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201609 CDS Hooks

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CDS Hooks

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


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.

At the May 2016 Connectathon in Montreal, we again had a great turnout of support for participants from several clients and two leading EHR vendors. We further developed the CDS Hooks specification, with all participants implementing and providing feedback on major changes to the specification.

Organizing a CDS Hooks track at the September 2016 Connectathon would allow the community to further develop and explore the possibilities with CDS Hooks. Coming out of the Connectathon in May 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.

Proposed Track Lead

Kevin Shekleton

  • Email: kevin dot shekleton at cerner dot com
  • Zulip: Kevin Shekleton

See Connectathon_Track_Lead_Responsibilities

Expected participants

  • Harvard, Josh Mandel
  • Cerner, Kevin Shekleton
  • RxREVU
  • Intermountain
  • Stanson Health, Inc
  • Epic
  • Healthwise
  • Prime Dimensions
  • Premier, Inc
  • HSPC
  • Polyglot

Summary & Report

The summary & report presentation of the work done during the Connectathon is available here.



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.


Display SMART App Link

Action: The EHR triggers a patient-view hook to the subscribed CDS Service, which returns a CDS app link card containing a link to a SMART app
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: N/A

Implement Security

Action: The EHR triggers a patient-view hook to the subscribed CDS Service using the security defined in the CDS Hooks specification
Precondition: N/A
Success Criteria: The CDS information card contains contextually relevant data about the patient based upon information about the patient from the FHIR server, all using a security context.
Bonus point: N/A