Negation Meeting Atlanta October 2015

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Altanta WGM October 2014

• Discussions on "negation" representation (Note - "negation" will be changed to some term more appropriate to avoid confusion with HL7 v3 implementation of negation)

- vigorous discussions on how negation should be represented in FHIR clinical resources including condition, procedure,, observation, medication, allergy/intolerance

- general agreement was reached to represent negation by a flag with a set of values:

~ yes

~ no

~ unknown

Example: representing patient did not have concussion

~ Condition = concussion

~ "flag" = no

- also agreement on restricting double negatives causing confusion

Example:

~ Condition = no concussion

~ "flag" = yes ("no" value should not be used)

- In case of precoordinated values, they should be represented as two clinical statements

Example: concussion with no loss of consciousness

~ this should be two clinical statements

- Note:

~ There is still a need to identify a set of standard terminology-based value to support negation

~ Examples:

- No known allergy

- No known medication

- No known procedure