Scope of negation is unclear - 2016-09 core #46

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    • Type: Change Request
    • Resolution: Persuasive
    • Priority: Medium
    • FHIR Core (FHIR)
    • DSTU2
    • Patient Care
    • Medication
      Procedure
    • 9.8 procedure & 11.3
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      Will add a usage note to Procedure.notPerformed saying:

      "If true, it means the procedure did not occur as described. Typically it would be accompanied by attributes describing the type of activity. It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period). Specifying additional information such as performer, outcome, etc. is generally inappropriate. I.e. it's not that useful to say "There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome" as it implies that there could have been an appendectomy done at any other time, by any other clinician or with any other outcome.

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      Will add a usage note to Procedure.notPerformed saying: "If true, it means the procedure did not occur as described. Typically it would be accompanied by attributes describing the type of activity. It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period). Specifying additional information such as performer, outcome, etc. is generally inappropriate. I.e. it's not that useful to say "There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome" as it implies that there could have been an appendectomy done at any other time, by any other clinician or with any other outcome.
    • Stephen/Elaine: 5-0-1
    • Enhancement
    • Non-substantive
    • DSTU2

      Comment:

      The support for asserting that something was not done is consistent across these resources, which is good.

      The scope of negation cannot be reliably determined--was an act not done at all, or only at the time specified (but possibly before or after), or only by the provider specified (but possibly by someone else). Guidance should provide that any time the flag is used, the resource should ideally scope either the encounter or the patient's history (leaving details out), and that further detail should only be used in extraordinary circumstances, as it will severely restrict the scope of the negated statement (and its intelligibility).

      Further, a "true" value is synonymous with status = completed, suggesting "not done" is simply another status for this act, not requiring a separate property.

      Summary:

      Scope of negation is unclear

            Assignee:
            Unassigned
            Reporter:
            Jay Lyle
            Watchers:
            3 Start watching this issue

              Created:
              Updated:
              Resolved: