What does a 'success' card represent?

[cds-hooks]

What does a 'success' card represent?

[kpshek]

@jmandel - Do you have thoughts on the success indicator since you came up with our original indicators (success, info, warning, and hard-stop)? I admit that I don't know when a CDS service would use that particular indicator value.

@robs16 - I logged #29 several days ago to address documenting what should be returned from the CDS service in the case that no decision support is required. Let's continue the discussion on that question over there.

[jmandel]

When I was putting this together, I just grabbed terms from bootstrap to have something quick to work with. So the short answer is: we might strip this out altogether.

If I had to justify, I guess the best I could do would be: "a card communicating the fact that a user's choice 'looks good' to the CDS system".

-J

[kpshek]

Thanks @jmandel!

Based upon this, my opinion is we remove 'success' as an indicator option. While there is a semantic difference between "your choice looks good" and "there is no decision support", I'm not sure this is needed. When I think about Cerner's proprietary rule engine and the 3rd party rules we have incorporated today, none of them offer a "your choice looks good" message to the user (at least none that I am aware of).

I'd love to hear other thoughts on this.

[jmandel]

If nobody says they want it, I'm A-OK with stripping it!

[robs16]

In my opinion, there is a need for something like 'success' though not necessarily implemented as a card. #29 suggests an empty set of cards, but you cant get to a solution for #13 without some data in the response (not saying this must be a card).

[brynrhodes]

I agree with the ability to represent "success", possibly even with a message, though that message may not be given to the user in that case. For example, we have decision support right now where we want to say "we looked at the meds you provided and they did not have any opioids". The user might not care, but it might be useful for retrospective analysis of how the service was used.

[jmandel]

We should be clear to separate out the issue of saying "the CDS Service ran successfully", from a user-facing card indicating a happy message. This issue is about the latter. If we want to contemplate the former, let's capture it in a separate issue?

[kpshek]

Well put @jmandel.

#13 deals with something close to recording the fact that the CDS Service ran successfully and this needs to be recorded somehow. Let's continue the discussion with that use case there.

@robs16 - Do you have a need at Stanson Health for showing the user a card that informs them everything is good?

I've added this issue to our list of notable issues for Connectathon participants to weigh in on. It would be great to hear from other CDS Service providers to get their thoughts here.

[robs16]

I don't see a particular need to represent 'success' in a user-facing card.

[peremarshall]

I think there are times when an "everything is okay" message is good to convey, but the "info" card should be sufficient for this purpose.

[kpshek]

At the Madrid Connectathon this past weekend (2017-05-07), a large group of us participating in the CDS Hooks track discussed this issue in an offline discussion. This group of ~12 represented a broad set of stakeholders, from multiple EHR vendors, several CDS Service providers, and a healthcare organization. What follows is the summary of our discussion and the consensus of the group.

We all agreed that the success indicator value should be removed as no one could articulate a use case that warrants its inclusion. Additionally, we all agreed that cards should be user facing constructs.

What is the proper way to tell the consuming system that there were no suggestions/warnings/information? Note that this may be required and include extra information for supporting PAMA/etc.

Regarding this use case, we acknowledge this needs to be addressed. See #48 regarding discussion around a proposal for this.