{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:05:15Z","timestamp":1785416715468,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["NU38OT000316"],"award-info":[{"award-number":["NU38OT000316"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      (or gonococcus, GC) infections have increased in incidence and antibiotic resistance, prompting updates to management guidelines. Additionally, patients with recent GC infections have been identified as a target population for human immunodeficiency virus (HIV) screening and prevention. With the rapidly changing nature of such biomedical knowledge, there is an imperative to adopt public health guidelines speedily to deliver knowledge to clinicians at the point of care. Therefore, the Public Health Informatics Institute and the United States Centers for Disease Control and Prevention sought to create a scalable clinical decision support (CDS) solution that could be easily integrated using interoperability standards with widely used electronic health record (EHR) systems in the United States.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A project team including informaticians and clinical partners developed a cloud\u2010hosted CDS system, with rule logic written in the Health Level Seven (HL7) Clinical Quality Language and using the HL7 CDS Hooks protocol. The system was designed to present alerts to clinicians who, based on available data, appeared to be treating uncomplicated GC with doses or agents that were not recommended based on the patient's weight, allergies, and other characteristics. Actionable suggestions were offered for the correct regimen, and HIV testing, if applicable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After extensive testing, the system was successfully integrated with the EHR system at two academic medical institutions. Subsequently, a three\u2010month pilot was conducted in emergency and urgent care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There were limitations related to functionality, workflow issues, and data quality. This successful implementation, however, demonstrates the feasibility of this approach for select use cases of CDS, and yields further understanding of the requirements for developing scalable solutions for disseminating public health guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lrh2.70104","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:45:03Z","timestamp":1785415503000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Standards\u2010Based, Cloud\u2010Hosted\n                    <scp>CDS<\/scp>\n                    System for Gonorrhea Treatment and\n                    <scp>HIV<\/scp>\n                    Screening"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2995-230X","authenticated-orcid":false,"given":"Edna","family":"Shenvi","sequence":"first","affiliation":[{"name":"Elimu Informatics  El Cerrito California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziz","family":"Boxwala","sequence":"additional","affiliation":[{"name":"Elimu Informatics  El Cerrito California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Shaw","sequence":"additional","affiliation":[{"name":"Public Health Informatics Institute  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Berro","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2161-678X","authenticated-orcid":false,"given":"Saugat","family":"Karki","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Pooser","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane E.","family":"Yang","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema","family":"Dumitru","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Ocampo","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrita","family":"Tailor","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjat","family":"Kanjilal","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Paredes","sequence":"additional","affiliation":[{"name":"Yale New Haven Health  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritche","family":"Hao","sequence":"additional","affiliation":[{"name":"Yale New Haven Health  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitu","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Emory Healthcare  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Liebovitz","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001763"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6507a1"},{"issue":"03","key":"e_1_2_8_4_1","first-page":"1","article-title":"Sexually Transmitted Diseases Treatment Guidelines, 2015","volume":"64","author":"Workowski K. A.","year":"2015","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6950a6"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7004a1"},{"key":"e_1_2_8_7_1","unstructured":"United States. Public Health Service; Centers for Disease Control and Prevention (U.S.);National Center for HIV\/AIDS Viral Hepatitis STD and TB Prevention (U.S.). Division of HIV\/AIDS Prevention. Preexposure Prophylaxis Work Group \u201cPreexposure Prophylaxis for the Prevention of HIV Infection in the United States\u20142021. Update: A Clinical Practice Guideline 2021 \u201daccessed February 28 2025 https:\/\/stacks.cdc.gov\/view\/cdc\/112360."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2196\/53000"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lrh2.10208"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artmed.2013.03.004"},{"key":"e_1_2_8_11_1","unstructured":"Health Level Seven \u201cCDS Hooks \u201daccessed February 11 2024 https:\/\/cds\u2010hooks.org\/."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocac085"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2196\/40338"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3233\/SHTI190326"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocac028"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2022.104749"},{"key":"e_1_2_8_17_1","first-page":"683","article-title":"FHIR Lab Reports: Using SMART on FHIR and CDS Hooks to Increase the Clinical Utility of Pharmacogenomic Laboratory Test Results","volume":"2020","author":"Watkins M.","year":"2020","journal-title":"AMIA Joint Summits on Translational Science Proceedings"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100038\u20101676466"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl\u20102011\u2010000334"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100041\u20101740484"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475\u20106773.2006.00635.x"},{"key":"e_1_2_8_22_1","unstructured":"\u201cUS Core Observation Pregnancy Status Profile\u2014US Core Implementation Guide v8.0.1 \u201daccessed April 15 2026 https:\/\/hl7.org\/fhir\/us\/core\/STU8.0.1\/StructureDefinition\u2010us\u2010core\u2010observation\u2010pregnancystatus.html."},{"key":"e_1_2_8_23_1","unstructured":"Health Level Seven \u201cClinical Reasoning Module\u2014FHIR v4.0.1 \u201daccessed March 11 2025 https:\/\/hl7.org\/fhir\/R4\/clinicalreasoning\u2010module.html."},{"key":"e_1_2_8_24_1","unstructured":"Health Level Seven \u201cClinical Quality Language (CQL) \u201daccessed February 28 2025 https:\/\/cql.hl7.org\/."},{"key":"e_1_2_8_25_1","unstructured":"National Library of Medicine \u201cValue Set Authority Center \u201daccessed February 28 2025 https:\/\/vsac.nlm.nih.gov\/."},{"key":"e_1_2_8_26_1","unstructured":"Red Hat \u201cKogito \u201daccessed March 13 2025 https:\/\/kogito.kie.org\/."},{"key":"e_1_2_8_27_1","unstructured":"Object Management Group \u201cBusiness Process Model and Notation Specification 2014 \u201daccessed April 18 2024 https:\/\/www.omg.org\/spec\/BPMN."},{"key":"e_1_2_8_28_1","unstructured":"Clinical Quality Framework \u201cCQL Engine 2024 \u201daccessed February 28 2025 https:\/\/github.com\/cqframework\/cql\u2010engine."},{"key":"e_1_2_8_29_1","unstructured":"Smile Digital Health \u201cHAPI FHIR. HAPI FHIR Documentation \u201daccessed February 28 2025 https:\/\/hapifhir.io\/hapi\u2010fhir\/docs\/introduction\/table_of_contents.html."},{"key":"e_1_2_8_30_1","unstructured":"Clinical Quality Framework \u201cClinical Quality Language (CQL)\u2014Visual Studio Marketplace \u201daccessed February 28 2025 https:\/\/marketplace.visualstudio.com\/items?itemName=cqframework.cql."},{"key":"e_1_2_8_31_1","unstructured":"Elimu Informatics \u201cSource Code Repository 2024 \u201daccessed February 28 2025 https:\/\/github.com\/elimuinformatics\/sti\u2010cds\u2010service."},{"key":"e_1_2_8_32_1","unstructured":"Elimu Informatics \u201cGC CDS Hooks Demo of API 2025 \u201daccessed April 1 2026 https:\/\/vimeo.com\/1183924516."}],"container-title":["Learning Health Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lrh2.70104","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lrh2.70104","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lrh2.70104","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:45:07Z","timestamp":1785415507000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lrh2.70104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":31,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/lrh2.70104"],"URL":"https:\/\/doi.org\/10.1002\/lrh2.70104","archive":["Portico"],"relation":{},"ISSN":["2379-6146","2379-6146"],"issn-type":[{"value":"2379-6146","type":"print"},{"value":"2379-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]},"assertion":[{"value":"2025-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70104"}}