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Negation Requirements Project Minutes 5 September 2018

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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
George Dixon Allscripts
Michelle Miller Cerner
Michael Padula Cerner
Stephen Chu


Agenda Topics

  1. review
    1. Problem - see Negation transform examples


  1. Problem
    1. No problems: CDA negated 'problem' = FHIR code "no problems". This seems unproblematic.
    2. CDA can negate a specific problem
      1. FHIR can negate a specific problem if there is a specific code (Diabetic retinopathy of eye not detected (situation))
      2. Usually, there is a reason
        1. Refute a rule-out or suspected problem (verification status)
        2. Resolve a problem (clinical status)
        3. Some are just protocol questions: not pregnant, no night sweats.
          1. these are observations, not conditions. There doesn't seem to be a lot of need for specific negation of conditions.
        4. Use case: if CCDA contains "diabetes" negated, then what?
          1. How often does this happen?
          2. Engine needs to specify assumptions, e.g.,
            1. if it's a negated condition, it's not a condition; drop it, or
            2. only send negated conditions with histories that tell us whether to tag it as Resolved or Refuted
  2. next week
    1. Ken: no physical impairment
    2. Jay: no problems (more examples)

Meeting Outcomes

  • 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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