SMART on FHIR: a standards-based, interoperable apps platform for electronic health records

Area of Science:

• Health Informatics
• Medical Application Development
• Healthcare IT Interoperability

Background:

• The Substitutable Medical Applications and Reusable Technologies (SMART) project aimed to create a platform for medical applications to function across different healthcare IT systems.
• Initial SMART development utilized contemporary web standards and custom clinical data models for consistency.

Observation:

• SMART was updated in 2013 to leverage the Fast Health Interoperability Resources (FHIR) standard, leading to the creation of the SMART on FHIR platform.
• Prototypes of SMART on FHIR were showcased in 2014, involving commercial healthcare IT vendors and app developers, demonstrating its feasibility.

Findings:

• The SMART on FHIR platform successfully demonstrated the potential for cross-platform medical application deployment.
• The project highlighted the need for standardized pragmatic constraints on the base FHIR specification for broader adoption.

Implications:

• SMART on FHIR facilitates the development of medical applications that can operate seamlessly across various healthcare IT infrastructures.
• The experience gained from prototyping SMART on FHIR provides insights into the challenges of transitioning from industry prototyping to widespread production use in healthcare IT.