Decision Support Bulk Export

How the Decision Support System fits together

There are two sets of linked tables that support Mirah’s decision support functionality.


The first is the setup instructions:

  • Entity Decision Algorithm supplies the configuration for what decision support is going to trigger, including what dates and the population of patients it applies to, and other settings.
  • Workflow is a specific action that an algorithm can trigger. For example, ‘if the patient endorses a self harm item…”.
  • Workflow Action is a specific action, either taken by the system or instructing the provider. For example:
    • “Add the patient to a given treatment track” (system)
    • “Complete a safety planning exercise for the patient” (instruction to provider)

These combine as follows:

  • Configure an algorithm to run on all patients currently in outpatient treatment… (entity decision algorithm)
  • Which triggers a workflow whenever a patient endorses a self harm item…(workflow)
  • That prompts them to do a safety plan (workflow action)

Whenever the triggering event occurs, an additional set of tables include information about what steps have happened for that particular patient:

  • Triggered Decision Algorithm links to Entity Decision Algorithm and a particular Episode of Care to show that this episode of care has been triggered by the algorithm.
  • Triggered Workflow shows that a particular workflow has been triggered for this patient, and is linked to the Triggered Decision Algorithm
  • Triggered Workflow Action shows the actions that are available for this patient
  • Triggered Workflow Action Log shows which actions were actually taken by the system or by a provider
  • Provider Notification shows the inbox notifications and emails sent to a provider

Entity Decision Algorithm

The Entity Decision Algorithm represents at a top level a Decision Support algorithm that is in use.

Column

Name

Format

Nullable

Description

Notes
id ID uuid false The mirah internal identifier of the algorithm
name Name string false The visible name of the algorithm
notes Notes string true Additional notes displayed as context for the algorithm
params Params json true Additional configuration params This is mirah internal and is not well documented for external use but is provided as context
sendNotifications Send Notifications? boolean false Whether notifications will be sent for this algorithm Providers will receive alerts in their inbox either way but this governs if emails will be sent
startDate Start Date datetime true The first date for which this algorithm will process data
status Status Active | paused | hidden | disabled false Is this algorithm active

Paused = algorithm will not trigger but existing alerts will be visible

Hidden = algorithm triggers but alerts will not be generated

Disabled = algorithm will not be triggered and alerts are hidden
workflowNote Workflow Note string false Additional information surfaced to the provider when the workflow triggers This can be used to customize instructions etc

Workflow

A set of potential decisions and actions that can be triggered by an event. Generally only one workflow is active per algorithm per episode of care at a time. The highest priority algorithm will take precedence.

Column Name Format Nullable Description Notes
id Id uuid false The mirah identifier
callToAction Call To Action string false The top description of the workflow designed to spur action E.g. “Patient has reported self harm”
defaultPriority Default Priority integer false The priority of this workflow
description Description string true An optional description of this workflow
emailBody Email Body string false The body of the email that is constructed when the workflow triggers
emailSubject Email Subject string false The subject of the email that is constructed when the workflow triggers
instructions Instructions markdown true The set of instructions that will be displayed to users when this workflow triggers
notificationMode Notification Mode Send_email | no_email false Whether emails will be sent
title Title string false The name of the workflow
createdAt Created At datetime false

updatedAt Updated At Datetime false

Workflow Action

An action that can be taken as part of a workflow, either by the system or as a prompt for a provider. For example - ‘add a patient to a treatment track’, or ‘complete safety planning with a patient’.

Column Name Format Nullable Description Notes
id Id uuid false The mirah identifier
phase Phase Manual | before | after false When this action occurs

Manual: this action can only be triggered by a user.


Before: this action will automatically trigger when the workflow starts


After: this action will automatically trigger when the workflow completes
reusable Reusable boolean false Whether this action can be used multiple times
sideEffectParams Side Effects json true This is an internal column which includes state on how to trigger parameters
text Text string false The text to display for this action
createdAt Created At datetime false

updatedAt Updated At Datetime false

workflowId Workflow Id uuid false The workflow this action is associated with

Triggered Decision Algorithm

This table represents the triggering of an algorithm for a particular patient’s episode of care.

Column Name Format Nullable Description Notes
id Id uuid false The mirah identifier
context Context json true An internal blob of information containing useful additional context on how the algorithm was triggered
status Status Active | complete | canceled false The status of this algorithm
triggeredAt Triggered At datetime false When the algorithm was triggered
careEpisodeId Care Episode Id uuid false The episode of care this algorithm has been triggered for
entityDecisionAlgorithmId Entity Decision Algorithm Id uuid false The algorithm triggered


Triggered Workflow

An active workflow for an episode of care.


Column Name Format Nullable Description Notes
id Id uuid false The mirah identifier
activeSince Active Since datetime false When this workflow became active
isCurrentlyTriggered Currently Triggered boolean false Is this workflow currently active
priority Priority integer false The priority of this workflow Only one workflow can be active for the same algorithm at the same time
reasons Reasons string true A text based summary of why this workflow was triggered E.g. “The patient scored a 14 on the PHQ-9 which is above the threshold of 7”
snoozedUntil Snoozed Until datetime true This item is snoozed until this time
status Status Active | snoozed | complete | canceled false The status of this item
triggeredAt Triggered At datetime false When this item was triggered
statusUpdatedById Status Updated By Id uuid true The user id who updated the status last
triggeredDecisionAlgorithmId Triggered Decision Algorithm Id uuid false The reference to Triggered Algorithm Decision
workflowId Workflow Id uuid false The reference to Workflow


Triggered Workflow Action

An action for a particular Triggered Workflow that may be taken.


Column Name Format Nullable Description Notes
id Id uuid false The mirah identifier
status Status Available | used false The status of the action

Available: this action can be taken

Used: this action has already been taken
createdAt Created At Datetime false

updatedAt Updated At Datetime false

triggeredWorkflowId Triggered Workflow Id uuid false Which Triggered Workflow this refers to
workflowActionId Workflow Action Id uuid false Which Workflow Action this refers to


Triggered Workflow Action Log

A log of the actions taken for a workflow.


Column Name Format Nullable Description Notes
id Id uuid false The mirah identifier
triggeredWorkflowActionId Triggered Workflow Action Id uuid false The Triggered Workflow Action used
userId User Id uuid false The user taking the action
usedAt Used At Datetime false When the action was taken


Provider Notification

A notification sent to an individual provider regarding a triggered workflow.


Column Name Format Nullable Description Notes
id Id uuid false The mirah identifier
sentAt Sent At datetime true If a notification was sent, when it was emailed
createdAt Created At datetime false

updatedAt Updated At datetime false

providerId ProviderId uuid false The provider receiving the notification
triggeredWorkflowId Triggered Workflow Id uuid false The triggered workflow requiring notification