Clinical Decision Support Hooks and Smart on FHIR for Sepsis Risk Assessment

ML-based Clinical Decision Support Hooks and SMART on FHIR

Purpose: Real-time clinical decision support for sepsis risk assessment within EHR systems. 

CDS Hooks and SMART on FHIR to Improve Decision Support for Identifying Patients at High Risk of Developing Sepsis

The integration of an AI-based clinical decision support system (CDSS) for sepsis risk assessment using SMART on FHIR and CDS Hooks involves several key components and workflows. The CDS Hooks are linked to the opening of a patient record in Epic, sending patient context to the CDSS. If high sepsis risk is detected, a notification card is returned to the EHR with a link to detailed patient information.

The SMART on FHIR app, integrated into Epic Hyperspace and Cerner, uses OAuth 2.0 for SSO-based user authentication and provisioning, allowing the CDSS to function both as a standalone solution and an EHR-integrated solution. The app has three main UX flows:

1. EHR Launch: Accessed from Epic’s UI, it displays a dashboard with basic patient information and sepsis alert status, with detailed patient views available upon selection.
2. Stand Alone Launch: Accessed via a separate login page, offering the same functionality as the EHR launch but outside the EHR environment.
3. SMS Launch: Users receive an SMS alert with a link to the app, directing them to a specific patient’s alert detail page after logging in with EHR credentials.

In all scenarios, the app authenticates against the EHR’s OAuth 2.0 system, retrieves patient lists and sepsis statuses from the CDSS Prediction Engine, and pulls additional patient data from the EHR FHIR server to populate the interface.