Stream: cds hooks
Topic: Interview Q1
Josh Mandel (Mar 03 2020 at 22:10):
What do you see as the main advantage to using CDS Hooks?
This depends on what your alternative is. I initially designed CDS Hooks with two advantages in mind:
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Advantage over using SMART Apps alone for CDS. When it comes to running a SMART app, clincians can connect all kind of CDS tools to the EHR and run them at-will. For example, you might run a bilirubin management app to guide you towards apporpriate therapy for a neonate. The main challenge becomes the cognitive burden for a clinician: there are too many apps, each doing a small job; how do you know which app to run in any given circumstance? And for apps that are critically useful but only rarely, this is an especially hard problem.
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Advantage over vendor-specific deep integration of CDS. Here, it comes down to a marketplace argument: as a service developer, it's very hard to keep up to date with a wide surface area of different EHR vendor APIs. Targeting a standard means you can focus on integrating with a consistent set of APIs, and really polishing the user experience around it. There are trade-offs here (e.g., the standard API is often going to lag behind specific vendor APIs in raw capabilities), but as the community grows, it drives consistency in the user experience.
Michaela Mirkovich (Mar 04 2020 at 22:02):
I think this first advantage you mentioned is so important. Currently working as a bedside nurse myself, I know clinicians can easily get overwhelmed with many different tasks and may not think to use a specific app that could be beneficial to them. I see great promise with CDS Hooks running these important apps automatically!
Isaac Vetter (Mar 11 2020 at 04:39):
From my perspective as an EHR developer, I see the advantage to CDS Hooks as the reverse side of Josh's second bullet --
as a service developer, it's very hard to keep up to date with a wide surface area of different EHR vendor APIs
As a CDS client developer, it's hard to educate and provide an ecosystem of testing tools and libraries that best enable a CDS service developer to use my own API. By using a standard, integration gets faster and cheaper for everyone.
Isaac Vetter (Mar 11 2020 at 04:43):
I actually disagree with Josh's point about consistent "UI". I believe that there's currently little commonality of the display of CDS Hooks cards across widely deployed EHRs.
Isaac Vetter (Mar 11 2020 at 04:49):
Lastly, CDS Hooks' modern security architecture and integration with FHIR are distinct advantages over previous remote CDS standards. Additionally, the prefetch mechanism and the CDS service's streamlined ability to query standard, RESTful FHIR APIs are novel.
Last updated: Apr 12 2022 at 19:14 UTC
