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CDS Hooks Interface for Hacking Health Brisbane 2017 Track 6

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This page describes the interface for track 6 for Hacking Health Brisbane 2017 (see [[1]])

Basics

The cds-hook is 'order-review' - see [[2]].

Given the scenario described in the track, we assume that there's no call back to the EHR - so all data is provided via pre-fetch. Therefore, the EHR provides the following information:

  • hook = order-review
  • a hook instance
  • a user id
  • a patient
  • an encounter (e.g. information about the GP consultation)
  • a patient and and encounter resource matching those in the pre-fetch data
  • at least one Condition - (problem list for the patient, also in the prefetch data
  • one or more ProcedureRequest resources, for each test (or panel) requested by the clinician (in the context)
  • no oauth/redirect details

The service returns a set of cards (no profile on the response yet).

Implementations

There's an implementation at http://test.fhir.org/r3/cds-services/hacking-health. All that implementation does is return a card that describes technical issues with the submission from the EHR.

Example

{
 "hookInstance": "b18905aa-3e49-42e0-8d07-b757b3431a78",
 "hook": "order-review",
 "fhirServer": "https://localhost.oridashi.com.au:8102",
 "redirect": "https://localhost.oridashi.com.au:8102",
 "user": "2",
 "patient": "23",
 "context": [
   {
     "resourceType": "ProcedureRequest",
     "id": "45-7D396A146D1FD03A92F7230356FACDE6",
     "meta": {
       "versionId": "20170711021134",
       "lastUpdated": "2017-07-11T12:11:34.473+10:00"
     },
     "text": {
       "status": "generated",

"div": "

2017-07-11 B-HCG (QUANTITATIVE)

"

     },
     "status": "active",
     "code": {
       "text": "B-HCG (QUANTITATIVE)"
     },
     "subject": {
       "reference": "Patient/23"
     },
     "occurrenceDateTime": "2017-07-11"
   },
   {
     "resourceType": "ProcedureRequest",
     "id": "45-9FC347A75ABE32AFAF65EB15792561DE",
     "meta": {
       "versionId": "20170711021134",
       "lastUpdated": "2017-07-11T12:11:34.473+10:00"
     },
     "text": {
       "status": "generated",

"div": "

2017-07-11 B12

"

     },
     "status": "active",
     "code": {
       "text": "B12"
     },
     "subject": {
       "reference": "Patient/23"
     },
     "occurrenceDateTime": "2017-07-11"
   },
   {
     "resourceType": "ProcedureRequest",
     "id": "44-E0C0F0DA74A4ECB181463073C0B14DE0",
     "meta": {
       "versionId": "20170711020919",
       "lastUpdated": "2017-07-11T12:09:19.277+10:00"
     },
     "text": {
       "status": "generated",

"div": "

2017-07-11 AIDS SCREEN

"

     },
     "status": "active",
     "code": {
       "text": "AIDS SCREEN"
     },
     "subject": {
       "reference": "Patient/23"
     },
     "occurrenceDateTime": "2017-07-11"
   },
   {
     "resourceType": "ProcedureRequest",
     "id": "44-C33384F0A2A439F9F70B0FF63F5B30A3",
     "meta": {
       "versionId": "20170711020919",
       "lastUpdated": "2017-07-11T12:09:19.277+10:00"
     },
     "text": {
       "status": "generated",

"div": "

2017-07-11 FBE

"

     },
     "status": "active",
     "code": {
       "text": "FBE"
     },
     "subject": {
       "reference": "Patient/23"
     },
     "occurrenceDateTime": "2017-07-11"
   }
 ],
 "prefetch": {
   "encounter": {
     "response": {
       "status": "200 OK"
     },
     "resource": {
       "resourceType": "Encounter",
       "id": "1-760",
       "meta": {
         "lastUpdated": "2017-07-11T12:11:40+10:00"
       },
       "text": {
         "status": "generated",

"div": "

2017-07-11 12:06 : General Practitioner

\r\nTuesday July 11 2017    12:06:46\r\nDr A Practitioner\r\nVisit type:\r\nSurgery Consultation\r\n\r\nActions:\r\nPathology requested: AIDS SCREEN;  FBE - \r\nPathology requested: B-HCG (QUANTITATIVE);  B12 - \r\n

"

