fhir_r5_cds_hooks

A Dart package implementing CDS Hooks 2.0 for FHIR R5. Provides model classes, a client for invoking remote CDS services, and utilities for building service responses.

Features

  • CDS Hooks 2.0 model classes -- Full JSON serialization and copyWith() support for all types: CdsRequest, CdsResponse, CdsCard, CdsAction, CdsSuggestion, CdsLink, CdsSource, CdsFeedback, and more
  • Hook context classes for all standard hooks:
    • patient-view -- When a patient chart is opened
    • order-select -- When an order is selected in a CPOE workflow
    • order-sign -- When orders are being signed
    • order-dispatch -- When an order is being dispatched
    • encounter-start -- When an encounter begins
    • encounter-discharge -- When a patient is being discharged
    • appointment-book -- When an appointment is being booked
    • medication-refill -- When a medication refill is requested
    • problem-list-item-create -- When a problem is being added
    • allergyintolerance-create -- When an allergy/intolerance is being recorded
  • CDS client -- Service discovery, hook invocation, and feedback submission with injectable HTTP client for testing
  • Response builder -- Fluent API for constructing CdsResponse objects with convenience methods for info, warning, and critical cards
  • Prefetch resolver -- Resolves prefetch templates ({{context.patientId}}) against a FHIR server with authorization
  • Enums -- Typed enums for indicators (info/warning/critical), action types (create/update/delete), link types (absolute/smart), selection behavior, and feedback outcomes

Installation

Add to your pubspec.yaml:

dependencies:
  fhir_r5_cds_hooks: ^0.5.0

Usage

Discover and invoke a CDS service

import 'package:fhir_r5_cds_hooks/fhir_r5_cds_hooks.dart';

final client = CdsClient(
  baseUrl: 'https://example.com/cds-services',
  headers: {'Authorization': 'Bearer <token>'},
);

// Discover available services
final discovery = await client.discover();
for (final service in discovery.services) {
  print('${service.id}: ${service.description}');
}

// Invoke a hook
final request = CdsRequest(
  hook: 'patient-view',
  hookInstance: 'unique-id-here',
  context: PatientViewContext(
    userId: 'Practitioner/123',
    patientId: 'Patient/456',
  ).toJson(),
  fhirServer: 'https://fhir.example.com/r5',
);

final response = await client.invoke('my-service', request);
for (final card in response.cards) {
  print('${card.indicator}: ${card.summary}');
}

Build a CDS response (service side)

import 'package:fhir_r5/fhir_r5.dart';
import 'package:fhir_r5_cds_hooks/fhir_r5_cds_hooks.dart';

final builder = CdsResponseBuilder()
  ..addWarningCard(
    summary: 'Patient has a known drug allergy',
    sourceLabel: 'Allergy Check Service',
    detail: 'The patient has a documented allergy to Penicillin.',
    suggestions: [
      CdsResponseBuilder.createSuggestion(
        label: 'Switch to Azithromycin',
        action: CdsResponseBuilder.createAction(
          resource: MedicationRequest(
            status: MedicationRequestStatus.draft,
            intent: MedicationRequestIntent.order,
            medication: CodeableConcept(text: 'Azithromycin 250mg'.toFhirString),
            subject: Reference(reference: 'Patient/456'.toFhirString),
          ),
          description: 'Create alternative medication order',
        ),
      ),
    ],
  )
  ..addInfoCard(
    summary: 'Patient is due for annual wellness visit',
    sourceLabel: 'Preventive Care Reminders',
  );

final response = builder.build();

Resolve prefetch templates

import 'package:fhir_r5_cds_hooks/fhir_r5_cds_hooks.dart';

final resolver = PrefetchResolver(
  fhirServerUrl: 'https://fhir.example.com/r5',
  authorization: 'Bearer <token>',
);

final prefetch = await resolver.resolve(
  {
    'patient': 'Patient/{{context.patientId}}',
    'conditions': 'Condition?patient={{context.patientId}}&clinical-status=active',
  },
  {'patientId': '456'},
);
// prefetch['patient'] is a Patient resource (or null on failure)

Send feedback

final feedback = CdsFeedbackRequest(
  feedback: [
    CdsFeedback(
      card: 'card-uuid',
      outcome: CdsFeedbackOutcome.accepted,
      acceptedSuggestions: [
        CdsAcceptedSuggestion(id: 'suggestion-uuid'),
      ],
    ),
  ],
);

await client.sendFeedback('my-service', feedback);

Additional information

Libraries

fhir_r5_cds_hooks