CDS Hooks Fall 2017 Update & 2018 Plans

[Kevin Shekleton]

Hi everyone!

It has been too long since my last post to the community via our mailing list so I have quite a few things to update everyone on. If you've been plugged into our other communication channels (Zulip, Github, Argonauts, etc), you will be aware of some of this. However, I have some new information for everyone so please read on. :-)

September 2017 Connectathon

We had another very well attended (32 participants) and successful Connectathon this past September in San Diego, CA. Between the 32 participants, we again had a great turnout from organizations with 5 EHRs and 12+ CDS Service providers (healthcare providers and dedicated CDS organizations) participating.

Like past Connectathons, the work by everyone was varied from developers writing their very first CDS Service to developers who were honing an existing service or tackling complex use cases like opioid prescription guidelines. One common goal across all participants was implementing our security model. This was a big success as we had all of the present EHRs and the majority of CDS Services implementing and providing feedback on our security model. On Sunday, we made a few changes to the internals of the JSON Web Token (JWT) used in our security model based upon implementation feedback during the Connectathon. This is a great example of the benefit our community derives from the Connectathon and everyone's participation.

A huge thank you to everyone that attended. It is great being able to speed the weekend in person making new connections, getting to know each other personally, and of course hacking on CDS Hooks and improving our project.

The high-level recap that was presented at the end of the Connectathon is available at https://speakerdeck.com/kpshek/cds-hooks-connectathon-sept-2017-summary

Argonaut Project

At the beginning of this year, the Argonaut Project chose CDS Hooks as as one of the projects it was going to support in 2017. With this, we have had the pleasure of having Brett Marquard get involved with CDS Hooks. Brett has been doing a fantastic job helping us improve both the website and specification.

We are currently in the midst of an external, 3rd party security and risk assessment with the same organization that undertook a similar evaluation for SMART on FHIR's security model. This assessment should finish in January 2018 and the results will be published publicly. All of the changes that result from this work will be logged and managed via Github like any other issue.

It has been great having the support and visibility that the Argonauts bring. The Argonauts are looking for feedback for projects to focus on in 2018 and if you have any ideas on additional CDS Hooks use cases that may be a good fit, let them (and us) know!

CDS Hooks @ Conferences

CDS Hooks has had some great visibility at conferences across the globe!

At AMIA 2017 this past November, CDS Hooks was name dropped in several sessions I attended and there were two sessions that directly dealt with CDS Hooks as the main subject of the session.

• Getting Hooked on CDS: Toward an Open Standard Architecture for Clinical Decision Support in Leading Electronic Medical Records
• Enabling Knowledge-Driven Care at Scale through CDS Hooks and the FHIR Clinical Reasoning Module (slides)

Also in November, I had the pleasure of presenting CDS Hooks at FHIR DevDays 2017 in Amsterdam. The community and developers who attended were impressive and the interest and support for CDS Hooks at the conference was great. The slides for my presentation are available at: https://speakerdeck.com/kpshek/remote-decision-support-with-cds-hooks-fhir-devdays-2017

And finally, Cerner held their health conference this past October. As part of that conference, they ran a developer track which included a CDS Service tutorial. The Cerner team released this tutorial under an open source license (Apache License, version 2.0) which you can view at https://github.com/cerner/cds-services-tutorial

Clinical Reasoning & CDS Hooks Unification

At the beginning of the year, the CDS Hooks and HL7 CDS communities agreed to work together to unify the Clinical Reasoning and CDS Hooks projects. Since then, Bryn Rhodes, Issac Vetter, and myself have been meeting weekly to hammer out the details (see this past update). All of our work over this past year is reflected in numerous Github issues and changes to both the website and specification. This work will continue as we continue to work closely with the HL7 CDS community.

As part of this effort, CDS Hooks will be moving under the HL7 umbrella and our aim is that the only visible changes to everyone is that we will now have the input and support from a broader and more diverse audience. We are still working through the logistics of this change and it will be finalized in 2018.

1.0 Release

We are steadily progressing towards our first release of the CDS Hooks specification: 1.0. Our original goal was to release 1.0 by the end of 2017 but a couple of factors have pushed this to Q1 2018.

First, the aforementioned external security review funded by the Argonaut Project is scheduled to complete in January 2018. Second, the next HL7 Connectathon and working group meeting (WGM) is at the end of January 2018.

Given that we were already holding 1.0 for the external security review, we decided to also hold for the feedback from both the Connectathon and WGM. While we would love to get 1.0 out in 2017, the additional short delay is worth the additional security scrutiny and community feedback, ultimately improving the quality of our release.

January 2018 Connectathon

The January 2018 HL7 Connectathon is just a couple months away and we'd love to see you all there!

January 27-28, 2018 (Saturday & Sunday)

Hilton New Orleans Riverside

2 Poydras St

New Orleans, LA 70130

Registration & details available at http://www.hl7.org/events/working_group_meeting/2018/01/

If you have never attended a Connectathon before, they are an essential aspect of the CDS Hooks community where we all meet in person and hack on prototypes around CDS Hooks. Our past Connectathons have been the best venue for us to flesh out and define many details of CDS Hooks.

We are still defining the scenarios for the CDS Hooks track (see track page). If you have ideas or proposals for scenarios, please get in touch. Broadly speaking, focusing on our 1.0 release will be a focus of the Connectathon as this will be the last Connectathon prior to our 1.0 release.

If you have attended a Connectathon previously, there are some changes this time around you will want to be aware of!

Now two days!

The Connectathon is now two full days (Saturday AND Sunday). Previously, Sunday was largely a write-off as we stopped around 11am. Based upon participant feedback, the Connectathon has been extended thru Sunday, including additional meals. As such, the Connectation registration has been increased to account for this.

Breakout Friday, January 26th from 4:00-6:00pm CDT

We have a breakout session scheduled for Friday, January 26th from 4:00-6:00pm CDT at the Hilton New Orleans Riverside (same venue as the Connectathon and WGM). In the past, we have held a breakout session during the Connectathon which has produced excellent discussion on a variety of issues and topics. This time, we're trying out holding this the night before the Connectathon. Given that most of us are already in town the night before the Connectathon, we thought we would try and hold this breakout discussion outside of the Connectathon, giving us all more time to spend hacking at the Connectathon.

We are still planning the agenda for this breakout session, but some topics we know we'll hit:

1. Connectathon plans for the weekend

2. 1.0 release plan

3. Gather feedback for post 1.0 release

4. Discuss 1-2 “hot topic” issues we want to discuss (need to determine these)

If you are planning to attend the Connectathon, please add your name to our Connectathon attendee tracking sheet so we can better prepare for the Connectathon.

Thanks

Thanks to everyone who has created or commented on a Github issue or pull request, participated in one of our Zulip discussions, or evangelized CDS Hooks. The CDS Hooks community is fantastic and it is great working with you all over the past year!

If you've made it this far, great job! :-)

Best,

Kevin Shekleton