       },
       "status": "in-progress",
       "type": [
         {
           "coding": [
             {
               "system": "http://snomed.info/sct",
               "code": "62247001",
               "display": "General Practitioner"
             }
           ]
         }
       ],
       "subject": {
         "reference": "Patient/23"
       },
       "participant": [
         {
           "type": [
             {
               "coding": [
                 {
                   "system": "http://hl7.org/fhir/v3/ParticipationType",
                   "code": "ATND",
                   "display": "attender"
                 }
               ]
             }
           ],
           "individual": {
             "reference": "Practitioner/2"
           }
         }
       ],
       "period": {
         "start": "2017-07-11T12:06:46+10:00"
       }
     }
   },
   "patient": {
     "response": {
       "status": "200 OK"
     },
     "resource": {
       "resourceType": "Patient",
       "id": "23",
       "meta": {
         "lastUpdated": "2017-07-03T15:19:08+10:00"
       },
       "text": {
         "status": "generated",

"div": "

ANDREWS,Maureen (Female 94y)

"

       },
       "extension": [
         {
           "url": "http://oridashi.com.au/fhir/Profile/patient-extensions#ethnicity",
           "valueCoding": {
             "system": "http://oridashi.com.au/system/abs/ethnicity",
             "code": "1104",
             "display": "Torres Strait Islander"
           }
         },
         {
           "url": "http://oridashi.com.au/fhir/Profile/patient-extensions#ethnicity",
           "valueCoding": {
             "system": "http://oridashi.com.au/system/abs/ethnicity",
             "code": "5100",
             "display": "Mainland South-East Asian"
           }
         },
         {
           "url": "http://oridashi.com.au/fhir/Profile/patient-extensions#ethnicity",
           "valueCoding": {
             "system": "http://oridashi.com.au/system/abs/ethnicity",
             "code": "1102",
             "display": "Australian Aboriginal"
           }
         },
         {
           "url": "http://hl7.org.au/fhir/StructureDefinition/indigenous-status",
           "valueCoding": {
             "system": "http://meteor.aihw.gov.au/content/index.phtml/itemId/602543#Codes",
             "code": "3",
             "display": "Both Aboriginal and Torres Strait Islander origin"
           }
         }
       ],
       "identifier": [
         {
           "use": "usual",
           "type": {
             "coding": [
               {
                 "system": "http://hl7.org/fhir/v2/0203",
                 "code": "MC",
                 "display": "Patient's Medicare Number"
               }
             ],
             "text": "Medicare Number"
           },
           "system": "http://ns.electronichealth.net.au/id/medicare-number",
           "value": "22947241715"
         },
         {
           "type": {
             "coding": [
               {
                 "system": "http://hl7.org/fhir/v2/0203",
                 "code": "PEN",
                 "display": "Pension Number"
               }
             ],
             "text": "Pensioner Number"
           },
           "system": "http://ns.electronichealth.net.au/id/customer-reference-number",
           "value": "561388922HL"
         },
         {
           "use": "usual",
           "type": {
             "coding": [
               {
                 "system": "http://hl7.org/fhir/v2/0203",
                 "code": "NI",
                 "display": "National unique individual identifier"
               }
             ],
             "text": "IHI"
           },
           "system": "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
           "value": "8003608233326545"
         },
         {
           "use": "usual",
           "type": {
             "coding": [
               {
                 "system": "http://hl7.org/fhir/v2/0203",
                 "code": "MB",
                 "display": "Member Number"
               }
             ],
             "text": "Health Fund Number"
           },
           "value": "19473022SB",
           "assigner": {
             "display": "BUPA AUSTRALIA HEALTH PTY LTD"
           }
         }
       ],
       "active": true,
       "name": [
         {
           "use": "usual",
           "family": "ANDREWS",
           "given": [
             "Maureen"
           ],
           "prefix": [
             "Mrs"
           ]
         },
         {
           "use": "nickname",
           "text": "Maureen"
         }
       ],
       "telecom": [
         {
           "system": "phone",
           "value": "12344321",
           "use": "home"
         },
         {
           "system": "phone",
           "value": "33334444",
           "use": "work"
         },
         {
           "system": "phone",
           "value": "12343212",
           "use": "mobile",
           "rank": 1
         },
         {
           "system": "email",
           "value": "andrews.m@hcn.samplesdb.com.au",
           "use": "home"
         }
       ],
       "gender": "female",
       "birthDate": "1923-06-23",
       "deceasedBoolean": false,
       "address": [
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/iso21090-preferred",
               "valueBoolean": true
             }
           ],
           "use": "home",
           "type": "physical",
           "line": [
             "314 Hope Street"
           ],
           "city": "Bundaberg",
           "state": "QLD",
           "postalCode": "4670"
         }
       ],
       "generalPractitioner": [
         {
           "reference": "Organization/0"
         }
       ],
       "managingOrganization": {
         "reference": "Organization/0"
       }
     }
   },
   "problems": {
     "response": {
       "status": "200 OK"
     },
     "resource": {
       "resourceType": "Bundle",
       "id": "423aff27-1d2a-41c6-9620-d1e0ecb0947b",
       "meta": {
         "versionId": "20170713234839",
         "lastUpdated": "2017-07-13T23:48:39.503+10:00"
       },
       "type": "searchset",
       "total": 16,
       "link": [
         {
           "relation": "self",
           "url": "https://localhost.oridashi.com.au:8102/Condition?patient=23&_list=%24current-problems"
         },
         {
           "relation": "last",
           "url": "https://localhost.oridashi.com.au:8102/Condition?patient=23&_list=%24current-problems&_page=1&_snapshot=636355865194254397"
         }
       ],
       "entry": [
         {
           "fullUrl": "https://localhost.oridashi.com.au:8102/Condition/145",
           "resource": {
             "resourceType": "Condition",
             "id": "145",
             "meta": {
               "versionId": "20170509013646",
               "lastUpdated": "2017-05-09T11:36:46.43+10:00",
               "security": [
                 {
                   "system": "http://hl7.org/fhir/v3/Confidentiality",
                   "code": "N",
                   "display": "normal"
                 }
               ]
             },
             "text": {
               "status": "generated",

