Negation Rationale is an attribute on nearly every QDM datatype, although it likely does not make sense (or is not well supported) on many datatypes. The QDM user group should review every datatype's use of negation rationale and consider it for removal.

QDM UG Accepted Solution (May 2015)

Only apply negation rationale to data types that indicate action (and anywhere else it is already being used in MU-2 measures). Remove negation rationale from all other data types.

The application of this criteria results in the removal of negation rationale from the following data types:

• Care Goal
• Device, Adverse Event
• Device, Allergy
• Device, Intolerance
• Diagnosis
• Family History
• Diagnostic Study, Adverse Event
• Diagnostic Study, Intolerance
• Encounter, Active
• Immunization, Allergy
• Immunization, Intolerance
• Intervention, Adverse Event
• Intervention, Intolerance
• Laboratory Test, Adverse Event
• Laboratory Test, Intolerance
• Medication, Active
• Medication, Adverse Effects
• Medication, Allergy
• Medication, Intolerance
• Patient Care Experience
• Procedure, Adverse Event
• Procedure, Intolerance
• Provider Care Experience
• Provider Characteristic
• Substance, Adverse Event
• Substance, Allergy
• Substance, Intolerance
• Symptom

After the indicated removals, negation rationale remains on the following data types:

• Communication: From Patient to Provider
• Communication: From Provider to Patient*
• Communication: From Provider to Provider*
• Device, Applied*
• Device, Order*
• Device, Recommended
• Diagnostic Study, Order*
• Diagnostic Study, Performed*
• Diagnostic Study, Recommended
• Encounter, Order
• Encounter, Performed
• Encounter, Recommended
• Functional Status, Order
• Functional Status, Performed
• Functional Status, Recommended
• Immunization, Administered
• Immunization, Order
• Intervention, Order*
• Intervention, Performed*
• Intervention, Recommended
• Laboratory Test, Order*
• Laboratory Test, Performed*
• Laboratory Test, Recommended
• Medication, Administered*
• Medication, Discharge*
• Medication, Dispensed
• Medication, Order*
• Physical Exam, Order
• Physical Exam, Performed*
• Physical Exam, Recommended
• Procedure, Order
• Procedure, Performed*
• Procedure, Recommended
• Risk Category/Assessment*
• Substance, Administered
• Substance, Order
• Substance, Recommended
• Transfer From
• Transfer To

* indicates that negation rationale is used on this data type in at least one MU-2 measure