This wiki has undergone a migration to Confluence found Here
<meta name="googlebot" content="noindex">

Difference between revisions of "Negation Requirements Project Minutes 30 March 2016"

From HL7Wiki
Jump to navigation Jump to search
(Created page with " <!-- LOOK FOR THE APPROPRIATE SECTION ****** TO ENTER INFORMATION--> Back to Negation Minutes ==Minutes Template== ===Meeting Information=== {|border="1" cellpadding="...")
 
 
(4 intermediate revisions by the same user not shown)
Line 5: Line 5:
 
<!-- LOOK FOR THE APPROPRIATE SECTION ****** TO ENTER INFORMATION-->
 
<!-- LOOK FOR THE APPROPRIATE SECTION ****** TO ENTER INFORMATION-->
 
Back to [[Negation Minutes]]
 
Back to [[Negation Minutes]]
−
==Minutes Template==
+
==Minutes==
 
===Meeting Information===
 
===Meeting Information===
 
{|border="1" cellpadding="2" cellspacing="0"  
 
{|border="1" cellpadding="2" cellspacing="0"  
Line 76: Line 76:
 
|colspan="4" style="background:#f0f0f0;"|
 
|colspan="4" style="background:#f0f0f0;"|
 
|-
 
|-
−
<!-- *****  Delete instructions  and change quorum requirements ON NEXT LINE *****-->
 
−
|colspan="4" |'''Quorum Requirements Met: '''(yes/No)
 
−
|-
 
  
  
Line 114: Line 111:
 
'''Minutes/Conclusions Reached:'''<br/>
 
'''Minutes/Conclusions Reached:'''<br/>
  
−
# Reviewed agenda
+
# Add link to PSS: it's on project wiki. Perhaps this referred to the TermInfo wiki.
−
# Wiki scope is OK. There is some discussion of how integral outreach to design teams should be. The "list, classify, design" spreadsheet currently provides a place to list use example data, a placeto classify those examples (both in scope), and a place to demonstrate how those examples are supported by design teams (not in scope). We do, however, want the design teams to use the tool (or to make suggestions for improving it and then use it).
+
## PSS status: still pending Vocab approval
−
# Agreement to consolidate existing wiki page. Jay will do it; attendees to review.
+
# Provenance
−
# Design activities continue to progress. We want requirements to be prior, but we can't help that. They will be as prior as we can manage.
+
## Provenance may affect interpretation of a negated fact, e.g., patient asserts no allergies. If there is a record of an reaction, this is reason to doubt such an assertion. However, positive assertions are also subject to trust and validation. Provenance is important, and may be a requirement for displaying allergy negation, but it's not specific to negation. This topic remains out of scope for this project.
−
# Content requirements do not address the "terminology or model" question. We will endeavor to provide guidance there as well.
+
# Use cases introduced by quality measure use case: need to identify actions not taken for cause.
−
# Next steps: see Actions below
+
## This information should not be specifically created for the measure calculation: if it's important enough for the measure, it should be in the record. Persistence is necessary to support cases such as "discontinued medication," which would presumably influence future opportunities for administration.
 +
## QDM models a property, "negation rationale," for recording such causes.
 +
## Whether such a note automatically excludes a patient from the denominator depends on the design of the rule -- for some rules, there are value sets of valid exclusion kinds.  
 +
## These reasons are not limited to contraindications; they may include patient refusal.
 +
## Note that the reason is distinct from the assertion that the act was not performed.
 +
## There was some discussion of identifying whether an act is not done# "intentionally." The "reason" property seems to at least offer the ability to identify intentionally omitted acts, and possibly some unintentional. All unintentionally omitted acts would be an infinite set, so we are not concerned with modeling it.
 +
## Current systems handle this case in a variety of ways.
 +
### Reason may annotate the order.
 +
### It may not be saved in a predictable place.
 +
### CDA template design: _act.negation, entryRel.reason: observation reason.
 +
## VA is considering ways to handle this issue.
 +
## CQL logical design under discussion.
 +
# New examples: see items 73 - 86 in spreadsheet.
 +
# Examples other than observations
 +
## Procedures & substance administrations pretty well covered above
 +
## Encounter: follow-up not needed; patient did not show up
 +
## Supply: did not provide electric wheelchair; did not use antithrombotic device on legs (as a supply item within a larger order or without order)
  
