CDS Hooks Walk-through

Introduction

CDS Hooks is a technology from SMART on FHIR that allows third-party CDS systems to register with an EHR using a "hook" pattern.  The third-party CDS system is able to provide the EHR with information in the form of "cards" that the EHR may use to show the end-user or otherwise interweave into the workflow.  The Logica Bilirubin system is able to use CDS Hooks to alert the EHR of babies that are at risk of Kernicterus.  

Prerequisites 

• Patient and observation data must be loaded into the EHR (see hspconsortium/bilirubin-cdshooksadapter/src/main/resources/himms-notes.txt)
  • See datapack dstu2/usecases/cds-hooks.fhir-bundle.xml 
  • Birthdays must be for one day prior to the current date
  • Observation effective date must be the same as the current date

Links

• https://github.com/cds-hooks/cds-hooks-wiki/wiki
• http://hooks.fhir.me

Example Using the Logica Bilirubin System

SMART on FHIR Test Harness

STEP 1

Launch the SMART on FHIR Test Harness at http://hooks.fhir.me/

STEP 2

Enable the Bilirubin Patient View hook (hint: search for "bilirubin", select Configure Hooks again to close)

STEP 3

Select Patient View. This represents an EHR patient view screen "action"

STEP 4

Observe the default patient (not a baby) sees no Bilirubin Card

STEP 5

Select Change Patient and enter value of "ID-BabyWithoutBilirubinObservation"

STEP 6

Observe a Bilirubin card is returned to the EHR stating that the baby has no bilirubin observations

STEP 7

Select Change Patient and enter the value of "ID-BabyWithBilirubinObservation"

STEP 8

Observe a Bilirubin card is returned to the EHR stating that the baby has a bilirubin level that exceeds thresholds.