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	Joint Commission

Agenda

Agenda Topics

1. review
   1. Problem

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

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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