS TO INCLUDE CONSIDERATION OF THE National Pre-Release processes, which might aid the development of a more comprehensive automated Test suite: National pre-release processes- Joint work item with the CMAGNational pre-release processes- Joint work item with the CMAGNational pre-release processes- Joint work item with the CMAG
  •  
• As discussed, the WORKING GROUP  has now completed it's gap analysis, with teh only identified assetions that could usefully be added to the RVF being those from OntoServer.  CSIRO ARE CURRENTLY WORKING ON THE GAP ANALYSIS IN ORDER TO PROVIDE THE RELEVANT ASSERTIONS TO COVER THEIR VALIDATION... they presented their findings yesterday...
•  
• ANY OTHER SUGGESTIONS AND/OR ASSERTION DONATIONS MORE THAN WELCOME!

SUB-DISCUSSION of More Frequent Delivery...

We need to continue discussions on this on-going item, in light of the strategic meeting before the conference. In addition we now have new members with additional experience, and we have also now lived with the more stable International Edition release process for the past couple of years.

Last time we discussed this everyone thought it a good idea in principle, but were concerned that we are not yet in a position to deliver the same level of quality on a daily basis than as on a monthly basis (due to the current gap in our manual/automated testing). Therefore we were going to discuss this once we had further progressed our automated testing - however as the new working group for the RVF service will testify this is a slow process, and therefore it may not be possible to wait for this to be completed in its entirety.

We have identified several additional potential issues with moving to Continuous Delivery, which we should consider before proposing a solution:

• Perceived quality issues:

  • There would be no time for Alpha or Beta Releases - so all Members would have to be comfortable with issues in Production for until the next interim release

  • All issues that normally get tidied up as part of the normal Content Authoring cycle will become public - they will get fixed quickly but in the meantime there may be an impact to the reputation of the quality of SNOMED CT.

• Roll up Releases:

  1. The 6 monthly delta releases would need to be relative to the prior 6 month release, and therefore named as such somehow (ie) we would need to somehow make it explicit as to which previous release the delta is a differential to.
  2. Other possibility is that each month is the same interim release, and then every 6 months we also release the Delta's relative to the priori 6 monthly release, in addition to the usual monthly release.  In this case we would need to reserve the 31st Jan + 31st July effectiveTime's /package naming for the 6 monthly roll up releases, so that the users who want to remain on 6 monthly schedule would remain unaffected.
• The other option is to have no roll up releases at all, thus releasing a stand-alone package every day/week/month, depending on the agreed frequency. The issue with this approach though is that anyone using the Delta files (rather than Snapshot) for uploads would need to keep up with the continuous schedule.

UPDATE FROM THE EVOLUTION WORKSHOP:

Pros

• Allows people to choose whether or not the users take one release every 6 months, or frequent monthly releases...
• Derivative maps wouldn't be a huge issue as just release them whenever we had a chance, dependent on whichever edition
• One of the plus points are that when we're still at 6 monthly releases, if the vendors miss a release its a big deal, whereas if they miss monthly releases then they have a smaller impact

Cons

• One drawback is for the non english speaking members, who need to keep up with translations - shouldn't really have an impact if they keep up with each smaller release.
• Could be painful for translations when a monthly release happens to contain a drop of a huge project like Drugs or something...
• What about interoperability issues, with some people taking each monthly release, and others still waiting for every 6 months? ADHA believe this hasn't caused a huge problem for them, just an addition to the existing problem even with 6 monthly releases...
• Also need to implement the metadata for identifying which dependent release each Delta is relative to...
• Refsets aren't too much work to keep up to date - however Mapping is a different ball game - this can take some time
• Maps that are still inherent in the int Edition (ICD-0 ICD-11 etc) are potentially problematic, and the workflow would need to be carefully worked out...
• If your projects happen to drop in-between the normal 6 monthly releases, then someone who might have taken Jan and July still, might miss out on the important big releases that happen in April and November!
• Also quality might be an issue - need to have the automated testing completely airtight before we move to continuous delivery! Thereafter you would run all major validation at input stage and ensure authors only ever promote to MAIN when everything perfectly clean. Then we run Daily builds with automated release validation every night, and provides a RAG status on release issues every morning. Then by the end of the month, we publish the last Green Daily build!

COMPLETE:

• Andrew Atkinson to create a survey to provide to everyone so that they can send out to all users and get feedback on the proposed changes (especially multiple effective Times in Delta files, and removal of Delta files - just a service now):
  
• https://docs.google.com/forms/d/17Rhxc3TrMgPq1lnhAm2G6LkGsaN05_-TMKr69WRVdc4/edit
  
• TRAG to add/update any of the questions....
• Question: What questions would we like to ask the vendors and affiliates to a) Ensure we cover off all problems/potential issues, but b) do NOT put us in a position where they think that we might not go ahead with the plans despite their answers.... just wording the survey to ensure that they know we're going ahead, but just want to ensure there's no negative impact to them that might tweak our plans, and c) How much time do they need to adapt to the change for multiple effectiveTimes in the same Delta, and d) How do we promote the benefits? (responsiveness to changes with more frequent releases, improvement to quality with more frequent fixes, etc)
  
• Andrew Atkinson to refine survey to ensure that it's accessible to those with more limited SNOMED knowledge/experience, as these are the preferable target market for the survey, given that the more advanced users will (or have already) speak up for themselves:
  • GDPR questions - verify with Terance whether or not we just need to provide a link to our data policy (https://www.iubenda.com/privacy-policy/46600952), or if we specifically need to ask the questions (of whether or not they're happy for us to store their data, etc) as questions in the survey? (check box) - If the latter, ask if we have standard legal wording I can use?
    
  • Small intro - description + pros/cons
  • Couple of fairly wide ranging questions as to whether or not they think they'll be impacted
  • If so, then either fill in the details here (conditional question in google forms) OR please just get in contact with your NRC to discuss
  • Avoid technical language for non native English speakers
  • Suzy to include in her UMLS survey in January
    • Not done yet as she's stuck with red tape in the NLM!
• Andrew Atkinson refined the survey accordingly, and sent out to TRAG members for final review on 16/10/2018: https://docs.google.com/forms/d/17Rhxc3TrMgPq1lnhAm2G6LkGsaN05_-TMKr69WRVdc4/edit
  
• Andrew Atkinson sent final survey to Terance and Kelly in particular, (from GDPR and comms perspective) to ensure in line with company strategy and verify whether or not they'd prefer this to be an SI survey or NRC surveys?
  