"div": "

2017-05-09 Diabetes Mellitus

"

             },
             "clinicalStatus": "active",
             "verificationStatus": "confirmed",
             "category": [
               {
                 "coding": [
                   {
                     "system": "http://snomed.info/sct",
                     "code": "439401001",
                     "display": "Diagnosis"
                   }
                 ]
               }
             ],
             "code": {
               "coding": [
                 {
                   "system": "http://oridashi.com.au/system/code/medicaldirectorterm",
                   "code": "diabm",
                   "display": "Diabetes Mellitus"
                 }
               ],
               "text": "Diabetes Mellitus"
             },
             "subject": {
               "reference": "Patient/23"
             },
             "onsetDateTime": "2017-05-09",
             "abatementBoolean": false
           }
         },
         {
           "fullUrl": "https://localhost.oridashi.com.au:8102/Condition/144",
           "resource": {
             "resourceType": "Condition",
             "id": "144",
             "meta": {
               "versionId": "20170504000145",
               "lastUpdated": "2017-05-04T10:01:45.153+10:00",
               "security": [
                 {
                   "system": "http://hl7.org/fhir/v3/Confidentiality",
                   "code": "N",
                   "display": "normal"
                 },
                 {
                   "system": "http://oridashi.com.au/system/code/include-in-summary",
                   "code": "SUMMARY",
                   "display": "summary"
                 }
               ]
             },
             "text": {
               "status": "generated",

"div": "

2017-05-04 FREE TEXT TEST (inactive)

"

             },
             "clinicalStatus": "resolved",
             "verificationStatus": "confirmed",
             "category": [
               {
                 "coding": [
                   {
                     "system": "http://snomed.info/sct",
                     "code": "439401001",
                     "display": "Diagnosis"
                   }
                 ]
               }
             ],
             "code": {
               "text": "FREE TEXT TEST"
             },
             "subject": {
               "reference": "Patient/23"
             },
             "onsetDateTime": "2017-05-04",
             "abatementBoolean": true
           }
         },
         {
           "fullUrl": "https://localhost.oridashi.com.au:8102/Condition/140",
           "resource": {
             "resourceType": "Condition",
             "id": "140",
             "meta": {
               "versionId": "20170426041908",
               "lastUpdated": "2017-04-26T14:19:08.9+10:00",
               "security": [
                 {
                   "system": "http://hl7.org/fhir/v3/Confidentiality",
                   "code": "N",
                   "display": "normal"
                 },
                 {
                   "system": "http://oridashi.com.au/system/code/include-in-summary",
                   "code": "SUMMARY",
                   "display": "summary"
                 }
               ]
             },
             "text": {
               "status": "generated",

"div": "

2017-04-06 Fracture - Elbow (Bilateral)

"

