Table 4.

Glossary of Implementation and EHR-related terms

Build	A broad term covering work that the CAH staff must do for the vendor so that the EHR system can be finalized for installation and use. Some of the build process involves providing CAH-specific data in a vendor-requested format (e.g. putting the charge master and pharmacy formulary into spreadsheets). Other activities include creating electronic templates for nursing documentation or physician order entry within the EHR. These templates capture the work steps represented on the paper forms that the CAH staff currently uses. Which forms the CAH builds and how these connect will affect the look and navigation of the final EHR for role-specific tasks and the overall workflow as each type of patient moves through the system.
Clinical Decision Support (CDS)	Is “HIT functionality that builds upon the foundation of an EHR to provide persons involved in care processes with general and person-specific information, intelligently filtered and organized, at appropriate times, to enhance health and health care.” [26] CDS, which is most often integrated into the CPOE module, can include the following: links to evidence-based reference sources; order templates updated with the latest best-practice treatments; alerts for drug-drug interactions, patient allergies and other reminders; relevant data presentation; and situation-specific flow sheets, and dashboards. [27]
Go-Live	Date when the new system is turned on and CAH staff begins to use it.
Integrated System	Is one in which the component modules effectively interact with each other to exchange data smoothly, without need for purchasing additional third-party interfaces to allow the components to interact.
Interface	Software that allows two systems to “talk” to each other so that data can move between them. An interface is necessary between each of a vendor’s system modules, but these are usually built in. Additional interfaces are necessary between the vendor’s EHR system and any systems you already have (e.g. picture archiving and communication “PACS” or financial systems from other vendors).
Interoperability	The ability of two or more systems or subcomponents to work together to exchange data correctly and smoothly.
Knowledge Management (KM)	Is “the process of capturing, distributing, and effectively using knowledge,” [28] KM encompasses CDS components, and the KM questions for the vendor become how much responsibility for, access to, and control over these does the CAH team have, who will update these, how, and when? [29]
Modules	Component parts of a system, such as the “nursing documentation” or “physician order entry” or “pharmacy” clinical applications within an integrated EHR system. Vendors also refer to subcomponents of a financial system, such as “accounts payable” or “third-party billing clearinghouse,” as modules.
Network Drop	Places where there is a physical connection for a computer to connect with the network. The CAH will need to determine where additional drops might need to be installed for computer workstations to access the EHR, and when and where staff will use wireless devices and a wireless network to do so.
Real-Time Dashboard	A type of automated reporting feature built into a user interface within a system that pulls in data from various modules in real time, so that the information displayed is up to date. Real-time dashboards can feature clinical or financial and other operations data.
Super Users	CAH staff members trained by the vendor on the EHR system, or a specific module, in advance of others and usually in more depth. Super users then help train other staff members and serve as go-to resources when others have questions.