• Survey sent to the TRAG to disseminate to their users
• Survey also sent to Kelly for inclusion in the newsletter, and also on LinkedIn

• Andrew Atkinson to continue to feed all of this into the continued internal discussions on whether or not moving to more frequent Delivery is feasible, and if so plan what the timelines would look like.
•  

AGREED:

• Move to Monthly Releases before we go to full continuous delivery - yes, everyone agreed
• How do we best automate all of the validation?  Member Forum item: "Development of a validation service where releases can be submitted for testing" - The Shared Validation Service
• Release Notes automation -
  • simple, just attach notes metadata to each change in MAIN then export on Release
• Question: Is it worth starting off with a trial using just Content Requests monthly, and then bring everything else in line once happy?
  • NO! Everyone feels strongly that there would be no benefit to this whatsoever, as the majority of urgent cases in CRS are to do with getting an ID to use in refsets etc before the next 6 monthly release, and as this has already been mitigated due to the new tooling providing those ID's early, there's no benefit in moving to CRS early. Small risk in moving to monthly at all, so better off just moving everything at once to prevent a) confusion for users b) confusion in message about continuous delivery, + c) overhead for SNOMED managing 2 different delivery schedules during pilot
• Question: What are the next steps that we need to consider to help move this forward?
  • Central RVF service, communication with community (survey etc)
• Question: Is everyone happy with the new plan to remove the Delta files from the RF2 packages completely, and just provide the Delta service to create Delta's on the fly? YES
• Question: How can we get a survey out to as many implementers as possible in order to ask a lot of these questions and get the
• Question: How do we manage translations? (including the Spanish release) - How do we cope with the likelihood that one month could have only 50 changes, and the next month 50,000 (Drugs project, etc)? -
  • No impact, as should allow for incremental translations - just need to not set expectations with your users that you stay one month behind the International Edition! Just need to decouple the translation release schedule from the International Edition schedule. ARTURO would prefer the Spanish edition to also move the Monthly (or even more frequent) releases, but he fully understands the natural latency required for translated Editions, and so understands even if we went to monthly we can't keep up with the monthly content changes
• Question: How do we manage extensions?
  • Again need to decouple them - MDRS will naturally get a lot bigger - also the versioning process internally currently takes a long time + a lot of effort for each upgrade to new International Edition...
• Question: How do we manage derivatives?
  • Just keep them decoupled from the International Edition release schedule, and do not set false expectations by promising to keep them closely up to date with monthly International Releases!
• Question: How do we manage maps?
  • So again there is a natural latency here where we can't keep up to date with monthly releases. WE ALSO NEED TO DEFINE WHAT AN ACCEPTABLE UNIT OF RELEASE IS FOR EACH TYPE F CONTENT CHANGE (so what our concept of "DONE" is for each type of change) - FOR EXAMPLE SOME CONCEPTS SHOULD NOT BE RELEASED UNTIL THE RELEVANT ICD-10 MAP COULD BE CREATED AND PUBLISHED AT THE SMAE TIME. OTHERS COULD BE RELEASED NO PROBLEM AND WAIT FOR 6 MONTHS FOR THE RELATED MAPS...
• WE ALSO NEED TO CAREFULLY DEFINE AND COMMUNICATE OUT WHAT THE SCOPE AND GOALS OF MOVING TO CONTINUOUS DELIVERY ARE - TO ENSURE THAT WE MANAGE EVERYONE'S EXPECTATIONS. FOR EXAMPLE, WHAT IT DOESN'T MEAN IS THAT EVERYONE WILL GET THEIR CHANGE INTO SNOMED WITHIN 4 WEEKS, JUST BECAUSE WE'RE RELEASING DAILY!!!
• 
  
• TRAG members to send out the survey...
• Awaiting all results... ANYTHING BACK YET from anyone?
  • ANY RESPONSES OF ANY USE FROM PEOPLE????
    • Nothing outside of what we were already aware of
  • 
    
  • THE RESPONSES WE GOT WERE QUITE INTERESTING IN SOME RESPECTS (lack of understanding of the proposal, evidence of use of Delta's still, etc):
    

    • WORTH HAVING A LOOK WITH THE TRAG

    • https://docs.google.com/forms/d/17Rhxc3TrMgPq1lnhAm2G6LkGsaN05_-TMKr69WRVdc4/edit#responses 

• New questions:
  • NEW PROPOSAL IS TO MOVE STRAIGHT TO DAILY CONTINUOUS DELIVERY!
    • WHAT DO PEOPLE THINK ABOUT THIS???
  • ALL OTHER POINTS NOT YET DISCUSSED IN THIS LIST:
    • Frequency of Releases
  • How do we validate translations? (NLP?)
    • Spain have had some experience with using a Spanish medical dictionary to validate translations - not the actual translations themselves obviously (they've still got no way to automate this), but at least testing that the translations are syntactically correct!
      • AAT to speak to Arturo about their experiences...

  • Implications on peripheral content (MRCM, on demand deltas)

    • LARGE impact on MRCM changes - we need to carefully consider whether or not we can publish MRCM concept model changes without first having waited for all of the concepts impacted by them to have been updated as well (so to isolate them all in a feature branch before publishing anything) - HOWEVER, this does restrict the time to market of the new concept model changes that might want to be published before we have time to update all of hte relevant changes...

    • We need to discuss further with Linda, Yong, etc...

  • Implications for DERIVATIVE products:

    • Do we just continue with these as separate entities and decide arbitrarily when the cut off date for content is?

    • Or do we decided each cycle what the cut off date is for the dependent International Content, depending on which day the important in-flight content changes are being published?

    • Do we have the same cut off for each Derivative product? (even though they might be published weeks apart?

      • Or do we just take a cut of the Daily release from the day we're starting each separate product's release cycle?

      • 
        

    • ICD-10 maps - should we remove it from the International Edition, as mappers might not be able to keep up to date when we move to daily! (or even monthly!)

      • Current plan is to keep them in the International package, but need to answer the below first...

      • YES - some people think we should remove it from the International Edition package, and have it on it's own cycle with the moduleDependency clearly stated
        

      • Mikael knows users that would likely want to have ICD-10 completely up to date...
        

      • Other potential is to slow down the International Edition release frequency to ONLY release once ICD-10 is updated in line - so this is part of the gateway to being "DONE" before authors promote... this makes the most sense, BUT could result in projects being much slower to market because of waiting for the ICD-10 maps to be complete - especially for large projects where a lot of the content was uploaded quickly via bulk imports or templates, etc...
        

      • Different opinions - some people clearly don't want to take International content UNTIL ICD-10 is completely up to date, others want to push ahead with the International content regardless of whether or not ICD-10 is up to date yet!
        

