Tire Swing Analogy: Using Plexina for Enhancing Quality Assurance

3 minute read in Our Work

Quality Assurance (QA) in the creation of CDS assets deployed in the EHR shares the same considerations of QA as manufacturing and software engineering. The goal is to deploy CDS tools in the EHR that meet objectives and specifications, are free of defects, and work properly when used by clinicians at point of care.

Wikipedia explains QA well, but allow me to contextualize how the Plexina platform in itself is a quality system supporting Quality Assurance.

The Plexina platform implements many features to support both administrative and procedural activities. Plexina is a quality system enabling the requirements and goals of CDS assets to be effectively deployed. Plexina systematically measures the development and validation progress, compares content to standards, formalizes testing and review processes, and provides a feedback loop from clinical knowledge contributor, reviewer to implementer. This ensures that what you conceived in order set development actually reaches production the way it was intended.

This is what happens when you don’t do quality assurance well.

General Plexina CDS Creation Process

The general process of CDS content creation in Plexina involves a straight-forward process. Please note that Plexina is agile and this process is usually iterative. The major stages of the process include: Conceptualization, Intake/Triage, Translation, Design/Transformation, Collaborative Design Review, Configuration, Release/Deployment.

Of course Maintenance may follow many of the same steps, but with much less content to deal with. Plexina supports maintenance with transparent version control and change control, with many reports to help detect and assess the impact of change, and illustrate the progressive states of the CDS content.

At any point, any content requirements and changes are fully documented, status through the client’s development workflow is tracked, and progress reports give governance tools to manage effectively.

Efficiency through Patented Automation

Additionally, at key points, Plexina fully automates very laborious tasks typically found in the CDS transformation process.

Real-time Mapping

Specifically, Plexina automatically maps concepts from your source to your target EHR’s terminology, or that of a standard. With a streamlined validation step, Plexina produces 100% accurate mapping in 98% less time.

“Plexina allowed me to validate the order set in 30 minutes instead of 30 hours.”

Dr. Peter Jamieson

This automated process instantly enumerates the work that needs to be done and creates a measurable means to quantify the progress.

Realistic Preview

Plexina also creates EHR realistic previews for review, thus allowing clinicians to get a realistic sense of how the CDS content will look. This reduces the number of reviews required, eliminates potential for translation errors, makes efficient use of key clinician time, and accelerates the delivery timeline.

Configuration Generation

Turning a CDS concept from a design to an actual artefact in the EHR is a simple push button. However, we’ve taken this further and combined it with a simple and robust release management process so you are aware of what version of CDS content is deployed in the EHR.


With Plexina’s bi-directional integration with the EHR, centralized deployment co-ordination, and intelligent patented comparative technology, Plexina can verify the configuration of the CDS meets design, and be consistent in all environments in which it is deployed. This is a 100% automated task, validating 100% of the content at every level of detail, and producing interactive gap reports that help you quickly drill down to the issue.

In addition to these major time saving capabilities, throughout Plexina you’ll find dozens of quality centric features that ensure what is deployed is what was designed and approved. The automation ensures complete coverage, and efficiency.