Open Clinical Decision Support (OpenCDS)

General Information

Technologies must be operated and maintained in accordance with Federal and Department security and privacy policies and guidelines. More information on the proper use of the TRM can be found on the TRM Proper Use Tab/Section.

Website:	Go to site
Description:	OpenCDS is a multi-institutional, collaborative effort to develop open-source, standards-based clinical decision support (CDS) components and resources that can be widely adopted to enable CDS at scale. OpenCDS provides a reference implementation of the Decision Support Service (DSS) standards adopted by the Health Level 7 (HL7) and Object Management Group (OMG) standards development organizations. The DSS standards specify a standard interface for providing clinical decision support as a software service, and is a part of a larger effort to standardize software service interfaces for health care known as the HL7-OMG Healthcare Services Specification Project. OpenCDS uses a flattened form of the Virtual Medical Record (vMR) internally as its data model. OpenCDS can also communicate with external systems using an XML form of the vMR. vMR is a standard HL7 data model optimized specifically for clinical decision support. OpenCDS does not utilize a database. Any data generated by this technology is saved to the user`s local drive.
Technology/Standard Usage Requirements:	Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.
Section 508 Information:	This technology has not been assessed by the Section 508 Office. The Implementer of this technology has the responsibility to ensure the version deployed is 508-compliant. Section 508 compliance may be reviewed by the Section 508 Office and appropriate remedial action required if necessary. For additional information or assistance regarding Section 508, please contact the Section 508 Office at Section508@va.gov.
Decision:	View Decisions

Decision Source:	TRM Mgmt Group
Decision Process:	One-VA TRM v20.12
Decision Date:	12/07/2020 at 22:46:20 UTC
Aliases:	OpenCDS
Introduced By:	TRM Request
Vendor Name:	Dr Kensaku Kawamoto

Vendor Release Information

The Vendor Release table provides the known releases for the TRM Technology, obtained from the vendor (or from the release source).

Version	Release Date	Vendor End of Life Date	Vendor Desupport Date
1.1	09/17/2012
1.2	05/16/2014
2.0	01/09/2015
2.1.x	10/20/2015

Current Decision Matrix (12/03/2020)

Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.

The VA Decision Matrix displays the current and future VA IT position regarding different releases of a TRM entry. These decisions are based upon the best information available as of the most current date. The consumer of this information has the responsibility to consult the organizations responsible for the desktop, testing, and/or production environments to ensure that the target version of the technology will be supported. Any major.minor version that is not listed in the VA Decision Matrix is considered unapproved for use.

Legend:

White	Approved: The technology/standard has been approved for use.
Yellow	Approved w/Constraints: The technology/standard can be used within the specified constraints located below the decision matrix in the footnote[1] and on the General tab.
Gray	Unapproved: This technology or standard can be used only if a POA&M review is conducted and signed by the Authorizing Official Designated Representative (AODR) as designated by the Authorizing Official (AO) or designee and based upon a recommendation from the POA&M Compliance Enforcement, has been granted to the project team or organization that wishes to use the technology.
Orange	Divest: VA has decided to divest itself on the use of the technology/standard. As a result, all projects currently utilizing the technology/standard must plan to eliminate their use of the technology/standard. Additional information on when the entry is projected to become unapproved may be found on the Decision tab for the specific entry.
Black	Prohibited: The technology/standard is not (currently) permitted to be used under any circumstances.
Blue	Planning/Evaluation Constraint:The period of time this technology is currently being evaluated, reviewed, and tested in controlled environments. Use of this technology is strictly controlled and not available for use within the general population. If a customer would like to use this technology, please work with your local or Regional OI&T office and contact the appropriate evaluation office displayed in the notes below the decision matrix. The Local or Regional OI&T office should submit an inquiry to the TRM if they require further assistance or if the evaluating office is not listed in the notes below.

Release/Version Information:

VA decisions for specific versions may include a ‘.x’ wildcard, which denotes a decision that pertains to a range of multiple versions.

For example, a technology approved with a decision for 7.x would cover any version of 7.(Anything) - 7.(Anything). However, a 7.4.x decision would cover any version of 7.4.(Anything), but would not cover any version of 7.5.x or 7.6.x on the TRM.

VA decisions for specific versions may include ‘+’ symbols; which denotes that the decision for the version specified also includes versions greater than what is specified but is not to exceed or affect previous decimal places.

For example, a technology approved with a decision for 12.6.4+ would cover any version that is greater than 12.6.4, but would not exceed the .6 decimal ie: 12.6.401 is ok, 12.6.5 is ok, 12.6.9 is ok, however 12.7.0 or 13.0 is not.

