Track Report
Submitting WG/Project/Implementer Group
CDS
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 has made its way into some DaVinci use-cases and as a launching point for SMART Web Messaging. As an HL7 standard with proposed enhancements for a 1.1 version, the connectathon will help solidify and mature those developments.
That being the case, the primary objectives for this track will be
- CDS Hooks 1.0 integrations focused on returning information cards, suggestion cards, and SMART App link cards
- Testing 1.1 candidate functionality
- Testing proposed patient-view updates
This track will use R2-R4 versions of FHIR.
Related tracks
Proposed Track Lead
Dennis Patterson (https://chat.fhir.org/#narrow/sender/191358-dennis.patterson)
Expected participants
- Cerner
- Epic
- Alphora
- Humana
- T-System
- Wolters Kluwer
- University of Utah
- Appriss Health
Logistics and Schedule
Participant Tracking: https://bit.ly/cds-hooks-connectathon-tracking
Track Zulip Stream: https://chat.fhir.org/#narrow/stream/179159-cds-hooks/topic/May.202020.20Connectathon
Rooms
Connectathon GoToWebinar (link in your e-mail) - main schedule
Schedule
Wednesday, May 13
4PM ET - Connectathon Kick-off at 4PM ET in GotoWebinar
Immediately after above kick-off - Track kickoff in Zoom
Thursday, May 14
9AM ET - FHIR Overview in GoToWebinar (Optional)
10AM ET - Track Daily Sync / Mini Kick-off in Zoom
2:30PM ET - 15-minute Track Overview and CDS Hooks 1.1 Plans in GoToWebinar (Optional)
3PM ET - Track Daily Sync in Zoom
6:30PM ET - Connectathon Day 1 Wrap-up in GoToWebinar
Friday, May 15
9AM ET - Connectathon Morning Announcements in GoToWebinar
10AM ET - Track Breakout in Zoom - Review progress, discuss issues, next Connectathon planning
3PM ET - Track Daily Sync in Zoom
6PM ET - Connectathon Event Wrap-up in GoToWebinar
Track Orientation
Slides: https://bit.ly/cdshooks-24-orientation
Recording:
CDS Hooks Connectathon 24 Track Orientation.mov
System Roles
CDS Service Provider - The CDS Service Provider role provides real-time clinical decision support as a remote service. The CDS Service is invoked on a desired hook and returns the decision support in the form of CDS cards. Those cards can also include a link to a SMART App.
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 and provide the ability to launch a SMART App.
Scenarios
v1.0 Integrations
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
v1.1 Candidates
Card Interaction
Override Reasons
Action: CDS Service returns an array of override reasons with a card.
Precondition: Read about card.overrideReasons and the OverrideReason structure.
Success Criteria: CDS Client gives ability to view override reasons on a card.
Bonus point 1: CDS Client allows selection of a service-provided reason when choosing not to follow the card's guidance.
Bonus point 2: CDS Client augments service-provided override reasons with any native override reasons.
Providing Feedback to CDS Services
Action: CDS Client displays a card from a CDS Service. CDS Client reports any card interactions back to the CDS Service's feedback endpoint.
Precondition: Read the pending pull request and wiki documentation. (Update with a link to the spec once merged.)
Success Criteria: CDS Service receives feedback on user interactions to a card.
Bonus point: CDS Service receives a service-supplied override reason that the user selected when a card's guidance is not followed.
Multiple Suggestion Interactions
Action: CDS Service returns a card with multiple suggestions, more than one of which are safe to be accepted in combination.
Precondition: Read about 'any' as a card.selectionBehavior and suggestion.isRecommended.
Success Criteria: CDS Client allows multiple suggestions to be accepted rather than limiting to only one.
Bonus point: CDS Service indicates that one of the suggestions is recommended among the choices. CDS Client renders it preselected for acceptance.
Card Categorization
Action: CDS Service returns a topic on a card to provide categorization denoting the nature of the guidance.
Precondition: Read about card.source.topic.
Success Criteria: CDS Client receives the topic successfully.
Bonus point: CDS Client uses topic in logic to process multiple cards with the same category of guidance.
Hooks
patient-view with a PractionerRole user
Action: CDS Client invokes patient-view hook with a PractitionerRole user. CDS Service defines prefetch request to retrieve PractitionerRole user, including other resources it references.
Precondition: Read the pending pull request and logged issue around prefetch issues with the current representation of context.userId.
Success Criteria: CDS Service successfully returns guidance based on hook invocation.
Bonus point: CDS Client fulfills prefetch requests related to PractitionerRole retrieval.
Security and Privacy Considerations
https://cds-hooks.org/specification/current/#security-and-safety