HeD+Glossary

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If you are interested in adding a term to the glossary for the CDS Artifact Sharing Use Case please do so by editing this page and adding in your suggestions. Otherwise please submit all suggested revisions to existing terms using the form below. If you run into any issues please contact the Use Case Support Lead Merideth Vida.

=Appendix A: CDS Artifact Sharing Use Case (Use Case 1) Glossary of Terms=


 * Clinical Decision Support (CDS):** Clinical Decision Support is a process for enhancing health-related decisions and actions with pertinent, organized clinical knowledge and patient information to improve health and healthcare delivery. Information recipients can include patients, clinicians and others involved in patient care delivery; information delivered can include general clinical knowledge and guidance, intelligently processed patient data, or a mixture of both; and information delivery formats can be drawn from a rich palette of options that includes data and order entry facilitators, filtered data displays, reference information, alerts and others. (Jerome A. Osheroff, Jonathan M. Teich, Donald Levick, Luis Saldana, Ferdinand T. Velasco, & Dean F. Sittig, 2012)


 * CDS Artifact Integrator:** An organization/person/system that imports, adapts and maps CDS Knowledge artifacts to be embedded within a CDS system.


 * CDS Content Developer:** An organization that produces CDS Knowledge Artifacts. Content developers will utilize the HeD Standard to make CDS Knowledge Artifacts available to the CDS Knowledge Artifact Supplier.


 * CDS Knowledge Artifact:** Medical knowledge represented in a structured and encoded form to enable computer based clinical decision support.


 * CDS Knowledge Artifact Supplier:** An organization/system that collects and/or distributes CDS Knowledge Artifacts.


 * CDS System:** This term is used to describe any system that provides clinical decision support. Often, though not exclusively, the CDS is provided by an EHR system.


 * Content Management Module:** A module that is part of the CDS system to edit, manage, and deploy/release CDS artifacts.


 * Critiques and Warnings (Immediate Alerts):** Urgent requests for clarification, correction or different action - often related to an order or prescription - based on an action the user just took or data they entered. These reactive interventions prompt the user to immediately address possible errors, hazards or quality improvement opportunities related to new data or orders just entered into an information system. (Jerome A. Osheroff, Jonathan M. Teich, Donald Levick, Luis Saldana, Ferdinand T. Velasco, & Dean F. Sittig, 2012)


 * Event-driven Alerts (Data-triggered) and Reminders (Time-triggered):** A common type of CDS intervention, typically an unsolicited message to a clinician about a patient's care or status that requires attention. Both alerts and reminders are not triggered by a user task, but instead raise awareness of events that are occurring throughout the care system: new highly abnormal lab results, new admissions or discharges of a physician’s primary care patients, consultant encounters, and many more. They can also detect important non-events that have not occurred in a prescribed period of time, such as failure to have a scheduled imaging study or a patient in a physician’s panel that has not had a health-maintenance visit in a long time. Fundamentally, alerts and reminders prevent errors of omission and commission, and lead to faster response to critical conditions. Typically, important data-driven alerts must reach the target user through a notification mechanism, such as paging, secure email, or appearance on a panel-wide notification screen. Lower-urgency reminders which can wait for the patient’s next real encounter can be displayed on the patient’s electronic-record facesheet. (Jerome A. Osheroff, Jonathan M. Teich, Donald Levick, Luis Saldana, Ferdinand T. Velasco, & Dean F. Sittig, 2012)


 * Local Adaptation:** Specifying when, where and by whom a given artifact can be used. This may include but is not limited to substitutions for local services & data elements.


 * Mapping:** Mapping of data elements and actions within a CDS Knowledge Artifact to local data elements and actions within the CDS System.


 * Structural Transformations:** Translating the format from the HeD approved standard to a format that is used by the CDS System (e.g. storing it in the database schema).


 * In Scope Artifact Type Definitions**
 * **Event Condition Action Rule: **An ECA rule has the general syntax "on event if condition is true do action.”
 * The event part specifies the signal that triggers the invocation of the rule
 * The condition part is a logical test that, if satisfied or evaluates to true, causes the action to be carried out
 * The action part consists of execution of operations. These actions may in turn cause further events to occur, which may in turn cause more ECA rules to fire (Wikipedia), (Pissinou, et al., 1994), (Papamarkos, Poulovassilis, & Wood, 2006)
 * **Documentation Templates:** A structured form for recording information on a patient into a set of pre-defined data slots.
 * **Order Set:** A pre-defined and approved group of orders related to a particular clinical condition (e.g., hypertension treatment and monitoring) or stage of care (e.g., hospital admission to Coronary Care Unit). Often the order set consists of both diagnostic and therapeutic orders. The goals in creating order sets are to standardize care, increase compliance with best clinical practices, and facilitate the order entry process.

=Works Cited= Jerome A. Osheroff, M. F., Jonathan M. Teich, M. P., Donald Levick, M. M., Luis Saldana, M. M., Ferdinand T. Velasco, M., & Dean F. Sittig, P. (2012). //Improving Outcomes with Clinical Decision Support:An Implementer's Guide, Second Edition.// Scottsdale Institute, AMIA, AMDIS and SHM.

Papamarkos, G., Poulovassilis, A., & Wood, P. T. (2006). Event-condition-action rules on RDF metadata in P2P environments. //Computer Networks (http://www.sciencedirect.com/science/article/pii/S1389128605003683)//, 1513-1532.

Pissinou, N., Snodgrass, R. T., Elmasri, R., Mumick, I. S., Özsu, M. T., Pernici, B., et al. (1994, 03). //Towards an Infrastructure for Temporal Databases: Report of an Invitational ARPA/NSF Workshop.// Retrieved 08 13, 2012, from http://www.cs.arizona.edu/~rts/pubs/SIGMODRecordMarch94p35.pdf

//Wikipedia//. (n.d.). Retrieved 08 13, 2012, from Wikipedia: http://en.wikipedia.org/wiki/Event_condition_action

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