Opening the Duke electronic health record to apps: Implementing SMART on FHIR.

Loading...
Thumbnail Image

Date

2017-03

Journal Title

Journal ISSN

Volume Title

Repository Usage Stats

137
views
2654
downloads

Citation Stats

Abstract

Recognizing a need for our EHR to be highly interoperable, our team at Duke Health enabled our Epic-based electronic health record to be compatible with the Boston Children's project called Substitutable Medical Apps and Reusable Technologies (SMART), which employed Health Level Seven International's (HL7) Fast Healthcare Interoperability Resources (FHIR), commonly known as SMART on FHIR.We created a custom SMART on FHIR-compatible server infrastructure written in Node.js that served two primary functions. First, it handled API management activities such rate-limiting, authorization, auditing, logging, and analytics. Second, it retrieved the EHR data and made it available in a FHIR-compatible format. Finally, we made required changes to the EHR user interface to allow us to integrate several compatible apps into the provider- and patient-facing EHR workflows.After integrating SMART on FHIR into our Epic-based EHR, we demonstrated several types of apps running on the infrastructure. This included both provider- and patient-facing apps as well as apps that are closed source, open source and internally-developed. We integrated the apps into the testing environment of our desktop EHR as well as our patient portal. We also demonstrated the integration of a native iOS app.In this paper, we demonstrate the successful implementation of the SMART and FHIR technologies on our Epic-based EHR and subsequent integration of several compatible provider- and patient-facing apps.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1016/j.ijmedinf.2016.12.005

Publication Info

Bloomfield, Richard A, Felipe Polo-Wood, Joshua C Mandel and Kenneth D Mandl (2017). Opening the Duke electronic health record to apps: Implementing SMART on FHIR. International journal of medical informatics, 99. pp. 1–10. 10.1016/j.ijmedinf.2016.12.005 Retrieved from https://hdl.handle.net/10161/17768.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Bloomfield

Richard Alan Bloomfield

Adjunct Assistant Professor in the Department of Pediatrics

As a hospitalist at Duke University who takes care of both children and adults, as well as the Director of Mobile Technology Strategy, I get to take care of patients both one at a time as well as a million at a time. Technology has never held so much promise for the improvement of medical care as it does right now.


Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.