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Submitting WG/Project/Implementer Group

CDS, Argonaut

Justification and Objectives

CDS Hooks provides a powerful framework for remote decision support, leveraging the power of FHIR as well as the ability to suggest a SMART App launch.  CDS Hooks consistently draws connectathon participants and we expect this to continue now that version 1.0 of the specification has been released and Argonaut discussions have been creating guidance around meeting PAMA use-cases with CDS Hooks

That being the case, the primary objectives for this track will be 

  • Exploration of CDS Hooks 1.0 functionality to return information cards, suggestion cards, and SMART App link cards
  • Focusing on PAMA use cases involving radiology ordering workflows and newer functionality like system-only actions and SMART Web messaging

This track will use R2-R4 versions of FHIR.  While R2-R4 versions are welcome to be used for exploration of CDS Hooks 1.0 functionality, participants focusing on implementing Argonaut guidance for PAMA use-cases will be converging on R4.

Related tracks


Proposed Track Lead

Dennis Patterson (

Expected participants

  • Cerner
  • Epic
  • many, many more

Participant Tracking:

Track Orientation

A webinar will be hosted over Microsoft Teams to share further participation information about this track.

Wednesday, September 4, 2019 2:00 pm | 1 hour | Central Time (US & Canada)

Join Microsoft Teams Meeting

+1 816-384-1534   United States, Kansas City (Toll)

Conference ID: 308 882 361#

Local numbers | Learn more about Teams

System Roles

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.

CDS Client / EHR - The CDS Client 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.


Information Card

Action: CDS Service returns info card, CDS Client (EHR) accepts display info card.

Precondition: Read the Quick Start Guide.  Explore the CDS Hooks sandbox.

Success Criteria: CDS Client (EHR) or sandbox displays info card.

Bonus point: CDS Service queries FHIR server while generating card.

App Link Card

Action: CDS Service returns app link card, CDS Client (EHR) accepts app link card.

Precondition: N/A

Success Criteria: CDS Client (EHR) or sandbox displays app link card.

Bonus point: CDS Client (EHR) generates SMART launch token, SMART app performs SMART handshake with OAuth2 server.

Suggestion Card

Action: CDS Service returns suggestion card, CDS Client (EHR) accepts suggestion card.

Precondition: N/A

Success Criteria: CDS Client (EHR) displays actionable suggestion card.

Bonus point: N/A

Implementing Argonaut Guidance for PAMA Use-cases

Scenario 1. Automated rating of orders in-workflow

Scenario 2. Suggestions for alternative orders presented in-workflow

Scenario 3. App-mediated order selection through SMART Web Messaging

These scenarios are described in detail here

Security and Privacy Considerations

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