Trial reportJournal of the American Medical Informatics Association : JAMIA2022
Using CDS Hooks to increase SMART on FHIR app utilization: a cluster-randomized trial.
Trial report in Journal of the American Medical Informatics Association : JAMIA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- The influence of electronic health record design on usability and medication safety: systematic review.BMC health services research · 2025Pooled it
- The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- A Standards-Based, Cloud-Hosted CDS System for Gonorrhea Treatment and HIV Screening.Learning health systems · 2026Article
- A lifecycle governance and learning health system framework for trustworthy, generalizable, and sustainable human-ai partnership in clinical practice: Lessons from the asthma-guidance and prediction system (A-GPS).Journal of the National Medical Association · 2026Review
- Opportunities and Challenges in Using National EHR Networks for AI in Learning Health Systems.Learning health systems · 2026Article
- Bridging Data, Semantics, and Clinical Reasoning: A Knowledge Graph Framework for Pediatric Obstructive Sleep Apnea.Children (Basel, Switzerland) · 2026Article
- Meeting the challenges of electronic health record (EHR) optimization.NPJ digital medicine · 2025Review
- Combining International Standards to Develop Clinical Decision Support for Parent Smoking Cessation in Pediatrics.Journal of medical Internet research · 2025Article
- Prompt Engineering in Clinical Practice: Tutorial for Clinicians.Journal of medical Internet research · 2025Article
- Article
- Design and implementation of electronic health record-based tools to support a weight management program in primary care.JAMIA open · 2024Article
- Machine Learning-Enabled Clinical Information Systems Using Fast Healthcare Interoperability Resources Data Standards: Scoping Review.JMIR medical informatics · 2023Article
- Current challenges for evaluating mobile health applications.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Continuing the journey toward semantic interoperability in clinical care and biomedical and health research.Journal of the American Medical Informatics Association : JAMIA · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveHL7 SMART on FHIR apps have the potential to improve healthcare delivery and EHR usability, but providers must be aware of the apps and use them for these potential benefits to be realized. The HL7 CDS Hooks standard was developed in part for this purpose. The objective of this study was to determine if contextually relevant CDS Hooks prompts can increase utilization of a SMART on FHIR medical reference app (MDCalc for EHR). MATERIALS AND
methodsWe conducted a 7-month, provider-randomized trial with 70 providers in a single emergency department. The intervention was a collection of CDS Hooks prompts suggesting the use of 6 medical calculators in a SMART on FHIR medical reference app. The primary outcome was the percentage of provider-patient interactions in which the app was used to view a recommended calculator. Secondary outcomes were app usage stratified by individual calculators.
resultsIntervention group providers viewed a study calculator in the app in 6.0% of interactions compared to 2.6% in the control group (odds ratio = 2.45, 95% CI, 1.2-5.2, P value .02), an increase of 130%. App use was significantly greater for 2 of 6 calculators. DISCUSSION AND
conclusionContextually relevant CDS Hooks prompts led to a significant increase in SMART on FHIR app utilization. This demonstrates the potential of using CDS Hooks to guide appropriate use of SMART on FHIR apps and was a primary motivation for the development of the standard. Future research may evaluate potential impacts on clinical care decisions and outcomes.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.