      • We need to get estimates of how often the ICD-10 mapping might hold up the International Content - and decide whether or not ICD-10 needs to be part of the "DONE" gateway - this could be decided on a Project by Project basis....
        

      • AAT to discuss with content and mapping team...

        • Requirements now changed and included in final proposal

    • 
      

  • Impact on NRCs present - how can they help out with testing/validation when Alpha/Beta periods are no longer in place?

  • Vendors (non-NRCs) view of frequent releases??

  •  

  • VALIDATION advances:

    • OWL testing - anyone worked on this as yet?

    • Template validation - thoughts?

    • Implementation testing feasible? (see Implementation Load Test topic below)

    • Need to identify Modelling areas that need improving - for example where concepts have 2x parents, this is usually an indication of areas that need re-modelling
    • Need automation of the QA system itself - so some quick way to validate RVF + DROOLS Assertions, both old + especially new!
    •  
    • MOST IMPORTANTLY, how do we avoid the usual pitfall of automated testing (ie) that the effort involved in maintaining the automated assertions and keeping them up to date with the content changes, doesn't start to exceed the effort involved in testing manually?!
      • Anyone with experience of a good answer to this?
    •  
    • Whitelisting - API required?

    • 
      

  • We need to re-consider the Critical Incident Policy, UNLESS we can get at least several different entities downloading and testing the monthly releases EVERY MONTH!
    • This is because if someone say only takes the release every 12 months (or even worse 24 months), and then finds a critical issue in a now 2 year old release, we would currently have to recall and republish 24 releases! 
    • Instead, we need to have agreement from the Community on a “Forward Only” approach, whereby any issues found (even Critical ones) are fixed from the next Release onwards (or possibly in several Releases time if they’re low priority issues).  Critical issues would simply have to be communicated out, warning everyone NOT to use any previous impacted releases.
    • For true critical incidents,
      1. do proper recall for ALL affected releases  +
      2. Provide patched versions of those releases, +
      3. Flag all those releases in MLDS to state that they're affected by critical incidents +
      4. Fix it going forward ASAP...
    • 
      
  •  
• WHAT ARE THE BENEFITS OF MOVING TO CONTINUOUS DELIVERY?
  • Who does it help? Any use cases of institutions that will actually be able to use more frequent releases?
  • How do we best up-sell these benefits?
  • Do we go for a phased migration?
    • We could move to Daily Builds for internal use only (and perhaps a very select few members/suppliers), and just continue with the 6 monthly releases for now?
    • Or we move to Daily Builds for internal use only (and perhaps a very select few members/suppliers), and just increase the Frequency of publishing the International Edition to monthly?
    • 
      
  • 
    
• HOW DO WE DEAL WITH INTEROPERABILITY?
  • Should we put out a white paper with the launch of Continuous Delivery to advise people as to how they can avoid the pitfalls of taking more frequent releases when others that they want to interact with might still be on annual or even longer update schedules?
  • Is it even feasible for anyone to take more frequent releases unless they want to work in silo?
  • If the rest of the community is still only updating annually then this could resign all others to the same pace for now?
  • One way to mitigate this even further is to add an end point to the Browser to allow entities to programmatically query a concept code that they have received from some other entity, but which doesn't yet exist in the version of SNOMED that they're currently dependent upon. This would address the situation where say an entity wants to send a load of encoded data to other entities (who might all be on different versions) - if those receiving entities find a code that doesn't exist in their dependent version of SNOMED, they can just query the browser API and get confirmation that it is in fact a valid SNOMED CT code that has been/will be published in a later release.
  • Would this be a helpful idea?
•  
•  
•  

• Content process for promotion

  • A decision is required here, in order to clarify the final architecture, as this might also be achievable with

  • less branches, instead using more cherry-picking of content changes to ensure promotion/demotion of Release Candidate content changes that have either passed/failed the content teams' validation and/or impact analysis.
    

    SnowStorm is NOT YET ready to allow authors to then easily cherry pick from Staging what gets promoted to MAIN to be released....

    • • If we do this we need some kind of validation system for Authors to run either standalone for
      • This is important, as they need to be able to work with long term projects as well, so may multiple Staging areas may still be required in order to properly manage short term vs long term projects?
    
    
    • looking at this from a different perspective, by instead flagging projects that can NOT be promoted yet - this might be a lot more efficient than trying to cherry pick out all the code that can be promoted?  
    • Any option here needs to consider things at the Project level rather than the individual change level, as it will be too time consuming for the content team otherwise flagging individual changes either way...
•  
• Peripheral Content:

  • Currently we have a cut off for MRCM updates well in advance of the Content cut off, in order to allow the content team enough time to ensure that they have tested the new content changes thoroughly against the final state of the MRCM refsets before we publish the new content).

    • What level of validation gateway will we need to put in place in order to ensure that new MRCM changes don't impact the Published content in unexpected ways?

  •  

• Requirements for adequate Content Validation coverage:

  • Automation of the relevant sections of the Share Validation Service that can be applied and run first at Project level, then again at Release Candidate level (across the entire RF2 spectrum as we currently do against the full RF2 release package before publication).  See section 3.2.3.1 "Creation of the Shared Validation Service:" for details....

  • Modelling validation - ECL the best bet - plus MRCM doing well so far - can we extend this? (Australia confirmed that so far only implemented modelling validation by writing manual rules for known issues)

  • Template validation where possible - new validation using the editorial rules in the new templates as a basis for automating modelling QA?
  • Implementation testing if possible? (see implementation load test topic in TRAG) 
  • Automation of the testing of the assertions themselves - a fast and reliable way to verify that the Shared Validation Service assertions themselves are correct and working
  • Smoke test of each Product
  • Whitelisting - API required?
•  
•  

Suzy Roy

Patrick McLaughlin

Suzy Roy to provide an update on progress:

• All agreed that whilst this is a large topic, we should start somewhere, and get at least some of the quick wins in (then request the change to content via the CMAG):

1. Check where the progress with the namespace metadata has got to - can we progress this?
2. Code systems (and versions) of the map baselines
3. Common strings such as boiler plate licence text etc
4. Description of use cases for the various refsets (using the text definition of the Refset concetps themselves) - either json or markdown representation of multiple pieces of info within the same field.