<Past

CY2023

CY2024

CY2025

Future>

Release

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

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Q3

Q4

1.1

Unapproved

1.2

Unapproved

2.0

Unapproved

2.1.x

Unapproved

Decision Constraints


[1]	Users should check with their supervisor, Information Security Office (ISO) or local OIT representative for permission to download and use this software. Downloaded software must always be scanned for viruses prior to installation to prevent adware or malware. Freeware may only be downloaded directly from the primary site that the creator of the software has advertised for public download and user or development community engagement. Users should note, any attempt by the installation process to install any additional, unrelated software is not approved and the user should take the proper steps to decline those installations.

[2]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500.

[3]	Technology must remain patched and operated in accordance with Federal and Department security policies and guidelines in order to mitigate known and future security vulnerabilities.

[4]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500.

References

The following reference(s) are associated with this entry:
Type	Name	Source	Description
There are no references identified for this entry.

Technology Components

Note: This list may not be complete. No component, listed or unlisted, may be used outside of the technology in which it is released. The usage decision for a component is found in the Decision and Decision Constraints.
Name	Description
Apelon DTS	The Distributed Terminology System (DTS) is an open-source and full-featured terminology support framework provided and serviced by Apelon. It includes the ability to maintain the content of medical vocabularies, and to maintain the relationships and mappings from one vocabulary to another.
Data Mappers	Maps structured data from standards such as Continuity of Care Document (CCD), Continuity of Care Record (CCR), Clinical Document Architecture (CDAr2), and C32 into the Virtual Medical Record (vMR) structure.
Drools DSL	Drools has the ability to create a domain specific language (DSL) for intuitive knowledge authoring. Users hide all of the technical details of knowledge authoring behind clinician-friendly interfaces using the OpenCDS DSL. This allows the "clinical rule author" to develop rules by selecting components which describe the relevant clinical aspects in a common clinical language. Users also use drop-down list selection for the concepts based in standard vocabularies.
DSS Wrappers	Wrapped Web services can be created for other CDS engines. The Health Level Seven (HL7) Infobutton standard uses this interface. OpenCDS wrappers are produced for existing CDS systems, including a system known as SEBASTIAN previously developed by Dr. Kawamoto and several other CDS systems.
JBoss Drools	Drools is an open-source inferencing engine supported by JBoss. It includes authoring and knowledge management tools at two levels: Web-based knowledge creation, testing, versioning and packaging using a built-in Drools tool named "Guvnor" ("KIE" in the latest version), and low-level technical rule creation and testing using the open-source Eclipse Integrated Development Environment (IDE) for Drools and Java. JBoss Drools and the Guvnor knowledge management tool are central components of OpenCDS.
JBoss jBPM	JBoss jBPM is an open-source business process management suite. OpenCDS uses JBoss jBPM to enable the use of flow diagrams to represent clinical decision logic.

VA Categories View the VA Categorization Framework

Domain Area	Category	Customer Guidance	Category Locked By ELT Date
Health Care Administrative	Health Delivery Support

Open Source

This entry is available as an open source technology.

Operating Systems Supported by the Technology

macOS - Approved w/Constraints
Red Hat Enterprise Linux (RHEL) - Approved w/Constraints
Windows Client - Approved w/Constraints

Technologies/Standards Relationships

Runtime Dependencies:

Comparable Technologies:

No comparable entries have been identified.

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

This is a mature technology.
There are no known Common Vulnerabilities and Exposures (CVEs) associated with this product at the time of writing.
This product can be acquired without cost through open source licensing and supports VA’s open source initiative.

Adoption Risks

This technology has the potential to collect, store, or transmit Personally Identifiable Information (PII), Protected Health Information (PHI), and/or other sensitive VA data.
Access to technical documentation for this product requires users to register as a collaborator for this project.
Support for this product may be limited to community support.
Per the Microsoft System Center Configuration Manager (SCCM), BDNA, and IBM BigFix scans on July 29, 2019, there were no instances of this technology found on VA’s network.

Architectural Benefits

This technology is portable as it runs on multiple VA approved platforms.

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VA Technical Reference Model v 24.7

General Information

Vendor Release Information

Current Decision Matrix (12/03/2020)

Decision Constraints

References

Technology Components

VA Categories View the VA Categorization Framework

Open Source

Operating Systems Supported by the Technology

Technologies/Standards Relationships

Runtime Dependencies:

Comparable Technologies:

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

Adoption Risks

Architectural Benefits

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VA Technical Reference Model v 24.7

General Information

Vendor Release Information

Current Decision Matrix (12/03/2020)

Decision Constraints

References

Technology Components

VA Categories View the VA Categorization Framework

Open Source

Operating Systems Supported by the Technology

Technologies/Standards Relationships

Runtime Dependencies:

Comparable Technologies:

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

Adoption Risks

Architectural Benefits

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