The Office of the National Coordinator for Health IT has awarded Boston Children’s Hospital a $275,000 grant to create a website aimed at streamlining the ability of developers to publish their apps online and for providers to access, compare and test them.

The award is intended to foster the development of an ecosystem of applications that integrate with EHRs based on HL7’s emerging Fast Healthcare Interoperability Resources standard.

“It’s interesting we actually already have the site,” says Kenneth Mandl, MD, director of the Computational Health informatics Program at Boston Children’s Hospital and chair of the Substitutable Medical Applications and Reusable Technologies (SMART) Advisory Committee. “It’s called the SMART App Gallery.”

Kenneth Mandl, MD
Kenneth Mandl, MD

Mandl notes that ONC’s March 2016 request for proposals specifically cited the SMART App Gallery—a project previously funded by the agency—for the ability of the public to browse online its open source FHIR-enabled apps and as a place where users can experiment with various apps in a “sandbox” testing environment that includes sample de-identified patient data.

However, the ONC solicitation pointed out some of the SMART App Gallery’s shortcomings: the sandbox datasets that are currently available are limited in diversity, size and data type, and the site does not consistently provide comparative factors, such as system compatibility, terms of use or fee information. According to Mandl, Boston Children’s Hospital will improve the site based on ONC’s recommendations, which he believes are the right areas of enhancement to extend its capabilities.

The RFP called for the awardee to “develop an online resource, innovation sandbox and conduct market research with the focus of improving the experience of app discovery through better infrastructure and information transparency.” The SMART platform is composed of open standards, open source tools for developers building apps and a publicly accessible app gallery. Mandl argues that the sandbox, in particular, is important because it will enable providers to actually test the EHR apps.

The vision for SMART on FHIR is one in which medical apps integrate into diverse EHR systems at the point of care. SMART is being adopted in its current form across several major health systems, including Boston Children’s Hospital, Duke Health, Geisinger Health System and Intermountain Healthcare. In addition, major EHR vendors are building SMART into releases of their products.

Developed with ONC funding, SMART leverages FHIR to make it easy for app developers to access data and for EHR vendors to implement a common application programming interface. Ultimately, ONC’s goal is to enable the development of market-ready, platform-agnostic apps that enable consumers to access their own electronic health information and improve the health IT user experience of providers as they deliver care.

“It’s an important step that ONC has taken in making a statement that this app economy is in fact a very important part of the national strategy,” concludes Mandl.

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