CDS Hooks
2.0.0 - ci-build
CDS Hooks
2.0.0 - ci-build
CDS Hooks, published by Clinical Decision Support WG. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cds-hooks/ and changes regularly. See the Directory of published versions
order-select| Metadata | Value |
|---|---|
| specificationVersion | 1.0 |
| hookVersion | 1.0 |
| Hook maturity | 4 - Documented |
The order-select hook occurs after the clinician selects the order and before signing.
This hook occurs when a clinician initially selects one or more new orders from a list of potential orders for a specific patient (including orders for medications, procedures, labs and other orders). The newly selected order defines that medication, procedure, lab, etc, but may or may not define the additional details necessary to finalize the order.
order-select is among the first workflow events for an order entering a draft status. The context of this hook may include defaulted order details upon the clinician selecting the order from the order catalogue of the CPOE, or upon her manual selection of order details (e.g. dose, quantity, route, etc). CDS services should expect some of the order information to not yet be specified. Additionally, the context may include previously selected orders that are not yet signed from the same ordering session.
This hook is intended to replace (deprecate) the medication-prescribe hook.
Decision support should focus on the ‘selected’ orders - those that are newly selected or currently being authored. The non-selected orders are included in the context to provide context and to allow decision support to take into account other pending actions that might not yet be stored in the system (and therefore not queryable).
The context of this hook distinguishes between the list of unsigned orders from the clinician’s ordering session, and the one or more orders just added to this list. The selections field contains a list of ids of these newly selected orders; the draftOrders Bundle contains an entry for all unsigned orders from this session, including newly selected orders.
| Field | Optionality | Prefetch Token | Type | Description |
|---|---|---|---|---|
userId |
REQUIRED | Yes | string | The id of the current user. For this hook, the user is expected to be of type Practitioner or PractitionerRole. For example, PractitionerRole/123 or Practitioner/abc. |
patientId |
REQUIRED | Yes | string | The FHIR Patient.id of the current patient in context |
encounterId |
OPTIONAL | Yes | string | The FHIR Encounter.id of the current encounter in context |
selections |
REQUIRED | No | array | The FHIR id of the newly selected order(s). The selections field references FHIR resources in the draftOrders Bundle. For example, MedicationRequest/103. |
draftOrders |
REQUIRED | No | object | A Bundle of FHIR request resources with a draft status, representing orders that aren’t yet signed from the current ordering session. |
CDS Hooks is designed to be agnostic of FHIR version. For example, all versions of FHIR can represent in-progress orders but over time, the specific resource name and some of the important elements have changed. Below are some of the mosty commonly used FHIR resources for representing an order in CDS Hooks. This list is intentionally not comprehensive.
{
"context":{
"userId":"PractitionerRole/123",
"patientId":"1288992",
"encounterId":"89284",
"selections": [ "NutritionOrder/pureeddiet-simple", "MedicationRequest/smart-MedicationRequest-103" ],
"draftOrders":{
"resourceType":"Bundle",
"entry":[
{
"resource":{
"resourceType":"NutritionOrder",
"id":"pureeddiet-simple",
"identifier":[
{
"system":"http://goodhealthhospital.org/nutrition-requests",
"value":"123"
}
],
"status":"draft",
"patient":{
"reference":"Patient/1288992"
},
"dateTime":"2014-09-17",
"orderer":{
"reference":"Practitioner/example",
"display":"Dr Adam Careful"
},
