Negation Requirements Project Minutes 25 July 2018

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Minutes

Meeting Information

HL7 PC-CIMI-POC Meeting Minutes Location: PC call line		Date: 2018-07-25 Time: 4:00-5:00 PM ET
Facilitator	Senthil Nachimuthu	Note taker(s)	Senthil Nachimuthu
Attendee	Name	Affiliation
	Jay Lyle	JP Systems
X	Yanyan Hu	Joint Commission
X	Senthil Nachimuthu	3M
X	Ken Lord	VA
	Gay Dolin	IMO
	Ben Hamlin	NCQA
	George Dixon	Allscripts
X	Lisa Nelson
	Emma Jones	Allscripts
X	George Dixon	Allscripts
X	Michelle Miller	Cerner
X	Michelle Miller	Cerner
X	Mia Nievera	Joint Commission

Agenda

Agenda Topics

1. Review schedule draft
   1. ballot for January (detail outline after WGM)
   2. limited objectives for October:
2. Review sample examples
   1. NHSN negated risk factor: Senthil
   2. immunization not given: Jay
   3. no functional impairment
   4. no section information?
   5. no known health concerns
   6. no implanted devices
   7. no medications
   8. no cognitive impairment
   9. no planned tests
   10. no known problems
   11. no diabetes
   12. not pregnant
3. revise
   1. never smoking: Ken Lord
   2. family history generic, including no history of x: George
   3. medication not done, with reason (QRDA): Yanyan
4. done
   1. no known allergies: Jay
   2. no allergy to peanuts: Jay

Minutes

1. Negation - medication administration QRDA CDA presented by Yanyan Hu.

               QRDA CDA template has negationInd = "true" when the medication was not administered.
               The effectivetime (both start and end) are set to the documentation time of the reason for why medication was not administered. (i.e., documentation time, not effective time of, e.g., child in incubator)
               The intended administration time of the medication (which was eventually not administered) is not captured in the QRDA CDA.

2. MedicationAdministration FHIR resource alignment:

                               .status = not-done
                               .statusReason
                                               - example binding to SNOMED CT
                               .effective[x].effectiveDateTime - the effective time when the drug was supposed to have been given (if status = not-done)
                               
               In addition, MedicationRequest resource has the .dosageInstruction.timing element. For a specific dose, the time specified in MedicationRequest.dosageInstruction.timing is expected to (~approximately) agree with the effectiveTime in MedicationAdministration, regardless of whether the medication was administered.
               

3. (C-CDA 2.1 also has a Planned Medication Activity template that we reviewed. The mood code describes whether this is an intent vs request, etc., and the effectiveTime indicates the intended time).

Meeting Outcomes

Actions stakeholders interested in completion, secure resources review posted document draft, examples

Next Meeting/Preliminary Agenda Items Agenda for 8/1: Review of family history generic, including ‘no history of x’: George Dixon.

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