Background: To deploy clinical decision support (CDS) systems in routine patient care they have to be certified as a medical device. The European Medical Device Regulation explicitly asks for the use of standards and interoperability in the approval process.
Objectives: We extended an existing dermatological CDS system with emerging standards for CDS interoperability, to facilitate a future integration into existing healthcare infrastructure, and approval as a medical device.
Methods: The data collection part of a CDS system was extended with the endpoints required by the CDS Hooks specification. FHIR QuestionnaireResponse resources trigger a newly defined hook.
Results: One hundred and seventeen clinical observations and patient variables needed for the ranking of a disease were mapped to SNOMED CT or LOINC and modeled as FHIR Questionnaire which is rendered using LHC LForms in a SMART on FHIR app with the SMART Dev Sandbox.
Conclusion: SMART on FHIR in combination with CDS Hooks facilitates the integration of existing CDS systems into EHR systems, potentially improving education and patient care.
Keywords: CDS Hooks; FHIR; Health Level Seven; SMART on FHIR; clinical decision support system.