"oralDiet":{
"type":[
{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"226211001",
"display":"Pureed diet"
},
{
"system":"http://goodhealthhospital.org/diet-type-codes",
"code":"1010",
"display":"Pureed diet"
}
],
"text":"Pureed diet"
}
],
"schedule":[
{
"repeat":{
"boundsPeriod":{
"start":"2015-02-10"
},
"frequency":3,
"period":1,
"periodUnit":"d"
}
}
],
"texture":[
{
"modifier":{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"228055009",
"display":"Liquidized food"
}
],
"text":"Pureed"
}
}
],
"fluidConsistencyType":[
{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"439021000124105",
"display":"Dietary liquid consistency - nectar thick liquid"
}
],
"text":"Nectar thick liquids"
}
]
},
"supplement":[
{
"type":{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"442971000124100",
"display":"Adult high energy formula"
},
{
"system":"http://goodhealthhospital.org/supplement-type-codes",
"code":"1040",
"display":"Adult high energy pudding"
}
],
"text":"Adult high energy pudding"
},
"productName":"Ensure Pudding 4 oz container",
"instruction":"Ensure Pudding at breakfast, lunch, supper"
}
]
}
},
{
"resource":{
"resourceType":"MedicationRequest",
"id":"smart-MedicationRequest-103",
"meta":{
"lastUpdated":"2018-04-30T13:25:40.845-04:00"
},
"text":{
"status":"generated",
"div":"<div xmlns=\"http://www.w3.org/1999/xhtml\">Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension (rxnorm: 617993)</div>"
},
"status":"draft",
"intent":"order",
"medicationCodeableConcept":{
"coding":[
{
"system":"http://www.nlm.nih.gov/research/umls/rxnorm",
"code":"617993",
"display":"Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension"
}
],
"text":"Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension"
},
"subject":{
"reference":"Patient/1288992"
},
"dosageInstruction":[
{
"text":"5 mL bid x 10 days",
"timing":{
"repeat":{
"boundsPeriod":{
"start":"2005-01-04"
},
"frequency":2,
"period":1,
"periodUnit":"d"
}
},
"doseAndRate":{
"doseQuantity":{
"value":5,
"unit":"mL",
"system":"http://unitsofmeasure.org",
"code":"mL"
}
}
}
],
"dispenseRequest":{
"numberOfRepeatsAllowed":1,
"quantity":{
"value":1,
"unit":"mL",
"system":"http://unitsofmeasure.org",
"code":"mL"
},
"expectedSupplyDuration":{
"value":10,
"unit":"days",
"system":"http://unitsofmeasure.org",
"code":"d"
}
}
}
}
]
}
}
}
{
"context":{
"userId":"Practitioner/example",
"patientId":"1288992",
"encounterId":"89284",
"selections": [ "NutritionOrder/pureeddiet-simple", "MedicationRequest/smart-MedicationRequest-103" ],
"draftOrders":{
"resourceType":"Bundle",
"entry":[
{
"resource":{
"resourceType":"NutritionOrder",
"id":"pureeddiet-simple",
"identifier":[
{
"system":"http://goodhealthhospital.org/nutrition-requests",
"value":"123"
}
],
"status":"draft",
"patient":{
"reference":"Patient/1288992"
},
"dateTime":"2014-09-17",
"orderer":{
"reference":"Practitioner/example",
"display":"Dr Adam Careful"
},
"oralDiet":{
"type":[
{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"226211001",
"display":"Pureed diet"
},
{
"system":"http://goodhealthhospital.org/diet-type-codes",
"code":"1010",
"display":"Pureed diet"
}
],
"text":"Pureed diet"
}
],
"schedule":[
{
"repeat":{
"boundsPeriod":{
"start":"2015-02-10"
},
"frequency":3,
"period":1,
"periodUnit":"d"
}
}
],
"texture":[
{
"modifier":{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"228055009",
"display":"Liquidized food"
}
],
"text":"Pureed"
}
}
],
"fluidConsistencyType":[
{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"439021000124105",
"display":"Dietary liquid consistency - nectar thick liquid"
}
],
"text":"Nectar thick liquids"
}
]
},
"supplement":[
{
"type":{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"442971000124100",
"display":"Adult high energy formula"
},
{
"system":"http://goodhealthhospital.org/supplement-type-codes",
"code":"1040",
"display":"Adult high energy pudding"
}
],