• Michael Lawley to provide an update from the related MAG topic...
• TRAG agreed that this should be incorporated into the discussions with the continuous delivery, in order that we can plan the changes here in line with the transition to more frequent releases. To be continued over the next few months...
• Michael Lawley to kindly provide an update on his work with David to help design and implement the solution - this will now be in the second TRAG meeting of the April 2019 conference, after they have met together....
  •  
  • DID THIS EVER GO ANYWHERE Michael Lawley?
  •  
• Ideas:
  • Some human readable metadata could potentially live as descriptions (which can then be translated)? David to discuss further...
  • David will mock up something in Json...
• Michael + David + Harold agreed to create a straw man to put up in the next meeting and take this further...
• This should now be combined with the Reference set metadata topic, to address all updated metadata use cases - Human readable, Machine readable, etc
  • We need to setup a JOINT Working group to deal with this!
  • Dion kindly volunteered for this group
• We've added a new machine-readable file to the International Edition this cycle, which can be refined for future usage:
  • Standard July 2020 International Edition metadata file:
    • release_package_information_INT_edition.json
  • NON-Standard July 2020 International Edition Rollup Delta metadata file:
    • release_package_information.json
•  
• Suzy Roy kindly volunteered to run a Project Group later in 2021 to refine and improve this data as needed going forward:
  • Volunteers confirmed in October 2021 TRAG meeting:
    • Dion, Mikael + Alejandro
    • + Andrew + Peter from tech team
    • + need 2 volunteers from MAG (as SMT decided we need wide range of views)
  • Suzy to setup meetings once we have MAG volunteers confirmed...
• This will be rolled into the holistic discussions on Metadata in the new Metadata Working Group... Working Group: Refined Metadata 
• •  Examples of extending this metadata:
    • .json format 5 ?? (Please see Michael Lawley's comments on 16/04/2021 here:  Re: Working Group: Refined Metadata)
    • Namespace data
    • Individual external Refset data
    • ranges of permitted values
    • mutability, etc?
    • Package Name? (Please see Michael Lawley's comments on  20/04/2021 here:  Re: Working Group: Refined Metadata:  Yes, regarding the "Name" entry, it would be ideal if it could be used to populate the "Product Name" field in a list of available packages (and other required and relevant fields for MLDS).  Then the zip contents would be sufficient to automatically populate MLDS (or an ATOM-based Syndication feed))
    • WE'RE STILL MISSING THE IDENTIFICATION OF THE ACTUAL MAP PRODUCT ITSELF, AND THE VERSION OF THAT ENTITY
      • (eg) "ICNP version Jan 2019" should exist as metadata somewhere within the ICNP map product package...
      • + possibly even the direct URI?
      • SUGGESTION IS TO USE THE JSON FILE FOR THIS - group to provide examples of how this would look to the TRAG for review...
    •  
    • ANYTHING TO SUPPORT FREQUENT DELIVERY USEFULLY???? 
  • Also create 2 new pages -
    • one to capture the requirements for all different use cases
      • Use cases and requirements for refined Metadata
    • one to discuss and agree on the proposed solutions....
      • Proposed Solutions for the requirements

•  Andrew Atkinson to present the current proposal, and gather feedback
• Feedback:
  • Uncertainty on use cases - however this was mitigated by the specific messaging from SNOMED licensed users to non-licensed recipients...
  • Content
    • DICOM in particular no representative without sub-division, PLUS actually risky with unverified attributes...
    • AAT to discuss further with Jane, etc
    • Agreed that SI are confident that DICOM will provide some use
  • Using the US PT instead of the FSN (whilst providing less exposure of the IP) prevents visibility of the hierarchy (due to lack of semantic tag) - however the reason for this is because the target users (who are NOT current SNOMED licensed users) will find more use from the PT in drop-downs, messaging, etc than the FSN...
    • Now included both!
  • Everyone happy with each subsequent release being a snapshot - so additions added but inactivations just removed - as long as we include something in the legal licence statement to state that use of all concepts that have ever been included is in perpetuity (even after they've been inactivated)
    
    • New requirements have suggested that we need to now include a full historical audit trail, even in the Freeset formatted file!
    • This means we've included an Active flag column to allow this to be added in future releases...
    • We don't need to do this for a few months, so we need feedback now on whether or not we think this is a good idea?
    • Any potential drawbacks?
      • None idenitifed in Oct 2019 - but no-one has used it yet!
      • Check again in April 2020 - no NONE - go ahead!
    • This is a dependency for signing off the final version of the Release packaging conventions and File Naming Conventions item (next)
      
  • In addition, Members would also like a Proposal to create an additional Simple refset (full RF2) of the entire GPS freeset in order to enable active/inactive querying etc by licenced users...

    • • Potential to automate the creation of this using ECL queries if we ensure all freesets are included in the refset tool..

    • Would people still see a valid business case for including an RF2 refset file in the GPS package as well?

      • OCTOBER 2019 - NOT IN THE ROOM - BUT RORY HAS BEEN ASKED FOR IT BY SEVERAL PEOPLE, SO WE NEED TO DO IT

        • This will be in line with the September 2020 GPS release.

      • Any potential drawbacks with doing this?

        • NO

      • If so, should it be part of the existing GPS release package, or a separate file released at the same time?

        • Separate, released at same time - this is because the use case is different for each file type -

          • Users who don't have SNOMED CT will use freeset format file to scope which concepts they can receive successfully

          • Users who already have SNOMED CT will use the RF2 file format to scope which concepts they can send successfully to those who aren't regular SNOMED users...

• APRIL 2020 - Any other feedback from actually using the GPS freeset file????

  • no - everyone would just like the RF2 file version in Sept 2020 as planned...

•  
• GPS RF2 format package published as promised on 30/09/2020 -
  • ANYONE USED IT ALREADY??  Any feedback yet?
    • Matt Cordell  about to use it - he will send feedback once uploaded the new RF2 file.
    • .....Matt never loaded it in the end, so no feedback other than generally that the format looks useful
    • Peter Williams + Michael Lawley confirmed the real benefit was the the PHIR project - it's working well for that so far
  • PLEASE CAN YOU DOWNLOAD IT AND PROVIDE FEEDBACK ASAP (even if it's just that it "all looks good"!)....
    • Anyone used this yet??
  • +++++ feedback on the Freeset format as well... 

    • AAT to then update the Release packaging conventions and File Naming Conventions with the final decisions on the freeset format, ONCE the next GPS release has been published and we've had time to receive any useful feedback on it all...

