| Time | Item | Who | Notes |
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| 30min | Definition of Phenomenon Measurement | Group | - Stephanie: Concerned about including the word "measurement" in the clinical statement type of Phenomenon Measurement' why can't we just call it Phenomenon since it will include more than just measurements, such as documenting that a patient has diabetes?
- Joey: Phenomenon = Finding, such as dot blot hemorrhage or diabetes; Phenomenon measurement = Observable entity. Talked about Keith;s previous discussion about ranges that should be used to express presence or absence.
- John: Keith had definite ideas of why phenomenon measurement would include things like a diagnosis (equivalent to a finding in SNOMED). Keith considers assertions of finding a "measurement, "which is why it's called "Phenomenon Measurement."
- Patrick: All Booleans are considered measurements (0s or 1s).
- Stephanie: We need to come up with what makes sense to us, based on the information we have, and present it to Keith. If it doesn't make sense to us, then it's probably an indicator that it won't make sense to others and we need to change it to how we think it makes sense. We shouldn't just throw up our hands in the air and say we give up on this task.
- Joey: For Phenomenon, there are two kinds and Keith wants them in the same model. There are two kinds for presence and absence with UOM.
- Sarita: What are we trying to represent? Is it 80% of all clinical statements can be represented with these four types of clinical statements? It just seems we keep discussing the same things over and over again. Claude: Agreed. Stephanie: She has heard Keith say several times that if there is a clinical statement that doesn't fit into one of the four clinical statement types we have identified, then we should bring that use case forward and we will need to decide what type of new clinical statement type is needed.
- Claude: Not everything will fit into these four types, such as how do we express something that is not done and address how do we capture the variability of techniques and constraints for things such as lab and medication orders.
- Claude: There are several requirements we know from Keith, as listed below. Patrick and Sarita agreed.
- Doesn't want the separation of findings from observations
- Favors a very small number of top-level classes that are supposed to represent the clinical world
- We are not limited to any specific terminology/concept model
- We are not limited to EL and can support complete domains and where the range of an attribute could be an integer, Boolean, or something else
- Does not want us to specialize things such as a surgical procedure and wants only 4 classes
- We can compose the structures together but can't use the inheritance hierarchy to do that
- John: Keith likes to identify the principles that we are operating under. One principle John found to be true is when you try to do very large things with a large scope, it's a lot harder than to do smaller things with a smaller scope. We are trying to do a theory of everything. Is there a way to limit what we are doing for a practical user?
- Claude: We can do two things:
- Not try to model the world and focus only on the KNART project
- Come up with a proposal and validate your points by proof of contradiction
- Claude: We can then regroup. It was agreed by the group that this effort is limited to the KNART project.
- Sarita: Claude, you have already done a lot of this work with Keith and mentioned a document that they had worked on together from earlier this year. She emailed it to the group.
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| 25min | Review of Current Draft ANF Modeling Whitepaper | Group | - Revised the first paragraph of the Introduction section, particularly to clarify the scope is limited to the KNART project.
- Added a third clinical statement for Action Not Performed.
- Defined clinical statement, action, phenomenon, and each of the now five types of clinical statements.
- Provided examples for each of the five clinical statement types.
- Started identifying the various clinical statement components (i.e., what, how, who, where, when, why, how much). Claude started by providing his thoughts on what each of these means for the Action and Phenomenon clinical statements.
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| 5min | Next Steps | Group | - The next call is scheduled for Thursday, 2-4 ET.
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