"text":"Adult high energy pudding"
},
"productName":"Ensure Pudding 4 oz container",
"instruction":"Ensure Pudding at breakfast, lunch, supper"
}
]
}
},
{
"resource":{
"resourceType":"MedicationRequest",
"id":"smart-MedicationRequest-103",
"meta":{
"lastUpdated":"2018-04-30T13:25:40.845-04:00"
},
"text":{
"status":"generated",
"div":"<div xmlns=\"http://www.w3.org/1999/xhtml\">Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension (rxnorm: 617993)</div>"
},
"status":"draft",
"intent":"order",
"medicationCodeableConcept":{
"coding":[
{
"system":"http://www.nlm.nih.gov/research/umls/rxnorm",
"code":"617993",
"display":"Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension"
}
],
"text":"Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension"
},
"subject":{
"reference":"Patient/1288992"
},
"dosageInstruction":[
{
"text":"5 mL bid x 10 days",
"timing":{
"repeat":{
"boundsPeriod":{
"start":"2005-01-04"
},
"frequency":2,
"period":1,
"periodUnit":"d"
}
},
"doseQuantity":{
"value":5,
"unit":"mL",
"system":"http://unitsofmeasure.org",
"code":"mL"
}
}
],
"dispenseRequest":{
"numberOfRepeatsAllowed":1,
"quantity":{
"value":1,
"unit":"mL",
"system":"http://unitsofmeasure.org",
"code":"mL"
},
"expectedSupplyDuration":{
"value":10,
"unit":"days",
"system":"http://unitsofmeasure.org",
"code":"d"
}
}
}
}
]
}
}
}
"context":{
"userId":"Practitioner/example",
"patientId":"1288992",
"encounterId":"89284",
"selections":[ "NutritionOrder/nest-patient-1-NUTR1", "MedicationOrder/smart-MedicationOrder-103" ],
"draftOrders":{
"resourceType":"Bundle",
"entry":[
{
"resource":{
"resourceType":"NutritionOrder",
"id":"nest-patient-1-NUTR1",
"patient":{
"reference":"Patient/1288992"
},
"orderer":{
"display":"Dr Adam Careful"
},
"identifier":[
{
"system":"http://goodhealthhospital.org/nutrition-orders",
"value":"123"
}
],
"dateTime":"2014-09-17",
"status":"draft",
"oralDiet":{
"type":[
{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"435801000124108",
"display":"Texture modified diet"
},
{
"system":"http://goodhealthhospital.org/diet-type-codes",
"code":"1010",
"display":"Texture modified diet"
}
],
"text":"Texture modified diet"
}
],
"schedule":[
{
"repeat":{
"boundsPeriod":{
"start":"2015-02-10"
},
"frequency":3,
"period":1,
"periodUnits":"d"
}
}
],
"texture":[
{
"modifier":{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"228049004",
"display":"Chopped food"
}
],
"text":"Regular, Chopped Meat"
},
"foodType":{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"22836000",
"display":"Vegetable"
}
],
"text":"Regular, Chopped Meat"
}
}
]
}
}
},
{
"resource":{
"resourceType":"MedicationOrder",
"id":"smart-MedicationOrder-103",
"status":"draft",
"patient":{
"reference":"Patient/1288992"
},
"medicationCodeableConcept":{
"coding":[
{
"system":"http://www.nlm.nih.gov/research/umls/rxnorm",
"code":"617993",
"display":"Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension"
}
],
"text":"Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension"
},
"dosageInstruction":[
{
"text":"5 mL bid x 10 days",
"timing":{
"repeat":{
"boundsPeriod":{
"start":"2005-01-04"
},
"frequency":2,
"period":1,
"periodUnits":"d"
}
},
"doseQuantity":{
"value":5,
"unit":"mL",
"system":"http://unitsofmeasure.org",
"code":"mL"
}
}
],
"dispenseRequest":{
"numberOfRepeatsAllowed":1,
"quantity":{
"value":1,
"unit":"mL",
"system":"http://unitsofmeasure.org",
"code":"mL"
},
"expectedSupplyDuration":{
"value":10,
"unit":"days",
"system":"http://unitsofmeasure.org",
"code":"d"
}
}
}
}
]
}
}
| Version | Description |
|---|---|
| 1.0 | Initial Release |
| 1.0.1 | Small documentation correction |
| 1.0.2 | Add DeviceRequest to list of order resources for R4. |
IG © 2019+ Clinical Decision Support WG. Package hl7.other.uv.cds-hooks#2.0.0 based on FHIR 4.0.1. Generated 2024-05-28
Links: Table of Contents |
QA Report
| Version History |
|
Propose a change