SMART on FHIR: Transforming patient experience while delivering quality care - Brillio
Yogesh Ghariya September 5, 2022

Health is one of the biggest concerns of human beings for ages and the current ongoing pandemic has enforced its importance again. Over a period since mankind started living in colonies & cities, the healthcare system came into the picture. With the advent of innovative technologies and instruments, the healthcare industry has traveled a long way and today it became the center of attraction, innovation, and growth. This advancement in technology also leads to the development of new products and solutions which ensure quality care. EHR (Electronic Health Record) products are the key breakthrough in recent times and have now become the backbone of healthcare providers. EHR system typically contains patient information like Contact Information, Information about a visit to HCPs (Health Care Professionals), Allergies, Immunization status, a record of hospitalization, etc. In a nutshell, EHR provides holistic information about a patient’s medical history.

Current challenges

EHR products offer multiple functionalities, but a lot of times custom development becomes a necessity to cater to the patient’s and provider’s needs and enable holistic patient records. These apps will be valuable for both providers and patients:

  1. Apps for providers – Healthcare providers need to create applications that leverage data residing in EHR systems. One of the main struggles of creating such an application is that EHRs (Electronic Health Records) are not guaranteed to follow the same formatting, standards, etc. It means that organizations need to create multiple applications for the same cause based on a unique EHR system.
  2. Apps for Patients – With increasing awareness about the health and advent of new wearables and wellness apps, patients’ health data can be captured accurately which can be leveraged for diagnosis, disease prevention, etc. These wearables & apps need to integrate with EHR systems to provide complete information about patient health but again the problem of integration with HER arises.

In a brief period, we have multiple applications without a common standard for development and integration causes inefficiencies where HCPs need to switch multiple tabs/applications and a lack of patient holistic information collected through apps & wearables. Most healthcare providers understand the importance of seamless omnichannel patient engagement, which is essential to delivering personalized, value-based healthcare services.


The Substitutable Medical Applications and Reusable Technologies (SMART) platform promises to solve the above challenges by standardizing how patient data is accessed and shared along with standardizing the process of integration with EHRs. With SMART on FHIR, data coming from multiple & disparate sources can be assembled in a longitudinal view so that HCPs & caregivers no longer need to switch between different applications to piece together a complete patient history, treatment, and progress over time. This unification of data unlocks a host of possibilities. For example, the application can display graphs of a patient’s progress, view the adherence to treatment/medicines, physical exercises, etc. Considering the benefits, a consortium of EMR & EHR product vendors has adopted SMART on FHIR which will provide the APIs (application programming interfaces) to external applications to integrate with EMR products.

What is SMART on FHIR?

SMART, which is an acronym for “Substitutable Medical Applications Reusable Technologies”, was born in 2010 to build a standard framework that enables the development of “interchangeable healthcare applications”. Initially, when SMART started, the objective was to define data standards and help developers to build the healthcare application that would work at any healthcare organization regardless of the underlying EMR/EHR product. In 2013, SMART was updated to leverage the FHIR standard. Today, SMART & FHIR represent an open, standardized, and practical means of exchanging data among EHRs, health system sites, and data sources.

Gradually, SMART moved away from developing the standard and started focusing on formalizing the process for interacting with FHIR interfaces, defining how the apps will be launched, and standardizing the security protocols leveraged by different third parties to exchange the data with healthcare organization’s EHR systems. SMART works in conjunction with and on top of Fast Health Interoperability Resources (hence the name “SMART on FHIR”).

Leveraging these two standards, developers can build applications that will work anywhere within the healthcare ecosystem.

  1. SMART provides open standards for protocols for authentication, authorization, and UI (USER INTERFACE) integration which define how to build applications with universal access to EHRs
  2. Vast resources for developers like Open-source tools and libraries for developers make it easier to use SMART standards during application development.
  3. The existing application gallery has applications and software that currently uses SMART on FHIR’s platform.

How Brillio can help?

Initially, larger EHR & EMR product vendors did not encourage the outside development of leveraging APIs. However, due to a cultural shift spurred by the Federal government’s ONC rulings which make SMART on FHIR capabilities within an EHR mandatory, the rise in smart wearables and awareness about health led to widespread adoption of SMART on FHIR.

Brillio is a true digital partner to transform patients’ & HCPs’ experiences while delivering quality care. We understand the unique challenges in this industry and apply fresh thinking to build holistic experience and develop innovative solutions to solve them leveraging Domain expertise, Product centric mindset, and Agile execution.

About the Author


Yogesh Ghariya

Sr Consultant, Cloud Engineering Studio, Brillio. Presales and Business Consultant with 9+ years of industry experience in areas such as Digitization, Cloud, Artificial Intelligence, AR/VR, and Automation. He is enthusiastic about Business Development, Digital & Strategy Consulting and Product Development leveraging human centric design & innovative solutions.

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