CDS Hooks, an HL7 specification for clinical decision support (CDS), enables real-time integration of CDS services within electronic health records (EHR) through RESTful APIs and specific workflow triggers or “hooks.” These hooks invoke CDS services to deliver actionable insights, such as recommending cost-effective medication alternatives or alerting clinicians to potential drug interactions, seamlessly integrated into the clinical workflow. 
 
While CDS Hooks has proven its value in clinical informatics, its application in imaging informatics remains underexplored. Expanding its use could bridge imaging findings with EHR workflows, integrating evidence-based guidelines and delivering actionable recommendations. Potential imaging applications include integrating guidelines like the Fleischner Society’s for pulmonary nodules, reporting imaging findings suggestive of drug toxicity, and providing educational resources for non-specialist clinicians. 
 
This session will review the CDS Hooks specification, including key actors, workflow triggers, and types of CDS Hooks cards. Experts will discuss current clinical use cases, explore imaging informatics applications, and provide practical frameworks for implementation. Attendees will gain insights into emerging use cases demonstrated by multidisciplinary efforts for the Radiological Society of North America’s 2025 Annual Meeting and engage in discussions to discover additional opportunities for integrating CDS Hooks in imaging informatics.

Objectives:

• Define the CDS Hooks specification and its role in clinical informatics.
  
• Identify opportunities to implement CDS Hooks in imaging informatics workflow.
• Apply a structured framework for incorporating CDS Hooks into imaging workflows.