POCP Blog

By Michael Burger, EDI Practice Lead

CDS Hooks are a new SMART on FHIR technology that will enable providers to receive timely information about individual patients, their condition and potential treatment options within their EHR workflow. The technology is rapidly coming onstream as vendors build application programming interfaces (APIs) based on HL7’s Fast Healthcare Interoperability Resources (FHIR) standard.

The Basics of CDS Hooks

CDS Hooks enable the creation of standard places within the EHR workflow where the EHR can issue a notification in the form of “cards” that an event is happening. Cards can be of three types:

• Information card: Conveys text that may be useful for the user
• Suggestion card: Provides suggestions
• App link card: Links to reference materials or apps

As conveyed in a recent HIT Perspectives article, development of CDS Hooks is just getting off the ground with eight ”hooks” defined as part of Version 1 of the standard:

• Patient View: When a patient is selected and his or her record opened
• Medication Prescribe: When a medication is being prescribed
• Order Review: When order(s) have been selected and are being reviewed
• Order Select: When order(s) are selected
• Order Sign: When order(s) are being signed
• Appointment Book: When an appointment is being scheduled
• Encounters Start: When a new-patient encounter begins
• Encounter Discharge: When a patient encounter is completed

A great example by which to visualize the way this technology works is in the context of prescription writing. The event of writing the prescription triggers a CDS Hook. The hook can be received by a patient engagement API. The API returns a suggestion card recommending that the patient be provided educational materials, enrollment into a support program and given an offer for copay assistance.

CDS Hooks Example: Medication Prescribe Source: https://cds-hooks.org/

Looking to the future. The beauty of CDS Hooks is that every vendor supports the same FHIR API and offers the same set of standardized hooks. In this manner, developers of decision support tools don’t need to write unique interfaces for each EHR, but rather can build to a single API that works with all.

Widespread adoption by EHR vendors of CDS Hooks creates an opportunity for innovative, complementary applications that supplement the core functionality of the EHR. With careful design to limit the possibility of alert fatigue, EHRs will be able to offer customers the advantages of a new clinical quality-enhancing functionality with limited development effort. Without a doubt, this is a win-win-win-win for providers, patients, EHR vendors and third-party software developers.

Point-of-Care Partners offers a wide range of consulting services specific to FHIR and CDS Hooks. Please contact me at michael.burger@pocp.com if your organization needs assistance in these areas.

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