understanding constraints when developing a new hook

[Barbara Moore]

I understand that you can create a novel hook in CDS Hooks when that workflow hook doesn't currently exist pre-built, eg, problem-list-review.

Would such a novel hook work even in an EMR system that might not currently have logic to support CDS triggering during eg problem list review? In other words, is its dependence on the EMR in any way impacted by the native EMR's ability to fire CDS at that point in workflow completely natively? Or does there merely need to be a FHIR resource that can call that workflow?

I'm thinking about Clinical decision support capabilities of commercially-available clinical information systems, J Am Med Inform Assoc. 2009;16:637– 644, in case not all EMRs have updated their systems for CDS triggering.

Thanks.

[Bryn Rhodes]

Hi Barbara,

The CDS Hooks specification provides for an approach for clinical system vendors and decision support service vendors to work together to define supported capabilities. Hook definitions have a process for proposal, discussion, testing, and implementation that enables new hooks to be defined and added (See the [Hook Maturity Model](https://cds-hooks.hl7.org/1.0/#hook-maturity-model).

Having said that, clinical systems must implement support for hook definitions and different vendors support different capabilities as they evolve at different rates. It's not enough for a service to propose a hook definition, clinical systems must provide the call out to the service. Does that help?

Regards,

Bryn Rhodes

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[Barbara Moore]

Thank you, Bryn, that does help.

I appreciate your response.

Barbara