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Negation Requirements Project Minutes 18 May 2016

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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 Topics

  1. Montreal debrief
  2. New requirements


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

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

Next Meeting/Preliminary Agenda Items
  • Continue review of requirements

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