Negation Requirements Project Minutes 25 July 2018

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Minutes

Meeting Information

HL7 PC-CIMI-POC Meeting Minutes

Location: PC call line

Date: 2018-07-25
Time: 4:00-5:00 PM ET
Facilitator Senthil Nachimuthu Note taker(s) Senthil Nachimuthu
Attendee Name Affiliation



Jay Lyle JP Systems
X Yanyan Hu Joint Commission
X Senthil Nachimuthu 3M
X Ken Lord VA
Gay Dolin IMO
Ben Hamlin NCQA
George Dixon Allscripts
X Lisa Nelson
Emma Jones Allscripts
X George Dixon Allscripts
X Michelle Miller Cerner
X Michelle Miller Cerner
X Mia Nievera Joint Commission

Agenda

Agenda Topics

  1. Review schedule draft
    1. ballot for January (detail outline after WGM)
    2. limited objectives for October:
  2. Review sample examples
    1. NHSN negated risk factor: Senthil
    2. immunization not given: Jay
    3. no functional impairment
    4. no section information?
    5. no known health concerns
    6. no implanted devices
    7. no medications
    8. no cognitive impairment
    9. no planned tests
    10. no known problems
    11. no diabetes
    12. not pregnant
  3. revise
    1. never smoking: Ken Lord
    2. family history generic, including no history of x: George
    3. medication not done, with reason (QRDA): Yanyan
  4. done
    1. no known allergies: Jay
    2. no allergy to peanuts: Jay

Minutes

  1. Negation - medication administration QRDA CDA presented by Yanyan Hu.
    1. QRDA CDA template has negationInd = "true" when the medication was not administered.
    2. The effectivetime (both start and end) are set to the documentation time of the reason for why medication was not administered. (i.e., documentation time, not effective time of, e.g., child in incubator)
               The intended administration time of the medication (which was eventually not administered) is not captured in the QRDA CDA.

2. MedicationAdministration FHIR resource alignment:

                               .status = not-done
                               .statusReason
                                               - example binding to SNOMED CT
                               .effective[x].effectiveDateTime - the effective time when the drug was supposed to have been given (if status = not-done)
                               
               In addition, MedicationRequest resource has the .dosageInstruction.timing element. For a specific dose, the time specified in MedicationRequest.dosageInstruction.timing is expected to (~approximately) agree with the effectiveTime in MedicationAdministration, regardless of whether the medication was administered.
               

3. (C-CDA 2.1 also has a Planned Medication Activity template that we reviewed. The mood code describes whether this is an intent vs request, etc., and the effectiveTime indicates the intended time).

Meeting Outcomes

Actions
  • stakeholders interested in completion, secure resources
  • review posted document draft, examples


Next Meeting/Preliminary Agenda Items

Agenda for 8/1:

  • Review of family history generic, including ‘no history of x’: George Dixon.

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