CDS Hooks are a new SMART on FHIR technology that will allow doctors to get real-time information about specific patients, their conditions, and potential treatment choices while working in their EHR. Vendors are building application software (APIs) based on the HL7 Fast Healthcare Interoperability Resources (FHIR) standard, and the technology is fast becoming available.
CDS Hooks is an attempt to make it easier for doctors to know what checks should be conducted by automatically executing them ahead of time and then delivering information in context inside the EHR.” CDS Hooks’ core method is defined by Mandel as follows: As events occur, the EHR sends out alerts.
CDS Hooks allow for the construction of common locations throughout the EHR workflow where the EHR may send out “cards” indicating that an event has occurred.
There are three sorts of cards:
Information card: Provides text that the user may find helpful.
Suggestions are provided on a card.
App link card: This card contains links to various reference resources and apps.
To construct cost-effective, high-quality care plans, clinicians require a range of timely information about individual patients, their illnesses, and prospective treatment alternatives. To be sure, electronic health records (EHRs) already include a wealth of useful data in the form of clinical decision support (CDS) to aid decision-making. However, in the face of continual breakthroughs in diagnosis and treatments, EHRs created largely as documentation tools confront a problem in providing sophisticated, precision decision support capabilities. A new standards-based technology known as CDS Hooks is addressing this problem.
As companies create application programming interfaces (APIs) based on HL7’s Fast Healthcare Interoperability Resources (FHIR) standard, CDS Hooks quickly become available. FHIR has taken the industry by storm (an FHIR-storm! ), spurred by the federal government’s required adoption.
How they work
CDS Hooks’ technical capabilities enable the construction of common areas inside the EHR workflow where the EHR may deliver a notification when an event occurs. An external program can receive this notice, which can then provide relevant data to the EHR for presentation to the user. The information returned is referred to as a “card” in FHIR jargon.
CDS Hooks are still in their early stages of development. There are now eight “hooks” defined in the standard’s Version 1:
- When a patient is chosen, and their record is accessed, this is referred to as the patient view.
- When a drug is prescribed, it’s called a prescription.
- When an order has been chosen and is being evaluated, it is called an order review.
- Pick an order: After you’ve chosen your order(s),
- When an order is signed, it is called an order.
- When an appointment is made, it is written down in a book.
- When a new patient interaction begins, it is called an encounter.
- When a patient’s contact is over, it is discharged.
The setting of prescription writing is an excellent approach to visualize how this technology works. The act of writing the prescription triggers a CDS Hook. A patient engagement API can get the hook. The API sends a recommendation card advising that instructional materials, registration in a support program, and a copay assistance offer be offered to the patient. Because FHIR is an open-source standard, anyone interested can build new hooks. While the list of hooks is currently somewhat small, we expect it to increase significantly as CDS Hooks becomes more generally embraced by EHR companies.
Such capability has been a feature of health information technology for quite some time. The Medical Manager program (a practice management system) introduced “Triggers” in the mid-1980s, which worked similarly to CDS Hooks today. The main difference between old-school triggers and CDS Hooks is that each EHR vendor chose which exact hooks to use in the past and built their APIs around them. Today, there is a unified solution based on a unified platform.
Why its gaining popularity
The benefit of CDS Hooks is that every vendor supports the same FHIR API and offers a defined set of hooks. Developers of decision support systems will no longer have to construct separate interfaces for each EHR. Still, they will instead build a single API that will operate with all.
There are benefits and drawbacks to each new technology. Decision support reminders aren’t always well received by providers since the information provided isn’t always relevant or actionable. Too many interruptions cause “alert fatigue,” a well-documented condition where providers click past reminders without reading or acting on them.
CDS Hooks overcomes some of these problems by allowing information to be returned that is particular to the patient and treatment stage. Even better, clinicians can use it as part of their EHR process. A well-designed CDS Hooks implementation will allow the software to remember when providers accept or reject cards, allowing meaningful and useful information to flow to the provider.
CDS Hooks are being widely adopted by EHR vendors, which opens the door for innovative, complementary applications to supplement the EHR’s core functionality. EHRs will provide consumers the benefits of a new clinical quality-enhancing capability with minimal development effort if they are designed carefully to avoid alert fatigue.
SMART CDS apps may use CDS-Hooks on SMART on FHIR to send a customized notification card to compatible EMRs. CDS-Hooks, such as SMART, is an open standard that has been modified to work with a variety of EHR vendor systems. The service will register for the hooks to reply to and issue CDS cards to initiate the required activities. The cards provide customized patient-specific data, making the end user’s task easier (clinician). EHRs allow CDS services to register on numerous CDS hooks and perform various activities as needed. CDS health care based on the electronic medical record (EMR) is scalable and may be used with other care improvement initiatives. To have a better understanding of clinical decisions, further study is needed.
In conclusion, CDS hooks are a great addition to the healthcare program. It allows healthcare practitioners to keep real time track of the information of specific patients. It has made work easier and faster however there are some drawbacks to it.