             },
             "clinicalStatus": "active",
             "verificationStatus": "confirmed",
             "category": [
               {
                 "coding": [
                   {
                     "system": "http://snomed.info/sct",
                     "code": "439401001",
                     "display": "Diagnosis"
                   }
                 ]
               }
             ],
             "code": {
               "coding": [
                 {
                   "system": "http://oridashi.com.au/system/code/medicaldirectorterm",
                   "code": "frac.elbo",
                   "display": "Fracture - Elbow"
                 }
               ],
               "text": "Fracture - Elbow (Bilateral)"
             },
             "subject": {
               "reference": "Patient/23"
             },
             "onsetDateTime": "2017-04-06",
             "abatementBoolean": false
           }
         },
         {
           "fullUrl": "https://localhost.oridashi.com.au:8102/Condition/139",
           "resource": {
             "resourceType": "Condition",
             "id": "139",
             "meta": {
               "versionId": "20170403045948",
               "lastUpdated": "2017-04-03T14:59:48.403+10:00",
               "security": [
                 {
                   "system": "http://hl7.org/fhir/v3/Confidentiality",
                   "code": "N",
                   "display": "normal"
                 },
                 {
                   "system": "http://oridashi.com.au/system/code/include-in-summary",
                   "code": "SUMMARY",
                   "display": "summary"
                 }
               ]
             },
             "text": {
               "status": "generated",

"div": "

2017-04-03 Fracture - Ankle (Left)

"

             },
             "clinicalStatus": "active",
             "verificationStatus": "confirmed",
             "category": [
               {
                 "coding": [
                   {
                     "system": "http://snomed.info/sct",
                     "code": "439401001",
                     "display": "Diagnosis"
                   }
                 ]
               }
             ],
             "code": {
               "coding": [
                 {
                   "system": "http://oridashi.com.au/system/code/medicaldirectorterm",
                   "code": "frac.ankl",
                   "display": "Fracture - Ankle"
                 }
               ],
               "text": "Fracture - Ankle (Left)"
             },
             "subject": {
               "reference": "Patient/23"
             },
             "onsetDateTime": "2017-04-03",
             "abatementBoolean": false
           }
         },
         {
           "fullUrl": "https://localhost.oridashi.com.au:8102/Condition/135",
           "resource": {
             "resourceType": "Condition",
             "id": "135",
             "meta": {
               "versionId": "20170206121715",
               "lastUpdated": "2017-02-06T23:17:15.053+11:00",
               "security": [
                 {
                   "system": "http://hl7.org/fhir/v3/Confidentiality",
                   "code": "N",
                   "display": "normal"
                 }
               ]
             },
             "text": {
               "status": "generated",

"div": "

2017-02-06 Diabetes Mellitus

"

             },
             "clinicalStatus": "active",
             "verificationStatus": "confirmed",
             "category": [
               {
                 "coding": [
                   {
                     "system": "http://snomed.info/sct",
                     "code": "439401001",
                     "display": "Diagnosis"
                   }
                 ]
               }
             ],
             "code": {
               "coding": [
                 {
                   "system": "http://oridashi.com.au/system/code/medicaldirectorterm",
                   "code": "diabm",
                   "display": "Diabetes Mellitus"
                 }
               ],
               "text": "Diabetes Mellitus"
             },
             "subject": {
               "reference": "Patient/23"
             },
             "onsetDateTime": "2017-02-06",
             "abatementBoolean": false
           }
         },
         {
           "fullUrl": "https://localhost.oridashi.com.au:8102/Condition/134",
           "resource": {
             "resourceType": "Condition",
             "id": "134",
             "meta": {
               "versionId": "20170204130943",
               "lastUpdated": "2017-02-05T00:09:43.377+11:00",
               "security": [
                 {
                   "system": "http://hl7.org/fhir/v3/Confidentiality",
                   "code": "N",
                   "display": "normal"
                 },
                 {
                   "system": "http://oridashi.com.au/system/code/include-in-summary",
                   "code": "SUMMARY",
                   "display": "summary"
                 }
               ]
             },
             "text": {
               "status": "generated",

"div": "

2017-02-05 Left Ventricular Hypertrophy

"

