The healthcare market is evolving, as providers and patients demand the kind of access to data that they experience in other industries, such as banking. Today, a new technology platform aims to improve interoperability by allowing healthcare data to be automatically sent or received, from system to system, in real time. It’s called SMART on FHIR® (Fast Healthcare Interoperability Resources).
A little background
Application programming interfaces (or APIs) do a lot of heavy lifting when it comes to trying to solve the healthcare industry’s interoperability challenges. APIs allow one piece of software to interact with another piece of software, sharing data. When an API is “open,” the owner of the software can give secure access to other authorized users.
APIs are already used by Amazon, Facebook, and Google, among many others, as they are designed to create better functionality and experiences for the user. The goal is the same in healthcare, and Seema Verma, administrator of the Centers for Medicare and Medicaid Services (CMS), believes the future of healthcare depends on the development of open APIs.
SMART on FHIR
SMART on FHIR is an open API that is getting a lot of buzz, especially with EHR providers. SMART stands for Substitutable Medical Applications, Reusable Technologies, and it is an open, standards-based technology platform that enables innovators to create apps that seamlessly and securely run across the healthcare system in real time. Open standards enable developers to build apps to connect to health data systems, such as EHRs and data warehouses, without requiring specialized knowledge about each system. SMART provides the layer of authentication.
SMART started in 2010 with a $15 million grant from the Office of the National Coordinator for Health Information Technology (ONC-HIT), to build a standard framework that allows the development of “interchangeable healthcare applications.” The goal was to enable any developer to create a healthcare application that would work at any healthcare organization, regardless of electronic health record (EHR). Providers could then select and use the applications best suited to their needs. The key feature of SMART technology is the interoperability it allows between various systems.
FHIR uses the API standards that apps need to exchange information, such as sharing data between two disparate EHR providers. The FHIR format creates the standardization that allows the transfer of data back and forth.
FHIR defines the structure of where data should live and how it should work. SMART outlines how apps will be launched in the EHR. It standardizes the securing protocols used by third-parties to exchange data with healthcare organizations. SMART works in conjunction with and on top of FHIR, which is why it’s referred to as “SMART on FHIR”. Together, SMART on FHIR allows more interoperability by acting as the communication layer technology.
The future is in the SMART apps. Libraries of SMART apps are being designed with the goal of improving clinical care, research, and public health. With SMART on FHIR, applications can be plugged into an EHR system , portal, Health Information Exchange, and other Health IT system, and feed information directly into the provider workflow, avoiding the pitfalls of document-based exchange, which often requires a provider to access data separately or acquire it in batch format.
Some EHRs are creating a sandbox for developers interested in linking to the EHR using FHIR. This is where the innovation with apps can occur. SMART on FHIR could allow custom user interfaces to be created to improve usability of EHRs. There are so many possibilities.
While SMART on FHIR may not affect clinicians directly, they will notice that the EHRs that have SMART on FHIR will facilitate easy sharing of data with physicians and patients, and will improve the efficiency of the provider through real-time support.