Negation Requirements Project Minutes 5 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
	George Dixon	Allscripts
	Michelle Miller	Cerner
	Michael Padula	Cerner
	Stephen Chu

Agenda

Agenda Topics

1. review
   1. Problem - see Negation transform examples

Minutes

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

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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