 
===Meeting Outcomes===
 
===Meeting Outcomes===
Line 139: Line 152:
 
* secure Vocabulary co-sponsorship (Rob H)
 
* secure Vocabulary co-sponsorship (Rob H)
 
* request involvement from SD & FHIR (Jay)
 
* request involvement from SD & FHIR (Jay)
 +
* consolidate wiki pages (Jay)
  
 
|-
 
|-

Latest revision as of 17:42, 30 March 2016



Back to Negation Minutes

Minutes

Meeting Information

HL7 PC-CIMI-POC Meeting Minutes

Location: PC call line

Date: 2016-03-30
Time: 11:00-12:00 ET
Facilitator Jay Lyle Note taker(s) Jay Lyle
Attendee Name Affiliation


Jay Lyle JP Systems
Floyd Eisenberg NQF
Serafina Versaggi
Michelle Miller Cerner
Susan Barber
Lisa Nelson
Juliette Rabini
Bob?

Agenda

Agenda Topics

  1. Review of prior minutes
    1. Provenance
    2. Quality use case
    3. New examples
    4. Cases other than observation

Minutes

Minutes/Conclusions Reached:

  1. Add link to PSS: it's on project wiki. Perhaps this referred to the TermInfo wiki.
    1. PSS status: still pending Vocab approval
  2. Provenance
    1. Provenance may affect interpretation of a negated fact, e.g., patient asserts no allergies. If there is a record of an reaction, this is reason to doubt such an assertion. However, positive assertions are also subject to trust and validation. Provenance is important, and may be a requirement for displaying allergy negation, but it's not specific to negation. This topic remains out of scope for this project.
  3. Use cases introduced by quality measure use case: need to identify actions not taken for cause.
    1. This information should not be specifically created for the measure calculation: if it's important enough for the measure, it should be in the record. Persistence is necessary to support cases such as "discontinued medication," which would presumably influence future opportunities for administration.
    2. QDM models a property, "negation rationale," for recording such causes.
    3. Whether such a note automatically excludes a patient from the denominator depends on the design of the rule -- for some rules, there are value sets of valid exclusion kinds.
    4. These reasons are not limited to contraindications; they may include patient refusal.
    5. Note that the reason is distinct from the assertion that the act was not performed.
    6. There was some discussion of identifying whether an act is not done# "intentionally." The "reason" property seems to at least offer the ability to identify intentionally omitted acts, and possibly some unintentional. All unintentionally omitted acts would be an infinite set, so we are not concerned with modeling it.
    7. Current systems handle this case in a variety of ways.
      1. Reason may annotate the order.
      2. It may not be saved in a predictable place.
      3. CDA template design: _act.negation, entryRel.reason: observation reason.
    8. VA is considering ways to handle this issue.
    9. CQL logical design under discussion.
  4. New examples: see items 73 - 86 in spreadsheet.
  5. Examples other than observations
    1. Procedures & substance administrations pretty well covered above
    2. Encounter: follow-up not needed; patient did not show up
    3. Supply: did not provide electric wheelchair; did not use antithrombotic device on legs (as a supply item within a larger order or without order)

Meeting Outcomes

Actions
  • review examples for completeness, classification for accuracy (all)
  • secure Vocabulary co-sponsorship (Rob H)
  • request involvement from SD & FHIR (Jay)
  • consolidate wiki pages (Jay)
Next Meeting/Preliminary Agenda Items
  • none identified

© 2012 Health Level Seven® International. All rights reserved.

Retrieved from "https://wiki.hl7.org/w/index.php?title=Negation_Requirements_Project_Minutes_30_March_2016&oldid=117480"