Negation Requirements Project Minutes 15 August 2018

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Minutes

Meeting Information

HL7 PC-CIMI-POC Meeting Minutes Location: PC call line		Date: 2018-08-15 Time: 4:00-5:00 PM ET
Facilitator	Jay Lyle	Note taker(s)	Jay Lyle
Attendee	Name	Affiliation
y	Jay Lyle	JP Systems
	Yanyan Hu	Joint Commission
y	Senthil Nachimuthu	3M
y	Ken Lord	VA
y	Rob Hausam	IMO
	Ben Hamlin	NCQA
y	Lisa Nelson
	Emma Jones	Allscripts
y	George Dixon	Allscripts
	Michelle Miller	Cerner
y	Michael Padula	Cerner
y	Stephen Chu	Joint Commission

Agenda

Agenda Topics

1. review
   1. family history generic, including no history of x: George

Minutes

1. family history updated (George)
   1. typically family history straightforward member and condition; no negations
      1. CCDA: example is fine, but it's pretty rare to negate family history
      2. breast cancer example of a condition where you might need a negation
      3. even breast cancer negation would tend to be in a progress note
      4. Issue of boundary between capture of data for human use and for automated processing
   2. no issues with CCDA example
   3. Issue: FHIR has two ways to go
      1. precoordinated code or List with empty reason
      2. no example to instruct us which way to go
      3. ask for one
   4. clinical need: to negate a specific condition for a specific relation; not, typically "no known problems"
      1. [track down fhir extension - allergyintolerance-substanceExposureRisk]
   5. List solution only addresses generic statement, not specific negation
      1. Also, Mappings that have already been done in CCDA on FHIR IG
         1. CCDA set of conditions -> fhir conditions, not a List
         2. Implementer community seems to prefer not to use list
   6. if precoordinated code exists 'no history of cancer'
      1. but none for a second disorder; use an expression?
      2. burden on terminology
   7. option: like Procedure, have a concrete tightly scoped property for presence/absence
      1. note: keep distinct from absence of data
   8. proposition: CDA negation and FHIR 'no known' mean the same thing for all practical purposes.
      1. no dissent
   9. Potential Rationale for when to use a list: to represent RIM Organizer

Meeting Outcomes

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

Next Meeting/Preliminary Agenda Items Agenda for 8/22: tbd

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