The up-and-coming SMART and FHIR health information interoperability protocols got another boost this week. Cerner Corp. Wednesday unveiled an online sandbox for mobile app and other developers to use the twin tools to interact with its electronic health records.
SMART and FHIR were developed to take the same sort of web-based communication tools – how an outside app connects to the proprietary software on a smart phone -- and apply them to a set of healthcare transactions. And while experts say it's just one step toward the holy grail of interoperability, it's an important one.
“This announcement by Cerner is very exciting because they're clearly trying to spark the other part of the equation,” app development, said Dr. Kenneth Mandl, the director of Boston Children's Hospital's Computational Health Informatics Program, home to the SMART project.
He said if an national interoperability effort using SMART on FHIR is implemented the right way, an app could run anywhere in the healthcare system, whether it be on Cerner, Epic or Meditech. “That market opportunity will attract better development and a much wider selection of apps for clinicians and health systems.”
With this move, Cerner has enabled developers to work out the kinks of their connections to the company's products using SMART and FHIR tools.
“Fostering new ideas from the developer community enables us to reach a broader market of potential users,” said Bob Robke, Cerner's vice president for interoperability, in a news release. “It's this open platform that has potential to unlock the next cutting-edge solution that could benefit not only our entire client base, but the industry as well.”
The North Kansas City, Mo.-based developer of electronic health records systems first participated in a coming out party for the combined technologies at the 2014 HIMSS trade show.
Since then, FHIR, (pronounced “fire”) and short for Fast Healthcare Interoperability Resources, has drawn some of the health IT industry's largest EHR developers to take a look and kick its tires. FHIR is a project of the standards development organization Health Level Seven.
SMART (Substitutable Medical Apps, Reusable Technology), a healthcare mobile application development project at the Boston Children's Hospital Informatics Program, has been pairing with FHIR for the past couple of years as well.
Combined, the two protocols are called SMART on FHIR.
The new workspace is called the Cerner Open Developer Experience (code_). There are 15 SMART on FHIR apps from various vendors either in use or under development that will be demoed by Cerner at HIMSS this year, Feb. 29-March 4 in Las Vegas, the company said.
Modules and apps that connect to EHR transactional systems can enhance usability, functionality and interoperability, said Dr. John Halamka, CIO at Beth Israel Deaconess Medical Center, a founding Argonaut participant, “Cerner's effort will educate the rest of the industry.”
There is a lot of pent-up demand for interoperability, said Robke, in an interview, adding that groups have been trying to figure it out for a long time now.
Several Cerner clients already have mobile apps using SMART on FHIR, he said. There are 15 SMART on FHIR apps from various vendors either in use or under development that will be tested by Cerner at the HIMSS convention this year.
At this point, most of the apps pull information from an EHR, but returning the data to the EHR with value-added analysis remains a nascent technology, he said. Some SMART on FHIR apps can send back a summary in document form for storage in an EHR, but “there's lots of value” even in one-way communication available so far, he said.
Mandl said there is significant value in what providers can do with one way communication. That could leave to visualization of existing data, a mash-up of EHR data with external data sources and the ability to deliver decision support.
“At the same time, we should not wait too long for two-way. Clearly, what's going to happen is we're going to have to figure out where to put the documents from these apps. I would think it's in the best interest of the EHR developers that those documents have a place.”
