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Difference between revisions of "Negation Requirements Project Minutes 15 August 2018"

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* Review of minutes from 7/25
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* family history updated
# case 1 Clinical use. Specific. Intended time important for missed repeating dose.
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## got 8:00 & 4:00 but not 12:00 dose.
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typically family history straightforward member and condition; no negations
# case 2 quality measure
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breast cancer example of a condition where you might need a negation
## Use encounter time (not given during encounter)?
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## Or quality rule parameter (not given in accordance with rule; e.g., within 4 hours of presentation)
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doc is old; xls is revised; added FHIR
## Quality team is looking for a reason. date and time not important to receiver
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## some facilities will include even out-of-spec data, e.g., 5 hours
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CCDA: example is fine, but it's pretty rare to negate family history
### some won't
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even breast cancer negation would tend to be in a progress note
# case 3 timeframe of Reason?
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no issues with CCDA example
## hearing screening not performed; patient in incubator
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### does incubator time have to cover encounter time or rule-defined time?
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Issue: FHIR has two ways to go
### probably an audit function; not main process
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precoordinated code or List with empty reason
### Quality team: all data may be in QRDA, but if reason applies within timeframe, it's a pass
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no example to instruct us which way to go
# case 4: Documentation time for statusReason?
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ask for one
## hard to see a rationale. can be reconstructed from Resource.Meta.lastUpdated
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# can we test these?
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clinical need: to negate a specific condition for a specific relation
## i.e., put into the spreadsheet comparison format
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not "no known problems"
## and then query live data? maybe Phase II.
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[track down fhir extension - allergyintolerance-substanceExposureRisk]
# Out of time; will review 8/1 next week, then smoking status.
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List solution only addresses generic statement, not specific negation
 +
 
 +
Mappings that have already been done in CCDA on FHIR IG
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CCDA set of conditions -> fhir conditions, not a List
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Implementer community seems to prefer not to use list
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 +
if precoordinated code exists 'no history of cancer'
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but none for a second disorder; use an expression?
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burden on terminology
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option: like Procedure, have a concrete tightly scoped property for presence/absence
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keep distinct from absence of data
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proposition: CDA negation and FHIR 'no known' mean the same thing for all practical purposes.
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no dissent
 +
 
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Potential Rationale for when to use a list
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to represent RIM Organizer
  
 
===Meeting Outcomes===
 
===Meeting Outcomes===

Revision as of 21:21, 15 August 2018

Back to Negation Minutes

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

  • family history updated

typically family history straightforward member and condition; no negations breast cancer example of a condition where you might need a negation

doc is old; xls is revised; added FHIR

CCDA: example is fine, but it's pretty rare to negate family history even breast cancer negation would tend to be in a progress note no issues with CCDA example

Issue: FHIR has two ways to go precoordinated code or List with empty reason no example to instruct us which way to go ask for one

clinical need: to negate a specific condition for a specific relation not "no known problems" [track down fhir extension - allergyintolerance-substanceExposureRisk] List solution only addresses generic statement, not specific negation

Mappings that have already been done in CCDA on FHIR IG CCDA set of conditions -> fhir conditions, not a List Implementer community seems to prefer not to use list

if precoordinated code exists 'no history of cancer' but none for a second disorder; use an expression? burden on terminology option: like Procedure, have a concrete tightly scoped property for presence/absence keep distinct from absence of data

proposition: CDA negation and FHIR 'no known' mean the same thing for all practical purposes. no dissent

Potential Rationale for when to use a list to represent RIM Organizer

Meeting Outcomes

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


Next Meeting/Preliminary Agenda Items

Agenda for 8/1:

  • tbd

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