SMART on FHIR: a standards-based, interoperable apps platform for electronic health records.
SMART on FHIR: a standards-based, interoperable apps platform for electronic health records.
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DOI：
10.1093/jamia/ocv189
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发表时间：
2016-09
期刊：
影响因子：
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通讯作者：
Ramoni RB
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文献类型：
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作者：
Mandel JC;Kreda DA;Mandl KD;Kohane IS;Ramoni RB
2010年初，哈佛医学院（Harvard Medical School）和波士顿儿童医院（Boston Children’s Hospital）启动了一个互操作性项目，其独特的目标是开发一个平台，使医疗应用程序只需编写一次，就可以在不同的医疗保健IT系统中不经修改地运行。该项目被称为可替代医疗应用和可重复使用技术（SMART）。方法应用程序接口传输、授权和用户界面采用现代web标准，编码数据采用标准医学术语。在最初的设计中，我们创建了自己的公开许可临床数据模型，以加强一致性和简单性。在2013年下半年，我们更新了SMART，以利用临床数据模型和应用程序编程接口，该接口描述了一个新的，公开许可的健康级别7草案标准，称为快速健康互操作性资源（FHIR）。我们将新平台称为FHIR SMART，标志着我们采用了新兴的FHIR标准。在2014年2月的健康信息管理系统协会会议上，我们在FHIR平台上介绍了SMART，包括几个商业医疗保健IT供应商和应用程序开发人员展示了原型。这确立了SMART在FHIR上的可行性，同时强调了在FHIR基础规范上普遍接受的实用约束的必要性。在本文中，我们描述了基于FHIR的SMART的创建过程，介绍了基于FHIR原型构建SMART的供应商和开发人员的经验，并讨论了从早期的行业原型到行业范围内的生产使用的一些挑战。
Objective In early 2010, Harvard Medical School and Boston Children’s Hospital began an interoperability project with the distinctive goal of developing a platform to enable medical applications to be written once and run unmodified across different healthcare IT systems. The project was called Substitutable Medical Applications and Reusable Technologies (SMART). Methods We adopted contemporary web standards for application programming interface transport, authorization, and user interface, and standard medical terminologies for coded data. In our initial design, we created our own openly licensed clinical data models to enforce consistency and simplicity. During the second half of 2013, we updated SMART to take advantage of the clinical data models and the application-programming interface described in a new, openly licensed Health Level Seven draft standard called Fast Health Interoperability Resources (FHIR). Signaling our adoption of the emerging FHIR standard, we called the new platform SMART on FHIR. Results We introduced the SMART on FHIR platform with a demonstration that included several commercial healthcare IT vendors and app developers showcasing prototypes at the Health Information Management Systems Society conference in February 2014. This established the feasibility of SMART on FHIR, while highlighting the need for commonly accepted pragmatic constraints on the base FHIR specification. Conclusion In this paper, we describe the creation of SMART on FHIR, relate the experience of the vendors and developers who built SMART on FHIR prototypes, and discuss some challenges in going from early industry prototyping to industry-wide production use.