Negation Requirements Project Minutes 2 August 2017

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Minutes

Meeting Information

HL7 PC-CIMI-POC Meeting Minutes Location: PC call line		Date: 2017-08-02 Time: 11:00-12:00 ET
Facilitator	Jay Lyle	Note taker(s)	Jay Lyle
Attendee	Name	Affiliation
y	Jay Lyle	JP Systems
y	Lisa Nelson
y	Rob Hausam
y	Craig Newman
	Rita Pyle
	Richard Esmond
	Andrew Haslam
	Floyd Eisenberg
	Susan Barber
	Larry McKnight
	Galen Mulrooney
	Kurt Allen
	Jim Case
	Juliet Rubini
	Hank Mayers

Agenda

Agenda Topics

1. Agenda review
2. Review of suggested quality measures (eCQI)
3. Other usage cases
4. Class coverage & definition
5. Impact on problem statement

Minutes

Minutes/Conclusions Reached:

1. Motivations for attending
   1. Craig: 5 years ago, OO discussion on how to record Salmonella not found in V2. For a Sal specific test, Negative works fine. For a general Micro ID test, Sal means Sal found. If you find E coli but no Sal, how do you say no Sal?
   2. Lisa
      1. How to harmonize CDA & FHIR so you can transform one into the other
      2. Ensure solution is comprehensible. And Document.
      3. Agree with position: "Negation" may be one problem for logicians, but the domain problems we face are different. Assuming it's one problem that can be solved with a common abstract design actually makes the problems worse.
      4. CDA examples task force is making decisions with minimal input; we need to check them out.
         1. E.g., prohibition on using "no known" concepts in value properties
      5. The idea that the CDA boat has sailed is not persuasive. There are many years left in its lifespan, and it should be fixed where broken.
      6. Input for 2.0 now, 2.1 in ballot. And FHIR.
   3. Who is target audience? Standards designers, not implementers. This needs to be clearer.
2. ECQI input
   1. Negation is used in specifications and patterns
   2. See QRDA I guide for suggested mapping from CDA document artifacts to QRDA measure format. Also paragraphs on negation in Vol 1.
   3. Note that QRDA negated Observation may be based on a CDA procedure not done.
3. Other uses
   1. Glimpse of VA project to identify SCT values with implicit negation
      1. Explicit negation (i.e., in Situation hierarchy) not a problem: this can be identified for special handling
      2. Implicitly negated values need to be flagged so that logical inference doesn't get tripped up
   2. Note that we're not trying to completely automate medicine & make people unnecessary
      1. But rules can support and assist clinical processes
   3. Role of project:
      1. Not to dictate to designers how to design
      2. but to dictate that designers explicitly address negative cases in their guidance to implementers. Perhaps a maturity checklist can address this.
4. Next week: focus on picture. Some readers find pictures easier than words.

Meeting Outcomes

Actions review Use Cases for completeness, classification for accuracy (all)

Next Meeting/Preliminary Agenda Items Continue review of requirements

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