• Document updated by Andrew Atkinson in line with the recommendations from the last meeting, and then migrated to a Confluence page here: SNOMED CT Release Configuration and Packaging Conventions
• To be reviewed in detail by everyone, and all feedback to be discussed in the meetings. AS OF OCTOBER 2017 MOST PEOPLE STILL NEEDED TIME TO REVIEW THE DOC - Andrew Atkinson INFORMED EVERYONE THAT THIS DOCUMENT WILL BE ENFORCED AS OF THE JAN 2018 RELEASE AND THEREFORE WE NEED REVIEWS COMPLETED ASAP... so now need to check if reviews still outstanding, or if all complete and signed off??
• AAT to add in to the Release Versioning spec that the time stamp is UTC
• AAT to add the trailing "Z" into the Release packaging conventions to bring us in line with ISO8601
• AAT to add new discussion point in order to completely review the actual file naming conventions. An example, would be to add into the Delta/Full/Snapshot element the dependent release that the Delta is from (eg) "_Delta-20170131_" etc. AAT to discuss with Linda/David. Or we hold a zero byte file in the Delta folder containing this info as this is less intrusive to existing users. Then publish the proposal, and everyone would then take this to their relevant stakeholders for feedback before the next meeting in October. If this is ratified, we would then update the TIG accordingly.
• AAT to add in a statement to the section 4 (Release package configuration) to state that multiple Delta's are not advised within the same package.
• AAT to add in appendix with human readable version of the folder structure. Done - see section 7
• IN ADDITION, we should discuss both the File Naming convention recommendations in the Requirements section (at the top of the page), PLUS Dion's suggestions further below (with the diagram included).
• Dion McMurtrie to discuss syndication options for MLDS in October 2018 - see hwat they've done (using Atom) and discuss with Rory as to what we can do. Suzy would be interested is this as well from an MS persepctive. UK also interested. This shouldn't hold up the publishing of the document. Discussions to continue in parallel with the creation of this document...
• Reuben Daniels to raise a ticket to update the fhir specs accordingly
• Reuben Daniels to talk to Linda to get URI specs updated accordingly.
• URI Specs to be updated and aligned accordingly - Reuben Daniels to assist
• EVERYONE TO REVIEW TONIGHT AND SIGN OFF TOMRORROW
• ONLY outstanding point from earlier discussing was Dion's point from the joint AG where he talked about nailing down the rules for derivative modules... -
• Dion McMurtrie to discuss/agree in the October 2018 meetings - REPORT FROM DION??
  
• Everyone is now happy with the current version, therefore Andrew Atkinson to publish - we can then start refining it as we use it.
• Andrew Atkinson to therefore agree all of the relevant changes that will be required as a result of this document internally in SNOMED International, and publish the document accordingly.
• FIRST POINT WAS THEREFORE TO have it reviewed internally by all relevant stakeholders...
  • This has been completed and signed off
• Do we consider anything in here needs to be incorporated into the TIG?
  • or perhaps just linked through?
  • or not relevant and just separate? YES - NOT RELEVANT!!
  • the litmus test should be whether or not implementers still use the TIG, or whether people now use separate documentation instead?
    • ??????????
• We also need to make a decision on the final Freeset distribution format(s), as I want to ensure we only have a MAXIMUM of 2 distribution formats - RF2 + the agreed new Freeset format (whatever that may be)
  • YES everyone is happy with this!
  • Add this into the Release Packaging Conventions and publish
• APRIL 2021 - DO WE NEED TO MAKE ANY REFINEMENTS IN ORDER TO PREPARE FOR CONTINUOUS DELIVERY? Did ADHA need any formatting changes when moving to monthly?
  • No, nothing beyond the new .json file and refinements to that 
  • We really need to tackle the Delta from and to release version in the Delta file naming, and possibly package file naming. At the moment it is impossible to know what a Delta is relative to making it hard to safely process it. Perhaps beyond the scope of this document, but quite important
    
    • THIS IS NOW ADDRESSED IN THE NEW Metadata file:
      • Standard July 2020 International Edition metadata file:
        • release_package_information_INT_edition.json
      • NON-Standard July 2020 International Edition Rollup Delta metadata file:
        • release_package_information.json
      • January 2021 International Edition metadata file:
        • release_package_information.json
      • March 2021 Belgium Extension metadata file:
        • release_package_information.json
      • DOES IT NOW COVER EVERYTHING NEEDED???
        • No!  We'll continue to discuss and agree ideas for new fields in this file as we progress towards Frequent Delivery....
        • This will therefore be rolled into the holistic discussions on Metadata in the new Metadata Working Group...
  • 
    
• THIS NEEDS TO BE CONTINUALLY REFINED OVER THE NEXT YEAR WHEN WORKING TOWARDS MORE FREQUENT DELIVERY:
  • Once all happy, the document will be published and opened up to anyone to view.
    
  •  
• Everyone was invited to either join the Working Group, or contribute ideas towards it - we will therefore continue to report back on how this is going...
•  

Michael Lawley

• Everyone confirmed no issues with the proposal in principle, in April 2018
• However, do we consider this to just be relevant to refsets in the International Edition release package?
  • Or to all derivative products as well?
  • Both refsets and maps?
• Also, are we talking about only human readable descriptive information, or also machine readable metadata such as
  • ranges of permitted values
  • mutability, etc?
    
• Michael Lawley to kindly provide an update on his work with David to help design and implement the solution - this will now be in the second TRAG meeting of the April 2019 conference, after they have met together....
• Michael + David + Harold agreed to create a straw man to put up in the next meeting and take this further...
  
  • Michael Lawley - where are the discussion on this currently?
  •  Michael confirmed (20210420) that this straw man was never created, and so we should use the published .json file as the straw man for future discussions... 
• Can we link this in to the .JSON file above? (Computer readable metadata) - yes, done!
•  
• IN FACT, are there any requirements for machine-readable or human-readable metadata that can't be addressed with extensions to the new .JSON file in the release packages?
  • No, not that people can foresee!
  •  
• This will be therefore be rolled into the holistic discussions on Metadata in the new Metadata Working Group...
•  
•  

