Glossary

Activation
A set of deliverables and activities to prepare for and conduct the go-live of the clinical information system and localized workflows within a specific site.
Bedside Medical Device Integration (BMDI)
This refers to clinical data automatically being electronically transferred from medical devices, such as ventilators and hemodynamic monitors, into the patient’s record.
Cerner Corporation
A health care information technology company, supplying software, services and hardware to health care organizations around the world.
Change management
This enables the transition from current state to the desired state by informing, involving and preparing the impacted individuals and groups. The CST Change Management Team is made up of change professionals representing VCH, PHSA and PHC. This team will partner with site leaders and, through the use of tools and processes, support all individuals affected by CST.
Clinical & Systems Transformation (CST)
A joint initiative of Vancouver Coastal Health, Provincial Health Services Authority and Providence Health Care to transform health care delivery systems and processes to improve the quality and consistency of the patient and caregiver experience. CST will support the health organizations in establishing common clinical and process standards, including workflows, order sets, clinical guidelines, integrated plans of care and a common electronic health record. This clinical transformation will be supported by the implementation of a clinical information system that will replace aging existing systems. The project will be implemented in stages across the health organizations.
Clinical information system
A computer system designed for collecting, storing, amending and retrieving information relevant to health care delivery.
Closed loop medication management
A fully electronic medication management process (ordering, verifying, preparing and administering), in which all relevant information is documented seamlessly.
Computerized provider order entry (CPOE)
The practice by which providers (physicians, midwives, nurse practitioners, clinical pharmacists and dentists) enter their orders for patient treatment electronically, rather than writing them on paper and having them transcribed.
Deliverable
A project management term for something that must happen (i.e. a document or task). If it doesn't, items dependent on that deliverable will be delayed, which can have a ripple effect on the timeline of the project.
Design/configuration teams

Design/configuration teams, in collaboration with Cerner and subject matter experts from VCH, PHSA and PHC, are responsible for developing future state workflows that incorporate the clinical information system, streamline care and support delivery of safe patient care; defining requirements (clinical, functional and business) for the new clinical information system; configuring content within the clinical information system based upon evidence and Canadian, regulatory and patient safety requirements; making design decisions related to configuration of functionality and tools within the clinical information system; and contributing to testing and training.

Each team includes a full-time manager or lead; full-time team members from VCH, PHSA, PHC and Cerner; and part-time subject matter experts.

Enterprise Master Patient Index (EMPI)
A Ministry of Health database that contains demographic information and personal health numbers of all clients of the publicly funded health system in BC.
Health Information Management (HIM)
This refers to the practice of acquiring, analyzing and protecting digital and traditional medical information for purposes related to patient care, institutional management, health care policies, planning and research.
Health Organizations
The three organizations involved in CST: Vancouver Coastal Health (VCH), the Provincial Health Services Authority (PHSA) and Providence Health Care (PHC).
HIMSS Level 5

HIMSS is the Healthcare Information Management and Systems Society and HIMSS Level 5 is a level on their "EMR Adoption Model". At this level, a clinical information system is capable of:

  • storing medical information centrally; 
  • automating flow sheets; 
  • sharing digital medical images; 
  • alerting users to possible problems (e.g. drug-to-drug interactions, allergies); 
  • allowing care providers to enter orders into a computerized system (CPOE); 
  • making standard clinical protocols available automatically, and; 
  • closed loop medication management.
Interfaces
A bridge to close the gap between two systems that weren’t designed to work together. Interfaces are being designed as connection points between existing systems and the new clinical information system.
North York General Hospital's eCare project
As part of the eCare project, Ontario's North York General Hospital replaced its manual systems with computerized provider order entry (CPOE) and closed loop medication management systems in October 2010.
Order set
A group of bundled standard orderables (a health care provider's instructions or directives to other health care workers regarding the treatment of a patient). These have been designed based on a condition, disease or procedure. The content of order sets can be modified or amended based on the needs of the specific patient. Order sets are the electronic equivalent of pre-printed orders.
PARIS
The Primary Access Regional Information System (PARIS) is an information system used by Vancouver Coastal Health, which is designed specifically for providing Community Health services.
Provider
Any health care professional licensed to prescribe or write an order, including physicians, midwives, nurse practitioners, clinical pharmacists and dentists.
Provider Decision Group (PDG)
A decision-making body that gives leadership and direction for providers' (physicians, midwives, nurse practitioners, pharmacists and dentists) content within the CST project and related projects. The group is made up of a team of providers, as well as CST project leaders and advisors.
Provider documentation
Structured electronic charting using templates that capture discrete data. It is distinct from electronic clinical documentation, which refers to documentation completed by nurses and allied health professionals in a clinical information system or electronic health record.
Stabilization
The process of ensuring adequate support and issue resolution required to ensure ongoing clinical adoption and use.
Standardization
The process of aligning our current clinical processes, policies and procedures, based on leading practices, to meet agreed-upon standards. Standardization is, in itself, a leading practice because it supports patient safety by reducing errors and enhancing the data quality of patient information captured within a clinical information system. Standardization does not replace clinical decision-making. Rather, the introduction of new standards helps ensure that common goals and practices are in place across similar clinical areas to deliver the best care.
Subject matter expert (SME)
A person who is considered to be an authority in a particular area. CST subject matter experts contribute as clinical experts to shape how best practice will be reflected in the standards, processes and system. They attend design sessions and provide feedback; provide information about the way things are done now; contribute to the development of future workflows; and review and validate the content of the clinical information system.
Technical environment
This refers collectively to the infrastructure that supports the clinical information system, interfaces (connection points between existing systems and the new clinical information system) and devices.
Tracking board
An electronic display or notice board that helps communicate patient movement in a hospital.
Transformation roadmap
This outlines the sequence in which sites across VCH, PHSA and PHC will activate the new clinical information system and localized workflows.
Zynx
An American corporation specializing in providing evidence-based clinical decision support systems. CST is using a Zynx tool to allow a wide cohort of providers to collaborate in the development of order sets.