HL7 and negation

Thomas Beale thomas.beale at openehr.org
Sat Jun 11 07:24:03 EDT 2016

On 11/06/2016 11:44, Grahame Grieve wrote:
>> Aside: apparently the FHIR approach to representing things like 'no 
>> known allergies' is to infer it by seeing if an allergies list is 
>> empty or not. That sounds like a bad idea to me. If 'no known 
>> allergies' is understood as a clinically meaningful statement made by 
>> e.g. a GP (based on reliable knowledge about the patient), checking 
>> for a list being empty in some EMR system isn't at all the same 
>> thing. All that latter does is establish that no allergies have been 
>> recorded on this particular system.
> Well, that would be a bad idea. But that's ok because that's not what 
> we do ;-)

good to know. I have incorrectly remembered the content of FHIR 
discussions on this topic.

> There is a specific flag on list for noting the clinically meaningful 
> statement, but what we've found is that almost all systems treat the 
> statement of no allergies in an allergy record as an explicit statement

that sounds right.

> Btw, I don't think that the statement of no allergy is a case of a 
> negation statement

Is there any online summary of how negations, exclusions etc are 
understood in FHIR?

- thomas

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