• Harold Solbrig to talk to Yong and others in the MAG about his proposals for future proofing against the possibility of having multiple ontologies referenced, prefixed axioms, etc.
• Harold confirmed nothing to report
• Some opposition to reverting back to having the OWL file on-demand for Jan 2019 - need to discuss through with Kai in tomorrow's session - preference is to release both Stated Rel's + the "addtiional" info only in the OWL files - as with July 2018 release. Is this the current intention?
• Done - Jan 2019 was implemented as requested - did anyone manage to use it and trial it effectively? Any feedback?
  • YES - Australia downloaded it and trialled it in their systems!
  • Worked well - however they have not got a lot of new validation to cover either the OWL format or the content itself, so these were trials to ensure that they can use it and author against it, rather than testing the actual content of the Axioms...
• Also, has the decision already been made to NOT create a full history back to 2002 (or 2011 at least)? Sounds like most extensions will do it anyway, so maybe we should? Decision made by content team - no history to be included
• Discussion on whether or not to go back and re-represent the content all the way back to 2002 in the new complete OWL file:
  • Pros:
    • Prevents the need of new tooling providers to create support for the ols Stated Rel way of doing things
    • If the International Edition doesn't go all the way back then the Extensions are restricted to not doinh it either, if the international Edition does then the Extensions have a choice.
    • Ability to go back through history and analyse prevent modelling decisions (if errors come up in future), even for those authors who haven't heard of Stated Rel's because they've now been deprecated for several years.
  • Cons:
    • Cost involved in creating the pure historical view
    • If the extensions have a choice as to whether or not to go back, then interoperability could be impacted - better to enforce going back if the international edition does.
    • Need to address the issue of some implmentations having both Stated Rel + OWL Axioms in the same full files going forward.
    • Uncertain use cases for most implementers
• This discussion needs further input in order to enable us to reach an informed conclusion. The relevant internal and external stakeholders (NRC's such as Australia) will take this away and come back with the results of feasibility studies and estimates as to how long the necessary work would take to complete..... a decision must then be made well in advance of the January 2019 International Edition, in order to ensure that we agree on the correct approach before creating the initial Alpha release in November...
  • We are currently proceeding on the assumption that there was no feedback from any sources that supported the retro-fitting of the OWL Axiom files? The major con here is breaking our own regulations on tampering with history - the Stated Relationships should remain in place in order to a) accurately represent history + b) prevent the false impression that extended functionality was available via OWL Axioms before July 2019!
    
• DOES ANYONE ELSE HAVE ANY OTHER CONCERNS WHATSOEVER ON THE TRANSITION PLAN TO OWL, OR IS EVERYONE NOW COMFORTABLE WITH IT? YES! All good to go...
•  
• We need to work with the Shared Validation working group to share as many OWL based validation assertions as possible, so that we can all effectively cover:
  • Technical validation of the OWL file structure
  • Content validation of the OWL records
  • Modelling validation post OWL
• Having worked with OWL for a few months now, does anyone have any suggestions for new validation assertions?
  • Linda and others are confident that the MRCM validator will cover most modelling scenarios for now, but we'll need to keep extending as we go
  • Dion investigating this as part of the CSIRO RVF project - have we confirmed as yet if any extended scope is required?
  • New idea for an RVF assertion regarding the ordering of OWL records (based on first concept) with disjoints:
    • Michael Lawley suggested it (and Kai agreed) in MAG last time -
      • Can we please discuss and agree if it's worth creating?
      • Michael confirmed (20210420) that he hasn't discussed with Kai yet, but the idea is to group Axioms together in the sort order in order to make the file more human readable, and thereby enable manual validation + debugging.  As this won't have any benefit for the current drive towards automation of the validation to support the transition to Frequent Delivery, we'll leave this requirement with Michael to discuss with Kai outside of this workstream.
  • Michael/Dion confirmed that this is not currently part of the scope for the CSIRO project, as the assumption is that the classifier will highlight any critical issues in the underlying Axiom data.  - we've therefore opened the question to the entire Advisory Group plus anyone within the community - they will provide feedback either direct to me or to SNOMED International.
  •  
• Any ideas to be fed back into the RVF Improvement Project that CSIRO are currently working on (as per the presentation earlier above) - everyone invited to feedback either direct to myself, via the new working group, or through SNOMED International.
•  
•  

This document was reviewed in detail and all feedback was discussed and agreed upon - new version (v0.3) is available for review, attached to the IHTSDO Release Management Communication Plan review page.

AAT has added in details to state that we'll prefix the comms with "Change" or "Release" in order to distinguish between the type of communications. See version 0.4 now - IHTSDO Release Management Communication plan v0.4.docx

Once we've collated the feedback from the revised comms processes that we've implemented over the past year (in the items above), we'll incorporate that into the final version and discuss with the SNOMED International Executive Lead for Communications (Kelly Kuru), to ensure that it is aligned with the new overall Communication strategy. Once complete, the Release Management comms plan will be transferred to Confluence and opened up for everyone to view.

We have publicised the Release Management confluence portal to both NRC's and the end users to get people to sign up as and when they require the information. Do we know of anyone still not getting the information they need?

We also agreed last time that the community needs more visibility of significant, unusual changes (such as bulk plural change, or case significance change). These changes should be communicated out not just when they're assigned to a release, but actually well in advance (ie) as soon as the content team start authoring it, regardless of which future release it will actually make it in. I have therefore created a new Confluence page here: January 2020 Early Visibility Release Notices - Planned changes to upcoming SNOMED International Release packages

I've left the previous items up (from the July 2017 International Edition) because there are no examples yet from the Jan 2018 editing cycle - so please take a look and provide feedback on whether or not this is useful, and how it can be improved.

• ACTION POINT FOR EVERYONE BEFORE OCTOBER 2018: (Dion McMurtrie, Matt Cordell, Orsolya Bali, Suzy Roy, Corey Smith, Harold Solbrig, Mikael Nyström, Chris Morris)
  The final version of the communication plan needs to be reviewed by everyone and any comments included before we agree the document internally and incorporate it into our communication strategy
• Suzy Roy will discuss the end use cases of her users with them and come back to use with feedback on the practical uses of SNOMED CT and any improvements that we can make, etc 
• We may now also need to add a new section in here wrt the comms for the TRAG, so that this is standardised and agreed with the community? Or is it outside of the scope for the Release Communication Plan? This was felt to be out of scope, and should this be restricted only to communication related to actual releases of products.
  
• Everyone is now happy with the current version, therefore Andrew Atkinson to publish - we can then start refining it as we use it.
• Andrew Atkinson to therefore agree all of the relevant changes that will be required as a result of this document internally in SNOMED International, and publish the document accordingly.
• AAT MIGRATED THE DOCUMENT FROM WORD TO CONFLUENCE, AND THEN SENT IT TO THE EPS Team for first review.....
• The feedback has been incorporated and the document refined accordingly.
• https://confluence.ihtsdotools.org/display/RMT/SNOMED+CT+Release+Management+Communication+plan
• Andrew Atkinson has now sent to the relevant members of the SMT for final sign off....
  • This has now been signed off and is ready for publication
• Do we consider anything in here needs to be incorporated into the TIG?
  • or perhaps just linked through?
  • or not relevant and just separate?
    
  • the litmus test should be whether or not implementers still use the TIG, or whether people now use separate documentation instead?
    