             },
             "clinicalStatus": "active",
             "verificationStatus": "confirmed",
             "category": [
               {
                 "coding": [
                   {
                     "system": "http://snomed.info/sct",
                     "code": "439401001",
                     "display": "Diagnosis"
                   }
                 ]
               }
             ],
             "code": {
               "coding": [
                 {
                   "system": "http://oridashi.com.au/system/code/medicaldirectorterm",
                   "code": "lvh",
                   "display": "Left Ventricular Hypertrophy"
                 }
               ],
               "text": "Left Ventricular Hypertrophy"
             },
             "subject": {
               "reference": "Patient/23"
             },
             "onsetDateTime": "2017-02-05",
             "abatementBoolean": false
           }
         },
         {
           "fullUrl": "https://localhost.oridashi.com.au:8102/Condition/131",
           "resource": {
             "resourceType": "Condition",
             "id": "131",
             "meta": {
               "versionId": "20161118041140",
               "lastUpdated": "2016-11-18T15:11:40.173+11:00",
               "security": [
                 {
                   "system": "http://hl7.org/fhir/v3/Confidentiality",
                   "code": "N",
                   "display": "normal"
                 },
                 {
                   "system": "http://oridashi.com.au/system/code/include-in-summary",
                   "code": "SUMMARY",
                   "display": "summary"
                 }
               ]
             },
             "text": {
               "status": "generated",

"div": "

2016 Tibial fracture

"

             },
             "clinicalStatus": "active",
             "verificationStatus": "confirmed",
             "category": [
               {
                 "coding": [
                   {
                     "system": "http://snomed.info/sct",
                     "code": "439401001",
                     "display": "Diagnosis"
                   }
                 ]
               }
             ],
             "code": {
               "coding": [
                 {
                   "system": "http://oridashi.com.au/system/code/medicaldirectorterm",
                   "code": "frac.tibi",
                   "display": "Tibial fracture"
                 }
               ],
               "text": "Tibial fracture"
             },
             "subject": {
               "reference": "Patient/23"
             },
             "onsetDateTime": "2016",
             "abatementBoolean": false
           }
         },
         {
           "fullUrl": "https://localhost.oridashi.com.au:8102/Condition/130",
           "resource": {
             "resourceType": "Condition",
             "id": "130",
             "meta": {
               "versionId": "20161118034559",
               "lastUpdated": "2016-11-18T14:45:59.507+11:00",
               "security": [
                 {
                   "system": "http://hl7.org/fhir/v3/Confidentiality",
                   "code": "N",
                   "display": "normal"
                 },
                 {
                   "system": "http://oridashi.com.au/system/code/include-in-summary",
                   "code": "SUMMARY",
                   "display": "summary"
                 }
               ]
             },
             "text": {
               "status": "generated",

"div": "

2016 Retinopathy

"

             },
             "clinicalStatus": "active",
             "verificationStatus": "confirmed",
             "category": [
               {
                 "coding": [
                   {
                     "system": "http://snomed.info/sct",
                     "code": "439401001",
                     "display": "Diagnosis"
                   }
                 ]
               }
             ],
             "code": {
               "coding": [
                 {
                   "system": "http://oridashi.com.au/system/code/medicaldirectorterm",
                   "code": "retinopa",
                   "display": "Retinopathy"
                 }
               ],
               "text": "Retinopathy"
             },
             "subject": {
               "reference": "Patient/23"
             },
             "onsetDateTime": "2016",
             "abatementBoolean": false
           }
         },
         {
           "fullUrl": "https://localhost.oridashi.com.au:8102/Condition/129",
           "resource": {
             "resourceType": "Condition",
             "id": "129",
             "meta": {
               "versionId": "20161116111603",
               "lastUpdated": "2016-11-16T22:16:03.21+11:00",
               "security": [
                 {
                   "system": "http://hl7.org/fhir/v3/Confidentiality",
                   "code": "N",
                   "display": "normal"
                 }
               ]
             },
             "text": {
               "status": "generated",

"div": "

2016-11-16 Diabetes Mellitus

"

             },
             "clinicalStatus": "active",
             "verificationStatus": "confirmed",
             "category": [
               {
                 "coding": [
                   {
                     "system": "http://snomed.info/sct",
                     "code": "439401001",
                     "display": "Diagnosis"
                   }
                 ]
               }
             ],
             "code": {
               "coding": [
                 {
                   "system": "http://oridashi.com.au/system/code/medicaldirectorterm",
                   "code": "diabm",
                   "display": "Diabetes Mellitus"
                 }
               ],
               "text": "Diabetes Mellitus"
             },
             "subject": {
               "reference": "Patient/23"
             },
             "onsetDateTime": "2016-11-16",
             "abatementBoolean": false
           }
         },
         {
           "fullUrl": "https://localhost.oridashi.com.au:8102/Condition/29",
           "resource": {
             "resourceType": "Condition",
             "id": "29",
             "meta": {
               "versionId": "20130220051313",
               "lastUpdated": "2013-02-20T16:13:13.46+11:00",
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