Clinical Decision
Support Systems Interoperability

How can interoperability facilitate the use of artificial intelligence in health information systems?

Clinical Decision-Support (CDS) involves systems aimed at collecting and reasoning on clinical data to assist clinicians. As the complexity of medical knowledge increases, a smooth integration of CDS systems within health information systems is necessary to ensure interaction with other IT components, particularly with the electronic health record. To deal with interoperability issues, healthcare stakeholders are advised to adopt open systems and implement international standards.

Why is interoperability important for CDS?

  • Ability for healthcare professionals to access medical knowledge with no technical limitations,
  • Promise of breaking down technical barriers to introduce and set up a market around the computerization of medical knowledge.

CDS: the 4 biggest barriers and how to overcome them


Non-standard data formats and interaction schemes between CDS systems and their client systems

Use of open source framework OpenCDS, the standard interaction mechanism CDS-Hook leveraging SMART on FHIR technologies

Diverging thesauri between CDS systems and their client systems

Semantic alignment of the concepts of CDS systems and their client systems, based on reference terminologies (e.g. SNOMED CT, LOINC, …) operated by a FHIR terminology server

Rules non-processable (pdf) or structured with proprietary syntaxes

Rules structured in a standard syntax (e.g. CQL) and organized into knowledge artifacts

A collaborative study project to foster CDS systems interoperabilityr

PHAST is leading a study aimed at strengthening the growing CDS market by removing all barriers between providers and client systems. This project is supported by a consortium  of software vendors, startups, organizations and governmental agencies acting together as partners.

Project goals:

  • To develop the components and interfaces to achieve a normalized and interoperable CDS framework.
  • To showcase the economical and public health gains on a representative sample of healthcare players.
  • To create favorable conditions to roll out these methods on the market.

The consortium creation

  • The CDS study is a large-scale study: it will involve at least a dozen partners, over a period of 36 months.
  • A dedicated legal perimeter is necessary: ​​it will guarantee contractualisation of the roles definition, the distribution of fees and funding, and data protection.

What are the benefits for the partners involved?

PHAST invites the healthcare professionals to take part in the project to build up an open and interoperable clinical decision-support systems environment.
Governmental agencies, organizations, scientific societies
  • Transformation of clinical knowledge into interpretable and normalized rules
  • Removal of interoperability obstacles to spread these knowledge rules
  • Integration of these rules into medical activity workflows and good practice guidelines
  • Promotion of a standardized and reproducible interaction mechanism into health Apps
  • Open Health Information System to unlock innovative App growth possibilities
Software vendors for hospitals, general practitioners or specialized care 
  • Integration of the CDS systems into the patient management workflow
  • Access to terminologies and value sets defined as per specific use cases
  • Use of a standardized and reproducible interaction mechanism by CDS app
Healthcare professionals,  patients
  • Availibility of CDS Apps from healthcare professionals software
  • Access to medical and medico-economic knowledge independant of the software choice