Tuesday, April 24, 2012

This Seems To Be A Very Interesting And Innovative Approach. I Wonder Where It Might Lead.

The following summary report appeared a little while ago

SMART platform 'promising' for EHRs

By mdhirsch
Created Mar 21 2012 - 10:17pm
The Substitutable Medical Applications, Reusable Technologies (SMART) platform appears to be a "promising approach" to improve electronic health records now that phase one of the project has been completed, according to its developers.
The creators report [1] this week in the Journal of American Medical Informatics Association that unlike current proprietary EHR systems, the SMART platform operates as a standard base platform to which users can add or subtract modular third-party applications, similar to the methodology used by iPhone or Android.
The researchers noted that in just 14 months, they have developed "containers"--such as EHRs and health information exchanges and charter applications--to showcase the system's capability.
"With the cost of switching kept low, the platform enables a physician using an EHR, a Chief Information Officer running a hospital IT infrastructure, or a patient using a personally controlled health record (PCHR) to readily discard an underperforming app and install a better one. Competition on quality, cost, and usability is enabled, and the pace of innovation increases," the developers said.
More here:
Here is the direct link to the full free paper.
The abstract is as follows:

The SMART Platform: early experience enabling substitutable applications for electronic health records

  1. Kenneth D Mandl1,2,
  2. Joshua C Mandel1,3,
  3. Shawn N Murphy4,5,
  4. Elmer Victor Bernstam6,
  5. Rachel L Ramoni1,2,
  6. David A Kreda7,
  7. J Michael McCoy8,
  8. Ben Adida9,
  9. Isaac S Kohane1,2
  • Received 3 October 2011
  • Accepted 12 February 2012
  • Published Online First 17 March 2012

Abstract

Objective The Substitutable Medical Applications, Reusable Technologies (SMART) Platforms project seeks to develop a health information technology platform with substitutable applications (apps) constructed around core services. The authors believe this is a promising approach to driving down healthcare costs, supporting standards evolution, accommodating differences in care workflow, fostering competition in the market, and accelerating innovation.
Materials and methods The Office of the National Coordinator for Health Information Technology, through the Strategic Health IT Advanced Research Projects (SHARP) Program, funds the project. The SMART team has focused on enabling the property of substitutability through an app programming interface leveraging web standards, presenting predictable data payloads, and abstracting away many details of enterprise health information technology systems. Containers—health information technology systems, such as electronic health records (EHR), personally controlled health records, and health information exchanges that use the SMART app programming interface or a portion of it—marshal data sources and present data simply, reliably, and consistently to apps.
Results The SMART team has completed the first phase of the project (a) defining an app programming interface, (b) developing containers, and (c) producing a set of charter apps that showcase the system capabilities. A focal point of this phase was the SMART Apps Challenge, publicized by the White House, using http://www.challenge.gov website, and generating 15 app submissions with diverse functionality.
Conclusion Key strategic decisions must be made about the most effective market for further disseminating SMART: existing market-leading EHR vendors, new entrants into the EHR market, or other stakeholders such as health information exchanges.
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Here is the link for the abstract.
You can see the data model (so far) from this link:
The idea of developing iPad and Android like apps for a Health Information Source is an interesting one. If such an approach can generate one thousandth of the innovation we have seen in those apps in the Health Information space all our Christmases may have come at once!
Here is the core site to keep an eye on.
http://wiki.chip.org/smart-project/index.php/Developers_Documentation:_SMART_Data_Model
David.

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