•  
• THIS NEEDS TO BE CONTINUALLY REFINED OVER THE NEXT YEAR WHEN WORKING TOWARDS FREQUENT DELIVERY:
  • Once all happy, the document will be published and opened up to anyone to view
    

Harold Solbrig

• Language refset conflicts are not yet resolved - Linda has been discussing this in terms of how to merge Language refsets or dictate whether or not one should override the other in cases of multiple language refsets - in the UK they combine them all into one but this is not ideal either. In translation situations they use the EN-US preferred term as the default where there is no translated term in the local language. Perhaps we need to do a survey on the members and who's using what how.
• Suzy Roy (or Harold Solbrig) to get Olivier's initial analysis and come back to us on what worked and what didn't, and we can take it from there.
• Suzy would like to ask Matt Cordell if he can share his ppt from his CMAG extensions comparison project.
  
• Matt Cordell will distribute this to everyone for review before the April 2019 meeting.....
• Harold to continue analysis and report back with the results of reviewing the specific examples that Olivier identified in the next meeting....
• 
  
• Can you please present the revisited presentation Matt Cordell ?
•  

Dion McMurtrie completed the Alpha release - did anyone have chance to review it? (I haven't had any requests for access to the remainder of the package)

The subject of Modularisation needs to be discussed between the various AG's who are considering the topic, before we can proceed with the Release-specific sections.

We need to discuss any red flags expected for the major areas of the strategy:

1. Modularisation
2. Members who want to abstain from monthly releases, and therefore need to use delta's with mulitple effective times contained within.
3. Also need to consider if we continue to hold the date against the root concept - works perhaps still for 12 monthly releases, but not necessarily for continuous delivery daily!

• THIS NOW BECOMES CRITICAL TO THE STRATEGIC DIRECTION WE DISCUSSED IN TERMS OF MODULARISING OUR CONTENT, AND IMPROVING THE WAY THAT THE MDRS WORKS, IN ORDER TO ALLOW RANGES OF DEPENDENCIES. THIS WILL ALLOW THE "UNIT" OF RELEASE TO BE REFINED ACCORDING TO THE RELEVANT USE CASES.
• Understand the Use cases thoroughly, and refine the proposal doc to provide people with more real information - Dion McMurtrie TO PROVIDE THESE USE CASES FOR Andrew Atkinson TO DOCUMENT
• Does the POC allow for concepts to be contained within multiple modules? NO - BUT DION CAN'T THINK OF ANY CONCRETE EXAMPLES WHERE THIS WOULD BE NECESSARY
• What about cross module dependencies? Michael Lawley's idea on having a separate Module purely for managing module dependencies
• IN THE FINAL PROPOSAL, WE NEED TO CREATE A NESTED MDRS TO MANAGE THE INTER-MODULE DEPENDENCIES (as per Michael's comments)
• NEED TO PROVIDE GOOD EXAMPLES AND WHITE PAPERS OF THE USE CASES FOR MODULARISATION IN ORDER TO ENGAGE OTHERS...
• 
  
• AFTER SIGNIFICANT DISCUSSION AND CONSIDERATION, THERE ARE NO VALID USE CASES LEFT FOR MODULARISATION. IT CAUSES A LOT OF WORK AND POTENTIAL CONFUSION, WITHOUT ANY TANGIBLE BENEFIT.
• THE PERCEIVED BENEFIT OF HAVING A WAY TO REDUCE THE SIZE/SCOPE FO RELEASE PACKAGES IS BOTH a) invalid (due to everyone's experience of being unable to successfully do anything useful with any small part of SNOMED!), and b) easily answered by tooling that using the ECL to identify sub-sections of SNOMED to pull out for research purposes, etc.
• THEREFORE AS OF APRIL 2018 THE FEEDBACK FOR RORY AND THE STRATEGY TEAM WAS THAT MODULARISATION SHOULD NOT BE IMPLEMENTED UNLESS A VALID USE CASE CAN BE IDENTIFIED.
• HOWEVER, KNOWING THE HISTORY OF THIS ISSUE, THIS WASN'T NECESSARILY GOING TO BE THE FINAL WORD ON THE MATTER, SO IS EVERYONE STILL SURE THAT THERE ARE NO KNOWN USE CASES FOR MODULARISATION?? (eg) linking modules to use cases, as Keith was talking about with Suicide risk assessment in Saturday's meeting,etc??
• This topic came up several times again during other discussions in the April 2019 meetings, and it was clear that people had not yet given up on the idea of Modularisation - we therefore need to discuss further in October 2019....
• Agreed to see where the linked discussions in the MAG etc end up going, and then discussing the proposals rather than just in abstract....

•  NO! Everyone is decidedly uncomfortable with this solution! In particular Keith Campbell, Michael Lawley and Guillermo are all vehemently opposed to changing history.
• The consensus is that in the particular example of the US problem, we should have instead granted permission for the US to publish an update record in the International module, thus fixing the problem (though leaving the incorrect history in place). This would have been far preferable to changing history.
• ACTION POINT FOR EVERYONE FOR OCTOBER 2018: (Dion McMurtrie, Matt Cordell, Orsolya Bali, Suzy Roy, Corey Smith, Harold Solbrig, Mikael Nyström, Chris Morris
  We therefore all need to come up with potential scenarios where going forward we may need to implement a similar solution to the Negative Delta, and send them to AAT. Once I've documented them all, we can then discuss again and agree on the correct approach in each place, then AAT will document all of these as standard, proportionate responses to each situation, and we will use these as guidelines in future. If we have issues come up that fall outside of these situations, we'll then come back to the group to discuss each one subjectively, and then add them back into the list of agreed solutions.

1. Preference now is to retain EVERYTHING in the Full file, regardless of errors - this is because the Full File should show the state at that point in time, even if it was an error! This is because there is not an error in the Full file, the Full file is accurately representing the error in the content/data at that time.
2. The problem here is that the tools are unable to cope with historical errors - so we perhaps need to update the tools to allow for these errors.
3. So we need the tools to be able to whitelist the errors, and honestly document the KNOWN ISSUES (preferably in a machine readable manner), so that everyone knows what the historical errors were.
4. The manner of this documentation is up for debate - perhaps we add it to a new refset? Then we could use something very similar in format to the Negative delta, but instead of it actually changing history retrospectively, we simply document them as known issues, and allowing people to deal with the information in their own extensions and systems in whatever way they feel is appropriate.
5. Only situation we can think of where we couldn't apply the above gentle response, would be copyright infringement - whereby if we discovered (several releases after the fact) that we had released content that was in direct infringement of copyright, then we would potentially have to revoke all releases since the issues occurred. However, this would raise a very interesting situation where patient safety might be compromised - as if we remove all historical content that contravened the copyright, then we run the risk of patient data being impacted, thus potentially adversely affecting decision support. This is simple to resolve when the problem is in the latest release (simply recall the release), but if found in a 5 year old release for example, it could be very problematic to recall 5 years' worth of content and change it!

