Commercial electronic health record (EHR) systems are beginning to provide support for standards-based clinical decision support (CDS) frameworks in their general-release software. Initial support is focusing on the HL7 Clinical Decision Support (CDS) Hooks standard, and some EHR vendors are beginning to support the HL7 Clinical Quality Language (CQL) standard as well. EHR vendors are also supporting the US Core Fast Healthcare Interoperability Resources (FHIR) profiles for data access. This panel will describe lessons learned from a Centers for Disease Control and Prevention (CDC) and Office of the National Coordinator for Health IT (ONC)-sponsored effort to pilot the use of opioid CDS knowledge resources using these EHR-supported CDS interoperability frameworks. Important lessons learned include the need for EHR support for additional CDS Hooks trigger events, in particular for medication ordering; the still early nature of direct CQL support in EHR vendor systems; the need to combine standards-based CDS with supplemental logic implemented using EHR platform-specific CDS rules engines; and the need for expansion and EHR vendor support for US Core FHIR profiles and interfaces, including for placing orders and for retrieving information on dispensed medications.

Learning Objective: The overall learning objective of the panel is for the learner to be able to understand the current state of standards-based CDS frameworks as well as their degree of support in commercial EHR systems.


Bryn Rhodes (Presenter)
Dynamic Content Group

Kensaku Kawamoto (Presenter)
University of Utah

Nitu Kashyap (Presenter)
Yale New Haven Health

Cole Erdmann (Presenter)

Presentation Materials: