What is SMART on FHIR?

If you’ve arrived at this article and you’re thinking “I don’t even know what FHIR is?!” then we would recommend starting off by giving our HL7 FHIR for Dummies article a quick read.

If on the other hand, you’ve arrived here thinking “I know exactly what HL7 FHIR is”, but you’re not exactly sure what SMART is, and why it’s been set on fire – you’re in the right place!

SMART on FHIR, in a nutshell, allows us to build apps which integrate very easily with a variety of major EHR (Electronic Health Record) vendors software. An oversimplified way of thinking about it is a bit like an Android or iPhone app which has been built and validated to work perfectly with your phone. You just have to download and install it. Voilà.

Here is a quote from SmartHealthIT.org which describes their goal:

The goal of the original SMART on FHIR API is audacious and can be expressed concisely: an innovative app developer can write an app once and expect that it will run anywhere in the health care system. Further, that one app should be readily substitutable for another. When apps are substitutable, they compete with each other which drives quality up and price down.

These SMART on FHIR apps essentially work with the security, data and UIs of the EHR platforms which support them. For security they use OAuth2 to inherit user rights from the EHR providing a seamless user experience (no forgetting passwords!). For data they tie into HL7 FHIR servers which have been deployed as an enhanced feature of the EHR, so they can access and query the patient information. And for a user experience a SMART on FHIR app can boot up externally or within the actual EHR itself – so for a clinician at the hospital it’s just there, in the software they use every day.

How you might want to use all the features available to a SMART on FHIR app really depends on the use case. If you’re building a PHR (Personal Health Record), booting up the app within the EHR itself isn’t going to be of much benefit to the patient. However, if you’re building the next latest and greatest EHR to EDC data transfer tool for a clinical study it’s going to be pretty damn useful.

SMART on FHIR is a fantastic solution for some brilliant applications. SMART on FHIRs current limitation is the availability of ‘it’ at hospitals. In the US, thanks the 21st Century Cures Act, many hospitals and EHR vendors have deployed (or are in the process of deploying) this type of technology.

In the UK/NHS, where we typically promote the quality of our health data, we’re still lacking in any such policy. FHIR is something which is being adopted but not as quickly as we would all like. Trailblazers such as the Royal Berkshire NHS Foundation Trust, Oxford University Hospitals NHS Foundation Trust and several others should be commended for their proactive developments to deploy realise this technology.

The future for healthcare interoperability with FHIR and SMART on FHIR make the future bright. The industry is only moving one direction and a world where we can easily deploy innovate applications which extend the power of EHRs across multiple hospitals creates so many amazing opportunities.

Maybe you’ve already thought of one whilst reading this article?

Here at IgniteData we’ve been using HL7 FHIR to build our EHR to EDC automation software Archer for all the reasons above. We’ve also been helping lots of our clients understand and develop their own solutions using this technology.

If you would like some friendly advice, or feel you’ve got something exciting to bring to the world, get in touch with us and we’re always happy to see how we might be able to help!