Negation Requirements Project Minutes 12 September 2018

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Minutes

Meeting Information

HL7 PC-CIMI-POC Meeting Minutes Location: PC call line		Date: 2018-09-05 Time: 4:00-5:00 PM ET
Facilitator	Jay Lyle	Note taker(s)	Jay Lyle
Attendee	Name	Affiliation
y	Jay Lyle	JP Systems
y	Yanyan Hu	Joint Commission
y	Senthil Nachimuthu	3M
y	Ken Lord	VA
y	Rob Hausam	IMO
	Ben Hamlin	NCQA
	Lisa Nelson
	Emma Jones	Allscripts
y	George Dixon	Allscripts
	Michelle Miller	Cerner
	Michael Padula	Cerner
	Stephen Chu

Agenda

Agenda Topics

1. WGM agenda
2. Confirming transformations with steward organizations
3. Cognitive Impairment
4. Problem
   1. Cases
      1. Refute a rule-out, suspected, or previously asserted condition
         1. use verification status
      2. Resolve a problem
         1. use clinical status
      3. Assert absence for protocol: not pregnant, no night sweats.
         1. Use Observation, not condition. We don't find evidence of a need for specific negation of conditions.
      4. Translate CDA asserting "diabetes" negated
         1. How often does this happen?
         2. Translation engine needs to specify assumptions, e.g.,
            1. if it's a negated condition, it's not a condition; drop it, or
            2. only transmit negated conditions with histories that tell us whether to tag it as Resolved or Refuted, or
            3. transmit negated conditions as observations: code = condition; answer = absent
   2. status matrix

Minutes

1. WGM
   1. Get confirmation from SD, FHIR
      1. Invite Sarah, Rick, Jean, Lisa
   2. propose connectathon
2. Cognitive Impairment
   1. CDA Section deprecated: use mental status
   2. Mental status is just like Problem: a code (classifier as cognitive status value) and value (finding)
   3. Also CDA Framework for Questionnaire Assessments
      1. Lays out design patterns for questions & assertions
3. Question: does C-CDA problem pattern define "observation" templates in addition to the problems?
4. Review of Problem cases in agenda, above
   1. Agreement: 1-3 should cover it.
   2. How to confirm #4 does not happen?
      1. Get a bunch of documents and look. Not feasible.
      2. Ask SD listserv, call.
      3. Deprecated Problem Status can say Inactive, Resolved; not Refuted.

• Excel version of diagram

Meeting Outcomes

Actions request FHIR example of negated family history requested tracker stakeholders interested in completion, secure resources review posted document draft, examples

Next Meeting/Preliminary Agenda Items Agenda for 9/19: Review Condition Status Matrix

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