Stream: cds hooks
Topic: Interview Q2
Josh Mandel (Mar 03 2020 at 22:16):
What do you see as the main disadvantage or challenge to using CDS Hooks?
I got into this a little bit above, but I think about disadvantages in two categories:
-
Issues with the current status of the spec and current levels of support. CDS Hooks is still in its early days: it's at a 1.0 level, and we're only just now in the process of formally standardizing the first hook definition (
patient-view). So support for the API in vendor products is still pretty limited, and especially when you get into some of the technical features (e.g., requesting that an EHR gather "pre-fetch" data to pass along to a service) or some of the more workflow-intensive features (e.g., providing a set of "action" buttons that a user can click to update an in-progress order), support in currently-deployed EHRs is still limited. -
Fundamental issues with the nature of a standardized interface. There's always tension between the API features you can get widespread agreement on, vs the API features that can be implemented within a given vendor product. So an excellent vendor-specific API might have more features and might be easier to use than a standard like CDS Hooks. In practice, I haven't seem much in the way of vendor-specific APIs that's "easier to use" from a developer perspective, but there are certainly some extra features. (Conversely, we're in the process of standardizing some really interesting features for CDS Hooks 1.1, like a feedback endpoint for services to learn when/how their advice is taken by clinicians; I'm not aware of any vendor-specific API that has introduced this kind of functionality, so we're actually pushing the envelope and standardizing expectations here at the same time.)
Brendan Keeler (Mar 05 2020 at 06:06):
Well put. Even when available, CDS Hooks are seemingly relegated to live with the dark confines of deepest pits of EHR API programs.
Really hoping that either policy or customer demand bring about more uniformity of deployment and easy accessibility.
Last updated: Apr 12 2022 at 19:14 UTC
