Negation Requirements Project Minutes 10 August 2016

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Minutes

Meeting Information

HL7 PC-CIMI-POC Meeting Minutes Location: PC call line		Date: 2016-08-10 Time: 11:00-12:00 ET
Facilitator	Jay Lyle	Note taker(s)	Jay Lyle
Attendee	Name	Affiliation
y	Jay Lyle	JP Systems
y	Richard Esmond	PenRad
	Gerard Freriks
y	Rob Hausam
y	Serafina Versaggi
	Cynthia Barton	NLM
	Viet Nguyen
	Floyd Eisenberg
	Susan Barber
	Larry McKnight
	Galen Mulrooney
y	Kurt Allen
y	Jim Case
y	Juliet Rubini
	Hank Mayers

Agenda

Agenda Topics

1. Update on inputs from workgroups.
   1. CQI
2. Implications of SCT from last week
3. Proposed publication format, viz.,
   1. background, objectives, scope
   2. principles, w/rationale
   3. requirements: list of semantic patterns
   4. template for design teams to stipulate preferred or prohibited patterns

Minutes

Minutes/Conclusions Reached:

1. Jay to find guidance on publication for Kurt
2. Update on inputs from workgroups
   1. Serafina getting input from Security, CBCC, Financial Mgt
   2. Rob H: Pharmacy
   3. Richard: Imaging
   4. CQI
      1. Main case is procedure not done with reason. We had it conceptually; now we have references.
      2. Edge case: do we need to represent "absence inferred from empty query"?
         1. While we assert that absence of evidence is not evidence of absence for clinical purposes, for CQI (a closed world scenario) it's all you have, so absence of evidence is evidence of absence. As long as that assumption is only operational in the scope of the rule, no problem. But it was suggested that one might record that inference somewhere, and it might wind up getting communicated sometime. If that's true, you'd want to make it very clear that there is no assertion of absence, only an inference.
         2. We may recommend this be done with a distinct concept (e.g., "empty query") rather than provenance or other metadata, as it's fundamental.
3. Question of "rule-out" diagnoses, which have been misinterpreted as diagnoses
   1. "Rule-out" is ambiguous: need to distinguish "differential" (I expect to rule this out) from "absent" (I ruled this out).
4. SCT guidance
   1. Findings that assert absence are under review. I.e., problematic.
   2. TIG explains how classifier inverts entailment for negative findings (7.8.2.4.7), specifically using the Situation axis.
   3. Similar guidance is suggested but not detailed for procedures
   4. Morphology is not addressed here.

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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