201605 CDS Hooks Connectathon Track Proposal

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CDS Hooks

Submitting WG/Project/Implementer Group

The CDS Hooks community, composed of vendors, developers, and CDS service providers whom support the CDS Hooks proposal.

Justification

CDS Hooks allow for a very important use of both FHIR and SMART that is outside of the normal transactional flow of data. With CDS Hooks, EHRs can further integrate FHIR and SMART into the workflow with clinical decision support. At the January 2016 HL7 WGM in Orlando, we held the first Connectathon track focused around CDS Hooks. This track garnered immense interest and support, with over 10 different companies and 20 individuals participating in the track. The work done as a result of that first Connectathon demonstrated that FHIR could be leveraged in open and interoperable and clinical decision support.

Organizing a second CDS Hooks track at the May 2016 Connectathon would allow the community to further develop and explore the possibilities with CDS Hooks. Coming out of the Connectathon in January 2016, there were several aspects of CDS Hooks that require more thought and analysis that was apparent from the implementers and holding another track would benefit the CDS Hooks community. CDS Hooks would be also exposed to the larger FHIR community, allowing others to see how FHIR can be used to provide clinical decision support in the EHR.

Note that there is another CDS related track at this connectathon [1]

Proposed Track Lead

Kevin Shekleton

  • Email: kevin dot shekleton at cerner dot com
  • Skype: kevin.shekleton

See Connectathon_Track_Lead_Responsibilities

Expected participants

Fill out our sign-up sheet!

Please sign up to participate using our sign-up sheet in Google Docs. Be sure to provide your basic contact details on the first tab, and then details about any EHR or CDS Services you'll be bringing to the table on the 2nd and 3rd tabs.

  • Cerner (Kevin Shekleton) [EHR, CDS Service]
  • SMART Health IT (Josh Mandel) [EHR, CDS Service]

Roles

EHR

The EHR will allow for the registration of interested CDS services on various CDS hooks, triggering each appropriately. The EHR will also display the CDS cards (obtained from the CDS services) to the user.

CDS Service

The CDS service will register themselves for the CDS hooks they are interested in and return CDS cards in response to trigger events as necessary.

Scenarios

1 Display a CDS Information Card when opening a patient record (patient-view)

Action: The EHR triggers a patient-view hook to the subscribed CDS Service, which returns a CDS information card.
Precondition: N/A
Success Criteria: The EHR displays the resultant CDS information card.
Bonus point: The CDS information card contains contextually relevant data about the patient based upon information about the patient from the FHIR server.

2 Display a CDS App Link Card when opening a patient record (patient-view)

Action: The EHR triggers a patient-view hook to the subscribed CDS Service, which returns a CDS app link card.
Precondition: N/A
Success Criteria: The EHR displays the resultant CDS app link card and clicking the app link launches the desired SMART app.
Bonus point: The CDS app link card is only returned based upon contextually relevant data from the patient.

3 Display a CDS Information Card commenting on a prescription at prescribing time (medication-prescribe)

Action: The EHR triggers a medication-prescribe hook to the subscribed CDS Service, which returns a CDS information card to be displayed to the user in a non-modal view.
Precondition: An EHR user is in the process of writing a prescription
Success Criteria: The EHR displays the resultant CDS suggestion card to change the prescription-in-progress for the patient. If the user clicks to accept the suggestion, the prescribing screen is updated to reflect the change.
Bonus point: The CDS suggestion card is only returned when it is contextually relevant (i.e. no information card should say the equivalent "nothing to report").

4 Display a CDS Suggestion Card to Cancel a Medication at order review time (order-review)

Action: The EHR triggers an order-review hook to the subscribed CDS Service whom returns a CDS suggestion card to cancel the proposed order.
Precondition: A proposed order exists for the patient.
Success Criteria: The EHR displays the resultant CDS suggestion card to cancel the proposed order for the patient. If the user selects to accept the suggestion, the proposed order is canceled.
Bonus point: The CDS suggestion card is only returned based upon contextually relevant data from the patient. For instance, perhaps the medication is only suggested for cancellation if the patient is allergic to the medication.

5 Display a CDS Suggestion Card to Order an additional Medication at order review time (order-review)

Action: The EHR triggers an order-review hook to the subscribed CDS Service whom returns a CDS suggestion card to create a new medication.
Precondition: A proposed order exists for the patient.
Success Criteria: The EHR displays the resultant CDS suggestion card to replace the proposed order for the patient with a new order. If the user selects to accept the suggestion, the proposal is accepted.
Bonus point: The CDS suggestion card is only returned based upon contextually relevant data from the patient. For instance, perhaps the medication is only suggested for replacement if a cheaper suitable medication is found.