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Difference between revisions of "Negation Requirements Project Minutes 18 May 2016"

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===Agenda===
 
===Agenda===
 
'''Agenda Topics''' <br/>
 
'''Agenda Topics''' <br/>
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# Administration
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# Montreal debrief
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# Quality case
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# New requirements
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# Continue with classification
 
  
 
===Minutes===
 
===Minutes===
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'''Minutes/Conclusions Reached:'''<br/>
 
'''Minutes/Conclusions Reached:'''<br/>
  
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# No quorum; information only
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# MnM the last WG to secure before PSS back to DESD
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# PSS delivered to DESD
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# Chart by exception: example of radiology
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# Principles moved from minutes to a wiki page
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## Radiology tools allow a radiologist reading a film to select "normal." The tool may be configured to infer from that, and from the modality, contrast, etc., all of the problems that should have been evident, if present, that can therefore be recorded as absent, and may record them explicitly.
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# Glossary started
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## The act of inference may introduce a Provenance requirement to these events.
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# CQI: if an action is not recorded as done, this is not clinically sufficient evidence it wasn't done. You still have to ask about aspirin before assuming it was or was not given. But when calculating a measure, there is no one to ask. One has to assume it was not done. (The measure may be sophisticated enough to identify exceptions, but it may not.)
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## There may be other questions around knowledge management & the appropriate authority for supporting inference.
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# Charting by exception is a critical topic
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## But the component assertions of "CXR: Normal" => "No mediastinal widening, valve disease, or CHF" are the same as other "absent finding" cases already addressed.
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## Assume things are normal unless stated otherwise
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# Condition absent
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## Radiology does this explicitly: report is pre-populated with negative findings appropriate to modality & site (e.g., CXR: no mediastinal widening). Radiologists modify those elements found and need not record the negatives.
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## We have condition refuted
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## Other contexts may not be so explicit: Review of Systems normal may imply several absent pathologies, but unless you know the ROS protocol for the location, you can't tell what they are.
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## Condition in remission isn't really absent
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## Open question of what to do with this.
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## Detailed family history records may actually record family member conditions as conditions rather than as risk factors for the patient, so Condition Absent does seem to be a requirement.
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# How negation behaves in containment
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## We think this is a design pattern issue.
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## In vanilla OO designs, parent class properties pertain to contained classes.
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## In RIM, we have a context conduction feature to manage that process.
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## In FHIR, resources don't share context.
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## No business requirement identified.
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# Jay to post relevant sources, including those by Alan Rector.
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# Collection pattern
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## In EMS, we broke "medications" into two questions: "medications (yes no unk)" and "Medications (list)," appropriate if the answer to the first was 'yes.'
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## Jay proposes that all collections follow a similar semantic pattern.
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## Rob points out a difference between no meds (known) and no known allergies (never really known). Pick up here next week.
  
 
===Meeting Outcomes===
 
===Meeting Outcomes===

Latest revision as of 19:40, 18 May 2016


Back to Negation Minutes

Minutes

Meeting Information

HL7 PC-CIMI-POC Meeting Minutes

Location: PC call line

Date: 2016-05-18
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
y Rob McClure
y Rob Hausam
y Viet Nguyen
y Matt Spielmann

Agenda

Agenda Topics

  1. Montreal debrief
  2. New requirements

Minutes

Minutes/Conclusions Reached:

  1. MnM the last WG to secure before PSS back to DESD
  2. Chart by exception: example of radiology
    1. Radiology tools allow a radiologist reading a film to select "normal." The tool may be configured to infer from that, and from the modality, contrast, etc., all of the problems that should have been evident, if present, that can therefore be recorded as absent, and may record them explicitly.
    2. The act of inference may introduce a Provenance requirement to these events.
    3. There may be other questions around knowledge management & the appropriate authority for supporting inference.
    4. But the component assertions of "CXR: Normal" => "No mediastinal widening, valve disease, or CHF" are the same as other "absent finding" cases already addressed.
  3. Condition absent
    1. We have condition refuted
    2. Condition in remission isn't really absent
    3. Detailed family history records may actually record family member conditions as conditions rather than as risk factors for the patient, so Condition Absent does seem to be a requirement.
  4. How negation behaves in containment
    1. We think this is a design pattern issue.
    2. In vanilla OO designs, parent class properties pertain to contained classes.
    3. In RIM, we have a context conduction feature to manage that process.
    4. In FHIR, resources don't share context.
    5. No business requirement identified.
  5. Jay to post relevant sources, including those by Alan Rector.
  6. Collection pattern
    1. In EMS, we broke "medications" into two questions: "medications (yes no unk)" and "Medications (list)," appropriate if the answer to the first was 'yes.'
    2. Jay proposes that all collections follow a similar semantic pattern.
    3. Rob points out a difference between no meds (known) and no known allergies (never really known). Pick up here next week.

Meeting Outcomes

Actions
  • review examples for completeness, classification for accuracy (all)


Next Meeting/Preliminary Agenda Items
  • Continue review of requirements

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