SMART Architecture and Application Development Overview

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Presentation transcript:

SMART Architecture and Application Development Overview Nikolai Schwertner nikolai.schwertner@childrens.harvard.edu Lead Software Developer, SMART (http://smartplatforms.org)

Vocabulary Apps API Containers

Vocabulary Apps API Containers

Vocabulary Apps API Containers

Apps and containers An app runs against one container (at a time) A container connects to multiple data sources

SMART components

SMART components

SMART components

SMART components

Inspired by Web APIs Facebook, OpenSocial, Google Web standards! Apps can run on separate servers, different implementation stacks

Apps need (at least!) UI Standards-based integration, flexibility Authentication In-browser, server-to-server Data Context, Medical Record Elements

Container UI

Container UI

Container UI

Container UI

Authentication Authentication Health IT systems have different authentication mechanisms! How to keep apps agnostic? Each container implements a consistent mechanism for delegating access: OAuth. The app only needs to speak OAuth.

Apps need data! Contextual data (patient, physician)  low-hanging fruit Medical data (blood pressure, cholesterol) existing standards? pragmatic approaches?

SMART data 80/20 approach concentrate on common outpatient data Payloads specified down to coding systems e.g. SNOMED for problems (we’re opinionated!) Extensible representations in RDF iterative design, building models over time

Data elements Sample SMART Problem (RDF) <sp:Problem> <sp:problemName> <sp:CodedValue> <sp:code rdf:resource="http://www.ihtsdo.org/snomed-ct/concepts/161891005"/> <dcterms:title>Backache (finding)</dcterms:title> </sp:CodedValue> </sp:problemName> <sp:onset>2007-06-12</sp:onset> <sp:resolution>2007-08-01</sp:resolution> </sp:Problem>

Data principles REST Paradigm: Each patient, data element has a URI John Smith: http://smart-emr.hospital.org/records/123 John Smith’s atorvastatin: http://smart-emr.hospital.org/records/123/medications/456 URIs can map to underlying EMR IDs

Data principles Consistent coding systems Medications: RxNorm (SCD, SBD, Packs) Problems: SNOMED CT Labs: LOINC Containers may need to translate from other terminologies, with provenance

Data principles Consistent coding systems Example of a translated LOINC code Medications: RxNorm (SCD, SBD) Problems: SNOMED CT Labs: LOINC Containers may need to translate from other terminologies, with provenance <sp:labName> <sp:CodedValue> <sp:code rdf:resource="http://loinc.org/codes/2951-2"/> <dcterms:title>Serum sodium</dcterms:title> <sp:codeProvenance> <sp:CodeProvenance> <sp:sourceCode rdf:resource="http://local-emr/labcodes/01234" /> <dcterms:title>Random blood sodium level</dcterms:title> <sp:translationFidelity rdf:resource="http://smartplatforms.org/terms/code/fidelity#automated" /> </sp:CodeProvenance> </sp:codeProvenance> </sp:CodedValue> </sp:labName>

Data principles source Consistent coding systems Example of a translated LOINC code Medications: RxNorm (SCD, SBD) Problems: SNOMED CT Labs: LOINC Containers may need to translate from other terminologies, with provenance <sp:labName> <sp:CodedValue> <sp:code rdf:resource="http://loinc.org/codes/2951-2"/> <dcterms:title>Serum sodium</dcterms:title> <sp:codeProvenance> <sp:CodeProvenance> <sp:sourceCode rdf:resource="http://local-emr/labcodes/01234" /> <dcterms:title>Random blood sodium level</dcterms:title> <sp:translationFidelity rdf:resource="http://smartplatforms.org/terms/code/fidelity#automated" /> </sp:CodeProvenance> </sp:codeProvenance> </sp:CodedValue> </sp:labName> source

Data principles SMART translation source Consistent coding systems Example of a translated LOINC code Medications: RxNorm (SCD, SBD) Problems: SNOMED CT Labs: LOINC Containers may need to translate from other terminologies, with provenance <sp:labName> <sp:CodedValue> <sp:code rdf:resource="http://loinc.org/codes/2951-2"/> <dcterms:title>Serum sodium</dcterms:title> <sp:codeProvenance> <sp:CodeProvenance> <sp:sourceCode rdf:resource="http://local-emr/labcodes/01234" /> <dcterms:title>Random blood sodium level</dcterms:title> <sp:translationFidelity rdf:resource="http://smartplatforms.org/terms/code/fidelity#automated" /> </sp:CodeProvenance> </sp:codeProvenance> </sp:CodedValue> </sp:labName> SMART translation source

Data challenges Different coding systems e.g. for medications, NDC  RxNorm e.g. for problems, ICD9  SNOMED CT (?) Different models e.g. is a problem event-at-a-time, or duration? No models – can’t expose data you don’t have. (but some may be worth storing, e.g., fulfillments)

Architecture Summary SMART Containers supply Apps with UI integration Authenticated API Access Data Containers shoulder significant responsibility! Data models are critical to enable app developers Keeping developer experience in mind Data need to be predictable, (relatively) simple