Getting SMART on FHIR


Getting SMART on FHIR
HL7 Fhir Getting SMART on FHIR

The key to the successful delivery of healthcare today is interoperability. It allows the collection and easy access to a patient’s PHI (protected health information). All this information is scattered in disconnected EHRs, connecting the fragments into a monolith of healthcare information to ensure healthcare organizations’ highest quality of care and smooth operation. A data standard needed to be put in place. That standard is known as FHIR. SMART sits on top of it. So, what is SMART on FHIR? Let’s break it down.


SMART and FHIR were developed for the same purpose of standardization. As the latter achieved it first, the two now work in conjunction, ensuring seamless data alteration and exchange.

What is FHIR?

Fast Healthcare Interoperability Resource is a standard defining how information is stored and exchanged between different EHR systems. It was developed by Hl7, an ANSI-accredited standards-developing organization ensuring the exchange and delivery of electronic health information. Initially, SMART (Sustainable Medical Applications, Reusable Technologies) was being developed as such a standard. However, spread first. That is why SMART now works on top of it, which is why it is referred to as SMART on FHIR.

What is SMART?

SMART Health IT was launched, proposing a universal API (application programming interface) to transform EHRs into platforms working on iPhone-like apps. Moving away from the original idea, SMART Health focused on formalizing and standardizing the data exchange process: how the  SMART FHIR apps will be launched from the EHR and defining the security protocols of the information exchange. An open, free, and standards-based API allows developers to create a health app that securely runs across healthcare systems.

What is SMART on FHIR, and How Does it Work?

EHR systems store patient information in accordance with how FHIR requires it. This information (data) is stored as FHIR resources. Should a third-party app need access to specific pieces of this information (the patient’s name, age, condition, etc.), and should that access be granted by the user, the data is altered, transferred, and presented in the app. SMART handles this data road trip – thus, we have answered the question of what is SMART on FHIR.

Challenges and Benefits of Implementing SMART on FHIR

The ONC’s (Office of the National Coordinator for Health Information Technology) Cures Act Final Rule calls for patients’ easy and secure access to their electronic health information. This is easily achieved through a standardized API – SMART was later identified as that API. However, this call is not mandatory for the private sector, which means that, outside of government organizations, it is up to private clinicians to decide whether they want their EHR systems to be compatible with SMART on FHIR.

Another potential challenge comes in the form of EHR vendors. Namely, given the efficiency and speed through which information is shared, implementing a standardized API would effectively cut into the revenue of EHR providers. While the standards do exist, their application is a process dependent on third parties. Failure of full standardized API implementation slows down achieving interoperability that would be made possible with SMART on FHIR.
It is, therefore, necessary to highlight the benefits this implementation will bring:

  • For hospitals and clinicians – easily transferable health data, ensuring seamless flow of electronic health information unburdened by traditional challenges of EHR integration
  •  For patients – better care due to the patient’s entire medical history being only a couple of clicks away
  • For developers – as SMART provides standards and specifications on FHIR, developers can focus on the health apps they are developing instead of the apps’ implementation. Effectively, more can be done for less, decreasing the costs of app development and implementation

Here at Vicert, we have already compiled a list of measurable benefits related to productivity and adherence rate amongst patients, among other things.

Implementing SMART on FHIR

We have also assembled a list of the highest-value recommendations based on our experience in the industry. If you wish to learn more about interoperability and its application to your business, take a closer look.
If you are looking for a SMART on FHIR tutorial, you can find a simple guideline on creating an app in their ecosystem posted by CERNER.

We are dedicated to ensuring the highest level of interoperability and developing healthcare apps; we strive to perfect the above process to reap the plentiful benefits. To accelerate the speed of digitalization, we recommend a few tricks of the trade to utilize tech and tools to help you with your transition. Redox has developed a tool that allows applications to communicate bi-directionally with a message-based workflow while modernizing existing healthcare interfaces and transforming them into FHIR-enabled APIs. Vicert was able to build a FHIR interface on top of Redox’s data exchange system.

SMART on FHIR is slowly becoming a requirement for easy access and seamless communication between different EHRs, proving that it is the right time to implement and roll out its capabilities. With the cultural shift of data-sharing, open APIs, and tutorials and sandboxes available, it has never been easier to develop and test SMART on FHIR apps with the potential to improve your business and the care that the customers today are deserving of. And here at Vicert – we do exactly that.