Negation Requirements Project Minutes 27 April 2016
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|HL7 PC-CIMI-POC Meeting Minutes
Location: PC call line
Time: 11:00-12:00 ET
|Facilitator||Jay Lyle||Note taker(s)||Jay Lyle|
|Jay Lyle||JP Systems|
|Ron Van Duyne|
- Prior minutes
- Action items
- Classify requirements
- Minutes: no comments; approved
- Action items:
- wiki updated
- PSS to go to DESD
- Classification of items in list
- Using term "symptom" in addition to "finding" needlessly complex; introduces different assumptions about definition
- Most current examples are "finding absent"
- SCT distinction between finding & observable tabled to design phase
- "No drug allergy" is also a "finding absent" but so common as to merit separate treatment
- example 11: "Begin light exercise (walking on a level surface for 5 minutes, 3 times a day). Add 1 minute to each session, each day until able to complete 10-15 minutes in each session without cardiac symptoms"
- We recommend recording explicitly "no cardiac symptoms" (or "cardiac symptoms absent") when executing the rule (rather than discontinuing treatment without comment)
- How the rule might represent the condition: potentially the same way (absence of finding), but within some kind of "goal" or subjunctive mood class.
- # 14 "No change": this is a positive assertion of stability, not a negation of another assertion.
- # 15 "If the patient does not produce 250ml urine in first 30 minutes, furosemide 40mg IV x1 should be administered": this is a threshold, not a negation.
- # 18 "Nothing to eat or drink until respiratory distress dissipates" -- a conditional prohibition
- # 25 "Provider notices that the patient did not tolerate Prazosin in the past (which was started to address difficulty sleeping)": this is the observation of a contraindication
- # 26 "and was discontinued due to irregular heartbeats and hyperventilation" -- this is two statements: one of discontinuing an order and one of a reason. State seems sufficient here.
- # 28 "Patient still refuses cessation treatment despite motivational interventions"
- If there is an order, it could have a state and reason, as above.
- Can we rely on that, or do we need a separate "act not done" kind of assertion?
- Compare # 99 "hearing screening not done - needed for quality measure": if there is a protocol for the measure that excludes valid reasons documented otherwise (on ventilator, e.g.), we don't. But is that assumption sufficient?
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