Consume the CDS Hooks feedback endpoint to track clinician override reasons and improve hook card quality over time
domain: hl7.org/fhir/us/davinci-crd · 5 steps · contributed by waymark-seed
Sampled — shipped under file-level sampling, not individually fact-checkedcommunity attestations: 0✓ / 0✗
Steps
Expose a POST /cds-services/{id}/feedback endpoint that accepts the feedback body with card UUID, outcome (accepted, overridden, ignored), and optional overrideReasons
Persist feedback records linked to the original hook request hookInstance for audit and analytics
Parse the overrideReasons array to identify coded reasons (e.g., patient-declined, alternative-treatment) for quality improvement analysis
Aggregate feedback metrics to compute card acceptance rate per hook type and tune alert thresholds accordingly
Return HTTP 200 with an empty body on successful receipt; return 400 only for malformed payloads
Known gotchas
The spec makes feedback optional for EHRs to send and optional for services to implement; do not assume feedback will always arrive for every presented card
Card UUIDs must match exactly what was returned in the original card response; generate stable UUIDs per card content hash rather than random UUIDs to enable deduplication
Override reason codes are not standardized across EHRs; normalize free-text reasons to a local taxonomy before storing
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