• October 2018 - Guillermo proposed a separate possibility, which is to introduce a new Status (eg) -1 whereby if you find this status in the latest snpashot you would just ignore it - this doesn't however address the use case where there is a legal contravention and you need to physically remove the content from the package - the use case where you would have something that contravenes RF2 paradigm, you can't use the RF2 format to correct something that is RF2 invalid! So this is unlikely to work...
  • Nobody is on board with this idea, as it's too fragile and introduces unnecessary complexity such as we had with RF1...
• 
  
• April 2019
• If we're still all in agreement with this, then steps 1-5 above should all be documented and disseminated to get confirmation of approval from everyone??
• Did everyone read through everything? Has anyone got any further scenarios that we can include in the documentation?
  
• 
  
• The EAG raised this issue again on 08/04/2109 - Peter to try to make it to the next TRAG to explain the use case that was raised today and elaborate on the new proposal...
• The TRAG discussed this issue at length, and came to the conclusion that we cannot address ALL potential use cases with a standard, generic, solution (certainly not any of those offered above).
  • Instead the solution in each case should be agreed on given each specific use case that comes up each time
  • So INSTEAD we should update the Critical Incident Policy to very clearly define the process to be followed each time we need to remove something from the Published release(s):
    • Which group of people should make the decision on the solution
    • Perhaps we also provide examples of how each use case might be resolved:
      
      • For Legal/IP contraventions, we should either remove content from history entirely, or redact it (leave the records in place, but remove all content from fields except for UUID, effectiveTime, moduleID, etc - thus allowing traceability of the history of the components, without including the offending content itself)
      • For Clinical risk issues, we can remove it from the Snapshot, but leave the Full file intact to leave a historical audit trail whilst ensuring that the dangerous content shouldn't get used again (as most people use the snapshot) - see Full file steps 1-5 above, etc
    • How to communicate it out to the users, etc
• OCTOBER 2019 - DISCUSSION RE-OPENED AS PART OF THE MAG:
  • Negative Delta file processing
    
  • 2019-10-28 & 30 Face to Face Meeting, Kuala Lumpur
    
  • .......
• ONCE FEEDBACK OBTAINED FROM MAG:
• Andrew Atkinson to update the Critical Incident Policy with
  • the various use cases that we've identified so far
  • the governing bodies who should be the deciding entities
  • the process for making the decision in each case
  • including the critical entities that need to be collaborated with in each case (all NRC's, plus 3rd party suppliers (termMed etc) who represent some of them), to ensure the final solution does not break outlying extensions or anything
  • the process for communicating out those decisions to ALL relevant users
  •  
• UPDATES FROM MAG?

• AAT CHECKED THE PREVIOUS IMPLEMENTATIONS OF DEPRECATION OF BOTH ICD-9-CM and RT Identifiers, AND AS THOUGHT BOTH WERE IN THE CORE MODULE, AND REMAINED IN THE CORE MODULE IN THE STATIC PACKAGES - SO ANY ISSUES WITH DOING THIS AGAIN?
• So the plan would be to follow the same deprecation process as we did with ICD-9-CM (ie)
  • move all of the content to a Static Package in July 2020, and inactivate all of the content
  • publish the reasons for inactivation in the historical associations
  • Release Notes similar to ICD-9 = SNOMED CT ICD-9-CM Resource Package - IHTSDO Release notes
  • CREATE A STATIC PACKAGE FOR CTV3 BASED ON THE JULY 2019 MAP FILES AND PUBLISH ON MLDS (and link through from Confluence link as well). ALSO LIFT THE CTV3 SPECIFIC DOCS FROM THE Jan 2020 RELEASE NOTES TO INCLUDE IN THE PACKAGE.
  1. Date of the files should be before the July 2020 edition (so say 1st June), in order to prevent inference of dependency on the July 2020 International edition
     1. So we set the effectiveTime of the Static package to be inbetween the relevant international edition releases (eg) 1st June
     2. This is to ensure that it's clear that the dependency of the Static package will always be the previous International Edition (here Jan 2020), and not continually updated to future releases
     3. It cannot therefore have an effectiveTime of July 2020 (as we would normally expect because we're removing the records from the July 2020 Int Edition) as this would suggest a dependency on the July 2020 content which doesn't exist
     4. It also can't have an effectiveTime of Jan 2020 as we need to distinguish between the the final published content which was Active in Jan 2020, and the new static package content where everything is Inactive.
  2. Inside the files should be all International edition file structures, all empty except for:
  1. Delta ComplexMap file needs to be cleared down (headers only), as no change in the content since the Jan 2020 files, so no Delta
  2. Full and Snapshot ComplexMap files exactly as they were in Jan 2020 release (including the effectiveTimes)
  3. ModuleDependency file needs to be blank, as CTV3 was in the core module (not in its own like ICD-10 is), and therefore the dependency of the core (and therefore the CTV3 content) module on the Jan 2020 edition is already called out in the Jan 2020 ModuelDependency file, and therefore persists for the static package too.
  4. Date of all of the files inside the package should be the new date (1st June)
  5. But all effectiveTimes remain as they were in Jan 2020
  6. Leave refsetDescriptor records as they are in the International edition
  7. RELEASE Notes Should describe all of the thinking we went through when creating this package, why the moduleDependency file remains blank, and why we’ve wiped the Delta, etc (see above)
• AND ALSO COMMS SAME AS WE DID WITH THE RT IDENTIFIER REFSET DEPRECATION:

  • RT Identifier Refset deprecation:

    We need additional comms around the July 2017 release, in addition to the usual Release Notes wording, in order to confirm what is happening and the rationale behind it.

    To re-iterate what was discussed on the previous call, Legal counsel confirmed that from a legal perspective, he doesn’t consider that it’s either necessary (or even advisable) for us to send CAP any further communications on this matter.  Legal counsel is confident that the informal discussions that we’ve already had with them (in order to remind them about what they need to do), are sufficient to cover our legal obligations, given that the licence is theirs and not SNOMED International's.  Therefore we no longer need to send a formal letter to CAP.

• Has anyone identified any issues with the proposed deprecation?

  • If so what?

• Is everyone still in favour of the refined process to use to deprecate??
  

• If all good then Andrew Atkinson to begin formal deprecation process

Jim Case +

Suzy Roy

This is a subject that would be helpful to include Jim in the discussions, as he has some definite opinions on how to improve the metadata in this area. 

Some suggestions would be to make more detailed information available for authors to describe their reasons for inactivation (especially in those areas where currently they are forced to use inactivation reason codes that aren't completely representative of the reasons in that instance).

Adding Jim Case - for further discussion later...

•  October 2021