Data Export - Decision Support System | Mirah Collaborative Care User Guide

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

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