Behavioral Health SMART on FHIR app
Client: Large Children’s Hospital on the East Coast
Purpose: Improving the quality of care for ADHD patients.
Our client is a Behavioral health Information system focused on providing evidence-based tools for improving the quality of care for ADHD (Attention deficit hyperactivity disorder) patients. Software is used by physicians, parents, school teachers & other stake-holders in the ADHD patient’s continued care to document their findings of the patient’s progress. Software in-turn consolidates data from all these sources & presents to physicians reports that help in deciding medication and other treatment options for the patients. This consolidated report needed to be shown within the EHR of hospitals. A SMART on FHIR app was developed to fulfill this need.
Solution
A SMART on FHIR JavaScript app was developed to show a subset of the existing consolidated report. Most of the backend .Net code was utilized to develop the report and evolving medications list. A chain of trust solutions was created to authenticate users within software utilizing the authenticated token from Epic (EHR) and an FHIR server URL. The FHIR server URLs were whitelisted to ensure the chain of trust. The token was first utilized to get user context from the FHIR server URL to a: ensure token’s validity and b: get user context for authentication in software. After the user authentication, the patient context was used to see if a patient was found within the software using primary and secondary matching criteria for the mapped facility. If no patient was found then a new patient record was created. If a patient is found within the system, then the consolidated report for that patient was generated and passed on to the SMART on FHIR app. Different patient assessments were also integrated into the SMART on FHIR app. This SMART on FHIR app has been integrated into Epic and Cerner. Allscripts integration testing underway. All vanilla FHIR calls are used and no EHR specific APIs are used to keep one SMART on FHIR
Requirements
The existing web app was needed to be visible within each EHR starting with Epic. The Physician should be able to see the app in a web frame in the EHR by clicking on a tab in the Patient‘s Record. Upon accessing the tab that the Patient’s identifier information and current medication need to be passed to the software web server, which will either return a “No Patient Found” message and create the patient within the software database or show a customized report in a web frame. EHR users need not enter user credentials into the Behavioral health app.
Technology Used
ASP Web Forms, Entity Framework, ADO.Net, jQuery, JavaScript, VB.Net, C#, Web Services, ASP.net Forms Authentication, OAuth 2.0.