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  1. FHIR Specification Feedback
  2. FHIR-36403

CDS Hooks performance description difficult to understand

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Highest Highest
    • US Da Vinci CRD (FHIR)
    • 1.1.0-ballot [deprecated]
    • Financial Mgmt
    • STU
    • CDS Hooks Card Suggestion Action Types Value Set
    • 4.2.3 Performance
    • Hide

      Will change "action until results have been returned by the CDS service. "

      to

      "action until cards have been returned by the CDS service.  E.g. an EHR might not allow progress of an 'order sign' business action until decision support has been returned from all order-sign services and the user has had a chance to interact with any cards they deem relevant."

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      Will change "action until results have been returned by the CDS service. " to "action until cards have been returned by the CDS service.  E.g. an EHR might not allow progress of an 'order sign' business action until decision support has been returned from all order-sign services and the user has had a chance to interact with any cards they deem relevant."
    • Bob Dieterle / Chris Cioffi : 8-0-0
    • Clarification
    • Non-substantive

    Description

      Current text "Depending on their location within the workflow, CDS Hooks may be processed in a synchronous manner. This means that the user who is performing the business action that triggers the hook might be 'blocked' from continuing the action until results have been returned by the CDS service. The corollary to this is that services must respond to hook invocations quickly to avoid impeding clinician workflow - and turning the intended benefit CRD is intended to provide into a detriment. Servers SHALL provide their card responses within 5 seconds, 95% of the time. It is recognized that this may limit the payer from providing full responses to all calls where a response is 'theoretically' possible. Systems should provide the best information they can in a timely fashion and rely on other layers of the payment and adjudication process to catch issues that require longer processing."
      Please explain the "blocked" comment. CDS Hooks configured based on a trigger will return a card. In what scenario would the next step be blocked? The current documentation is not clear and seems to assume the reader understands the author's thinking process. Comments about response time are useful but if you are talking about unacceptable time delays for synchronous processing then say so. Or define "blocked".

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            feisenberg Floyd Eisenberg
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              Updated:
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