Use Cases

Clinical Decision Support (CDS)

CDS workflows are based on CDS Hooks. CDS Hooks is an HL7 published specification for clinical decision support. CDS hooks communicate using FHIR (Fast Healthcare Interoperability Resources). For more information you can consult the official documentation.

When	Where	What you receive	What you send back
Triggered at certain events during a clinician's workflow, e.g. when a patient record is opened.	EHR	The context of the event and FHIR resources that are requested by your service. e.g. patient ID, Encounter and Patient.	“Cards” displaying text, actionable suggestions, or links to launch a SMART app from within the workflow.

Data Flow

Stage	Input	Internal Data Representation	Output
Client	N/A	N/A	CdsFhirData
Service	CdsRequest	CdsFhirData	CdsResponse

CdsFhirConnector handles the conversion of CDSRequests CdsFhirData CdsResponse in a HealthChain pipeline.

Attributes of CdsFhirData are:

• context
• prefetch

(CdsFhirData API Reference)

Supported Workflows

Workflow Name	Description	Trigger	Maturity
patient-view	Triggered when a patient chart is opened	Opening a patient's chart	✅
order-select	Triggered when a new order is selected	Selecting a new order	⏳
order-sign	Triggered when orders are being signed	Signing orders	⏳
encounter-discharge	Triggered when a patient is being discharged	Discharging a patient	✅

Generated API Endpoints

Endpoint	Method	Function Name	API Protocol
/cds-services	GET	cds_discovery	REST
/cds-services/{id}	POST	cds_service	REST

What does the data look like?

Example CDSRequest

{
   "hookInstance" : "23f1a303-991f-4118-86c5-11d99a39222e",
   "fhirServer" : "https://fhir.example.org",
   "hook" : "patient-view",
   "context" : {
     "patientId" : "1288992",
     "userId" : "Practitioner/example"
    },
   "prefetch" : {
      "patientToGreet" : {
        "resourceType" : "Patient",
        "gender" : "male",
        "birthDate" : "1925-12-23",
        "id" : "1288992",
        "active" : true
      }
   }
}

Example CDSResponse

{
  "summary": "Bilirubin: Based on the age of this patient consider overlaying bilirubin [Mass/volume] results over a time-based risk chart",
  "indicator": "info",
  "detail": "The focus of this app is to reduce the incidence of severe hyperbilirubinemia and bilirubin encephalopathy while minimizing the risks of unintended harm such as maternal anxiety, decreased breastfeeding, and unnecessary costs or treatment.",
  "source": {
    "label": "Intermountain",
    "url": null
  },
  "links": [
    {
      "label": "Bilirubin SMART app",
      "url": "https://example.com/launch",
      "type": "smart"
   }
  ]
}

Implemented FHIR Resources

• Patient
• Encounter
• Procedure
• MedicationRequest