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SMART on FHIR

 

 

 

 

 

 

 

What is FHIR?

FHIR (Fast Healthcare Interoperability Resources – Pronounced as ‘Fire’) is a healthcare information exchange standard that makes use of an HL7-defined set of “resources” to support information sharing by a variety of means, including documents, messages, services, and RESTful interfaces. FHIR is intended to be the next generation of healthcare interoperability. It combines the best features of HL7 Version 2, 3, and CDA while leveraging the latest web service technologies.

 

 

 

 

 

 

What is SMART?

SMART(Substitutable Medical Apps, Reusable Technology) is an App Platform for Healthcare. SMART Health IT is an open, standards-based technology platform that enables innovators to create apps that seamlessly and securely run across the healthcare system. Using an electronic health record (EHR) system or data warehouse that supports the SMART standard, patients, doctors, and healthcare practitioners can draw on this library of apps to improve clinical care, research, and public health.

 

 

 

 

 

What is SMART on FHIR?

SMART (“Substitutable Medical Applications, Reusable Technologies”) on FHIR is an open, HL7 FHIR standard-based platform that enables developers to create apps that can securely and seamlessly be integrated into all the major EHRs in the industry. SMART on FHIR is a set of open specifications to integrate apps with Electronic Health Records, portals, Health Information Exchanges, and other Health IT systems.

 

Few Sample SMART on FHIR Apps We Develop

1. Meds Price Compare

Med Price Compare allows us to fetch all the medication of selected patients and compare prices, print free coupons & save up to 80% on prescription and nonprescription meds. The app notifies the hospital when the patient arrives at the outpatient clinic at the time of their appointment. View at Smart App Gallery

 

SMART on FHIR helps software vendors reach more health organizations and improve their offering with easy access to patient data.

 

HL7 FHIR app

 

2. 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 CernerAllscripts 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 needs 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.

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