HIMSS 2019 DaVinci demo question: CDS Service that writes resources

[Kyle Neumeier]

We plan on responding to the open-chart CDS hook by writing allergies (and potentially other resources) that the payer has about the patient, but which the EMR does not. There are a few ways we could do this:

1. Write allergies within CDS Service by using a Bearer token provided in hook invocation, then return a card listing allergies that we wrote

2. Return a card with a Action with Type=Create and Resource=allergy resource for each allergy. I assume EMR would then handle Actions with Type=Create by creating an allergy.

3. A link to a SMART on FHIR app that would do the create.

I'm wondering:

1. Is method 2 an option?  Does Cerner handle cards with Action where Type=Create?

2. If not, is there any guidance for doing method 1?

[Kyle Neumeier]

After today's Da Vinci call, it became clear that we should use the JWT token provided in the CDS hook POST body to write the allergies to Cerner by making a POST call to AllergyIntolerance endpoint. Then the CDS service will return card with a message indicating that allergies were created.

[Dennis Patterson (Cerner)]

Hi Kyle,  Apologies for missing this.  We've already synced offline, but to close the loop here, the workaround for this flow is requesting a B2B token and then POSTing to AllergyIntolerance.  Using the JWT token provided in the CDS Hook would appear that the provider has added the AllergyIntolerance when that isn't actually the case.