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201801 CDS Hooks

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Return to Jan 2018 Proposals

CDS Hooks

Submitting WG/Project/Implementer Group

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. Over the four Connectathon tracks, the CDS Hooks project has garnered immense support and interest from a variety of organizations. At the Connectathon in San Diego (Sept 2017), we had participation from 4 EHR vendors, many more CDS service providers, and 32 developers.

CDS Hooks has been presented at the American Medical Informatics Association (AMIA) 2016 Annual Symposium, the AMIA 2017 Annual Symposium, and the Argonaut Project has chosen CDS Hooks as a focus for 2017.

Organizing a CDS Hooks track at the January 2018 Connectathon would allow the community to further develop and explore the possibilities with CDS Hooks. Holding another Connectathon track for CDS Hooks will further draw more developers and companies to HL7 and allow the community to work within the FHIR ecosystem. Additionally, the CDS Hooks community has found great benefit from participating in the Connectathons so continuing that participation would be appreciated.

Proposed Track Lead

Kevin Shekleton

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

See Connectathon_Track_Lead_Responsibilities

Expected participants

  • Cerner
  • Epic
  • athenahealth
  • T-System
  • University of Utah - OpenInfobutton
  • many, many, more

Please sign up in the google sheet!


CDS Service

The CDS Service role provides real-time clinical decision support as a remote service. The CDS Server is invoked on a desired hook and returns the decision support in the form of CDS cards.


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.


Implement 1.0 spec

Action: Both the EHR and CDS Service fully implement the 1.0 spec (includes security)
Precondition: N/A
Success Criteria: TDB
Bonus point: N/A

Implement Infobutton features using 1.0 spec

Display a CDS suggestion card with links to relevant resources and a CDS App Card showing condensed results of a SMART app called “Clinical Knowledge Summary” (CKS) with a link to launch the app

Action: The EHR triggers either a patient-view hook or a medication-prescribe hook to the subscribed CDS Service, which returns a CDS suggestion card and/or an card with condensed search results and a link to the SMART app
Precondition: An EHR user opens up a patient’s chart or enters a medication prescription
Success Criteria: The EHR displays (1) a suggestion card with links to patient education materials in MedlinePlus and drug monographs within UpToDate; and an app card with the number of Systematic Reviews and Clinical Trials found by the CKS app along with a link that successfully launches the app with the appropriate search results.
Bonus point: The CDS suggestion card is only returned when results are found.

Connectathon Recap