Stream: implementers
Topic: X12 and FHIR
Peter Bernhardt (Oct 08 2018 at 17:41):
I'm puzzled as to why there are no X12 -> FHIR mappings provided in the documentation for financial resources. I understand that this may be unique to the US realm, but still it's in very wide use. Is this something the Financial WG is investigating? @Paul Knapp
Paul Knapp (Oct 08 2018 at 17:46):
@Peter Bernhardt X12 owns the IP for their standard and we will not violate their IP by posting such a mapping without their participation and approval. Financial Management (FM) and HL7 have been trying to work with X12 for several years to formally undertake such a mapping. I expect that X12 would want to publish the mapping on their site available only to parties who have purchased X12 so that they preserve their IP.
Peter Bernhardt (Oct 08 2018 at 17:54):
@Paul Knapp Hmm... too bad. Yet another reason to not like the way healthcare works in the US. ;) Thanks for the quick reply!
Grahame Grieve (Oct 08 2018 at 18:29):
@Paul Knapp US copyright law is that you can't copyright the technical names. have we checked whether X12 are able to prevent us from publishing the mapping?
Grahame Grieve (Oct 08 2018 at 18:29):
Also, should I escalate this with US Govt?
Paul Knapp (Oct 08 2018 at 18:32):
@Grahame Grieve We have supported their IP in the same manner that HL7 expects its IP to be supported. HL7 and X12 senior management are supposed to be engaged in resolving this.
Grahame Grieve (Oct 08 2018 at 18:38):
HL7 expects its IP to be supported
legally, I'd hope. I'll chase it up
Peter Bernhardt (Oct 08 2018 at 19:15):
Thanks for following up, @Grahame Grieve
Paul Knapp (Oct 19 2018 at 17:47):
My understanding from both the HL7 and X12 sides is that they own the IP. In meeting with representatives from X12 at HL7 meetings we have been clear that we need to work together as organizations, and we engaged the official HL7-X12 liaisons, to ensure the appropriate mechanisms are followed before the work is undertaken including how any work products would be shared - which we expect would be by X12 as only they can verify if a party has purchased X12 and therefore may have a legitimate need for mapping to FHIR.
Grahame Grieve (Oct 19 2018 at 20:30):
are X12 claiming that only those licensed to use X12 have any reason to know anything about the mappings?
Paul Knapp (Oct 22 2018 at 10:14):
I'd expect they are the only ones with a legitimate need for given that you need to license to use. Again it is for X12 to articulate not HL7 as they have whatever restrictions they have.
Lloyd McKenzie (Oct 22 2018 at 15:22):
There are different types of needs. Actually transforming X12 data, presumably you should have a license. However, knowing what's potentially transformable, understanding where FHIR content is expressible in X12 (or vice versa) could be relevant to a broader set of stakeholders.
Lloyd McKenzie (Oct 22 2018 at 15:23):
Has X12 actually said "no, you can't include mappings"?
Paul Knapp (Oct 22 2018 at 16:37):
From the HL7 X12 SOU:
2.4 Participation by HL7 and X12 in this agreement does not convey free access to, or the
right to use or distribute any of our respective intellectual property. (Also, see 4.1.f)
4.1.f To respect one another’s copyrights, fair use policies and all other aspects of
recognized intellectual property.
a. The current X12 copyright, fair use and other intellectual property rights policies
are available on the X12 website. These policies shall be referenced regularly to
ensure that any and all individual initiatives originating from HL7, regardless of
organizational overlap, comply with the posted policies.
Also, any joint work requires a joint project statement and they don't quite know what that is.
Lloyd McKenzie (Oct 22 2018 at 16:47):
I take it that means no one has actually asked?
Paul Knapp (Oct 22 2018 at 19:07):
No because its written on their website and we have X12 people in HL7 who already have a very good sense of X12's stance. As you can see from our SOU with them, which HL7 senior people updated a year ago, and their fair-use and IP policies - we have to work with them and they have to review and approve. When we reached out we were clear that their IP needed to be respected and that we needed their participation. The ball has been in their court with reminders to senior levels there about every 6 months.
We have done mapping to the paper forms and the NUBC manual has a crosswalk from the paper forms to X12 so anyone who has purchased that manual is good to go with a little effort on their own.
Grahame Grieve (Oct 22 2018 at 19:12):
I'm ok with respecting their IP but I think they're wrong if they think that protecting their IP is usefully done by prohibiting FHIR including X12 mappings.
MaryKay McDaniel (Oct 23 2018 at 14:09):
There is a history of an uneasy relationship between HL7 and X12. Some folks are still unhappy about the use of their IP back in v1.0 ...
It isn't helping that comments along the lines of HL7 is out to put them out of business are supposedly getting back to their management.
So, we did ask. The first time it was not warmly received. Subsequent conversations have been more productive. The last conversation was actually rather positive, they were contemplating how to manage the mapping maintenance. I will reach out again today. Once we get the approval, the lift to get a project plan in place will take some time.
Lloyd McKenzie (Oct 23 2018 at 14:55):
@MaryKay McDaniel Thanks for pushing this forward. If you find out where such comments originated from, pass it on to the appropriate governance level (FMG, TSC, Wayne) depending on the source. We don't want to be stoking tensions. There's no intention to put X12 out of business. FHIR is designed so that X12 could take it and run with it if that was something of interest to them.
Robert McClure (Oct 23 2018 at 17:42):
@MaryKay McDaniel We have had a similar stalemate regarding the inclusion of X12 "terminology" in NLM's VSAC hence VSAC still does not have the 1336 code set that is referenced by C-CDA. In all these cases there is clearly no intent to distribute the content to those who do not already have license for it. Sure would be nice if a clear path to a workable solution was reached.
MaryKay McDaniel (Oct 23 2018 at 18:21):
@Robert McClure
Rob, if you can tell me what 1336 is - THAT I know how to get updated at NLM. I'm close to the chair of that committee...
Last updated: Apr 12 2022 at 19:14 UTC
