‘SMART on FHIR’ is relatively well-known in the world of healthcare IT. In 2023, Sidharth Ramesh (Medblocks) and Sebastian Iancu (CODE24), both part of the openEHR Specifications working group, worked together on an extension to the SMART on FHIR specifications: SMART on openEHR. Since then, our developer Rik Keppel has also contributed by developing a proof-of-concept app on these specifications. But what does SMART on openEHR have to offer healthcare IT?
SMART on openEHR is, in a nutshell, a specification for building interchangeable applications that work with healthcare data based on international standards.
With SMART on FHIR (also known as SMART App Launch), data exchange is specified. Technology based on these specifications is also already actively deployed by several healthcare information system vendors. The addition of SMART on openEHR also adds specifications for data modelling and data storage.
With the openEHR REST API, you can already achieve a lot in terms of linking applications with openEHR data sources. Nevertheless, it usually does require a lot of development hours. This is because for the REST API, quite little is specified in terms of authorisation, authentication, protocols and other aspects required for a proper integration. In simple terms: what you can do with it has not been elaborately defined.
SMART on openEHR is an addition to the openEHR REST API, to make connecting applications easier, more accessible and faster. So you still use the REST API, but in addition you use the SMART specification. By using these additional specifications, the operation of an integration is standardised. The SMART applications themselves contain a minimal amount of application-context data and can use data as ‘blocks’ (or ‘compositions’) while communicating with the APIs.
Ultimately, the SMART technology contributes to the freedom of healthcare organisations to decide what their application landscape looks like. If applications can be implemented and interchanged quickly and easily, it also means less vendor lock-in and more competition between them. SMART Health IT anticipates that increased competition will ensure better quality apps and lower prices.
The SMART on openEHR specifications have been documented by Sidharth Ramesh and Sebastian Iancu. They can be accessed on the website of openEHR International.
The steps you need to take as a software vendor are also related to the role you want to fulfil: do you want to give your healthcare information system the ability to link with SMART applications? Then you will have to develop a so-called SMART launcher. If you want to build a SMART application, you can link it to an open source SMART launcher in the development phase and extend it with the openEHR functionalities as stated in the specifications.
From CODE24, we see SMART on openEHR playing an important role in the healthcare IT of the future. For that reason, our open platform will include a SMART launcher and we are exploring which of our modules will be made available as SMART applications as well.
Does this article raise questions or would you like to talk to us about the possibilities SMART on openEHR has to offer? We would love to hear from you!