SMART on FHIR: Future of Interoperability

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Close up of Doctor is showing medical analytics data, Medical technology concept

By Kishore Pendyala of KPi-Tech Services

Most health institutions understand that providing individualized, value-based healthcare to today’s consumers requires seamless omnichannel customer engagement (a “digital front door”). In practice, however, most healthcare organizations find it difficult to adopt this digital front door strategy due to the fragmented nature of healthcare data.

By standardizing how patient data is accessible and shared, the Substitutable Medical Applications and Reusable Technologies (SMART) platform aim to address these data fragmentation issues. Because SMART was included in the 21st Century Cures Act, it will soon become the standard protocol for accessing electronic health records (EHRs).

We’ll go through what SMART implies for the healthcare ecosystem and how it will boost health data interoperability and the overall value of healthcare technology in the following sections.

Understanding SMART on FHIR?

FHIR promotes an open ecosystem of information suppliers and consumers via open APIs, it focuses on lowering interoperability costs and unlocking technical innovation in healthcare. However, there will be security concerns with any API, especially one that exposes Personal Health Information (PHI). SMART adds a layer of security to FHIR interfaces, allowing secure access to data stored in an EHR or any other repository.

SMART is a standards-based open-source API that uses the OAuth 2.0 standard to allow secure, universal access to electronic health records. The SMART platform builds on the Fast Health Interoperability Resources already in place (hence the name “SMART on FHIR”).

These two standards, when combined, provide everything developers need to create apps that work anywhere in the healthcare ecosystem:

Open-source tools and frameworks for developers that make it easier to employ SMART standards during application development. Open-source protocols for authentication, authorization and UI integration outline how to construct applications with universal access to EHRs. The platform also includes a free sandbox for developers to test their apps before releasing them.

How SMART Improves Healthcare Delivery and Interoperability

The majority of EHR databases today use a proprietary API (their own unique plug and socket configuration). As a result, in order to access medical data, IT businesses must create a specific connection to each database. This is not only expensive, but it also limits healthcare professionals’ and patients’ freedom to access their data using the technology that best suits them.

SMART, on the other hand, offers a consistent, universal API for accessing electronic health records. Any SMART-based technology is compatible with any SMART-based EHR database. As a result, healthcare technology becomes more interchangeable, allowing health systems and patients to access medical data through whatever applications best suit their needs, rather than just those that operate with the EHR database they employ.

How Improved Interoperability Increases Healthcare Technology’s Value

Interoperability is important for healthcare tech companies because it ensures innovations may be extensively understood and developed. SMART also fosters healthcare technology innovation by improving interoperability.

SMART, for example, separates the protocols for accessing EHRs from the program. As a result, healthcare technology businesses can develop their products and services without having to worry about how their changes would affect how patients and doctors access their data. As a result, healthcare applications are developed more quickly, improving the overall quality of the marketplace (and consumer care).

For software companies, SMART also makes app creation easier. Developers no longer need to create specific connections to each EHR database; instead, they can use SMART to create their apps once, and those apps will operate with any EHR databases created using SMART. As a result, their apps are more valuable to a wider range of health organizations and individuals.

The Importance of SMART’s Inclusion in the 21st Century Cures Act

The implementation of a universal API was advocated for in the 21st Century Cures Act (approved in 2016), which would “enable users to safely and conveniently access organized electronic health information utilizing smartphone applications.” The Office of the National Coordinator for Health Information Technology (ONC) later selected SMART as that universal API in its Final Rule on Interoperability (released in 2020).

This means that SMART’s API is now required for ONC-certified health IT (mainly government applications). SMART’s API, on the other hand, isn’t legally necessary for companies whose technologies aren’t employed in government applications because the ONC certification program is voluntary for the private sector.

CMS also has policies in place that “require or encourage payers to develop Application Programming Interfaces (APIs) to improve the electronic sharing of health care data.” The ideal technological standard for doing so is SMART on FHIR, which means that any health system that accepts Medicare or Medicaid must also embrace SMART.

For Healthcare Providers, SMART on FHIR is a Must

It was always difficult to extend the Healthcare IT system to as large a population as possible. This part had to deal with a slew of issues involving technology, standards, and diverse systems. SMART on FHIR, on the other hand, is a very promising and fruitful step in solving these issues and eventually leading to superior Healthcare IT systems with a much greater reach.

SMART on FHIR is a forward-thinking, successful, and widely used platform. The SMART project is establishing the next generation of FHIR-based standards to facilitate the integration of clinical decision support into provider workflows and the clinical utilization of genetic data through the SMART CDS Hooks and SMART Genomics efforts.

Healthcare is a serious and wide-ranging topic. To get the right solution, you’ll need IT expertise, healthcare domain knowledge, and dedicated resources. We have 15+ years of experience and certified developers at KPi-Tech Services.

Kishore Pendyala has more than 18 years of experience in Healthcare IT domain. He prides himself on understanding the complexities of enterprise business as well as the intricacies of running a small company. He has worn many hats (often at the same time) throughout his career including data analyst, product owner, business analyst, software engineer, team leader, QA engineer, and probably several others he’s forgotten. Out of all of this, he’s discovered his passion is really in identifying simple and effective solutions to the Healthcare Interoperability issues. This has driven his leadership at KP-Tech Services as CEO and co-founder has proven to be sustainable, and productive for the company.