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What is SMART on FHIR?

What is SMART on FHIR?
What is SMART on FHIR?

>> What is SMART on FHIR?

As data interoperability in the healthcare world becomes the new standard for providing quality solutions to patients, SMART has emerged on top of the health app developing race.

SMART stands for ‘Substitutable Medical Applications, Reusable Technologies.’ This, as the name suggests, focuses on using applications that can run on any EHR or medical applications and can be substituted at any given time.

Since it looks pretty similar to FHIR, it is often confused to be the same thing. However, FHIR had set the data interoperability standards upon which SMART works. That’s the reason why it is popularly referred to as SMART on FHIR.

The Idea Behind SMART

SMART was created to make a framework of data interoperability standards. That would make healthcare applications capable of interchanging data between themselves. A $15 million federal research grant by the government had initiated research on it.

The main goal was to launch an API that would be universal, turning every EHR/LIMS or other medical apps into a substitutable app for healthcare professionals.

That would make changing the platform of viewing and sharing the data more accessible, regardless of what EHR it was accessed on. This way, individuals could pick applications that suited them better without having to compromise on data accessibility.

How Is It Implemented On FHIR?

Before moving towards implementation, it is essential to understand that both SMART and FHIR are guidelines for implementing a specific technology. Although the process may be simple to spell out, it complicates towards the end.

The essential steps towards implementation are:

  1. A specific standard is created by Health Level Seven International (HL7).

  2. The specific standards will be implemented by healthcare apps vendors e.g. EHR or LIMS vendors. They can implement the standards in different ways, staying true to their requirements.

  3. The medical software vendors will pass on the standard to their customers, the health systems, which will then incorporate it into their systems via installation, configuration, etc.

  4. The substitutable applications will be developed on a framework of specifications provided by the health systems.

The Difficulty In The Last Step

The implementation process becomes more challenging as we move towards the end because, by the time we reach the stage of developing the application, there are many chances to stray from the original standard.

If such a deviation occurs, then the apps that are created would no longer be interchangeable. This is why extra care is given to staying true to the specific standard, no matter how different it is implemented by various healthcare systems.

The Many Forms of SMART

SMART is seen in many different forms as other apps implement the technology to further data interoperability in the healthcare industry. Some examples of the apps that use SMART technology are:


● Microsoft Azure SMART API

● Apple Health Records API

The list does not end here, SMART on FHIR is constantly being improved, and new developments in the technology bring researchers closer to achieving its ideal state.

The Difference Between SMART and Redox

Although, for the time being, both SMART and Redox technologies may seem the same, in their ideal form, SMART would be much different. Currently, both are achieving EHR integration by authorizing the process at the system level.

However, SMART aims to make authorization possible at the user level in its ideal state and provide a more patient-to-provider experience. As improvements in the SMART technology continue to grow, it furthers the goal of data interoperability in the healthcare world.


DevScripts Solutions is an IT Consultant Firm Specializing in Interoperability within the Healthcare Arena.

We are a small team solving big interoperability challenges on a daily basis. With our vast knowledge of interoperability we can integrate ourselves as part of your organization just like we are part of your full-time team. We develop a variety of custom interfaces for healthcare organizations such as Healthcare Vendors, HIEs, Health Systems, Hospitals, Medical Practices, Payors and ACOs using Mirth Connect.

We work with businesses in California, Georgia, New York, Florida, Texas and throughout the wider United States.

For more information on our services or to arrange a consultation call please contact us today.

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Healthcare Interoperability, Healthcare IT USA, healthcare it, interoperability, mirth connect, nextgen connect, interface engine, integration engine, HL7, FHIR, CCD, CCDA, FHIR, IHE, Sequoia, interface development.
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