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🧬 What SMART on FHIR Means for the Future of Healthcare

📈 SMART on FHIR is poised to transform #data #interoperability — here's how it will improve healthcare.


Most health systems know that seamless omnichannel customer engagement (a “digital front door”) is essential in order to deliver the personalized, value-based healthcare today’s consumers expect. In practice, however, implementing this digital front door strategy is challenging for most healthcare systems, due to the fragmented nature of healthcare information.

The Substitutable Medical Applications and Reusable Technologies (SMART) platform promises to solve these data fragmentation challenges by standardizing how patient data is accessed and shared. And given SMART’s inclusion in the 21st Century Cures Act, the platform will become the standard protocol for accessing electronic health records (EHRs) in the near future.

Below, we explain what SMART means for the healthcare ecosystem and how it will improve both health data interoperability and the value of healthcare technology as a whole.

What is SMART on FHIR?

SMART is an open-source, standards-based API that leverages the OAuth 2.0 standard to provide secure, universal access to EHRs. The SMART platform builds on the existing Fast Health Interoperability Resources (hence the name "SMART on FHIR").

Together, these two standards contain everything developers need to build applications that will work anywhere within the healthcare ecosystem:

  1. Open standards for protocols for authentication, authorization, and UI integration that define how to build applications with universal access to EHRs
  2. Open-source tools and libraries for developers that make it easier to use SMART standards during application development. The platform also offers a free sandbox that helps developers test their apps before deployment
  3. An application gallery that highlights all of the existing healthcare applications and software that currently uses SMART on FHIR's platform



The original idea behind SMART was first introduced in an article in the New England Journal of Medicine back in 2009. With the help of federal funding in 2010, SMART developed into the platform it is today, which is currently used by both Microsoft Azure and Apple.

How SMART Improves Healthcare Interoperability and Delivery

SMART improves healthcare interoperability in the same way standard electrical sockets and plugs simplify the process of powering different devices in your home.

Today, most EHR databases use a proprietary API (their own unique plug and socket configuration). As a result, tech companies have to build a custom connection to each database in order to access medical data. Not only is this costly, but it also hinders the ability of healthcare providers and patients to access their data with the technology that works best for them.

SMART, on the other hand, provides a standard, universal API for accessing EHRs. Any technology built with SMART works with any EHR database that uses SMART as well. As a result, healthcare technology becomes interchangeable, allowing health systems and patients to access medical data on the applications that best suit their needs, rather than only the ones that work with the EHR database they use.

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