1. ITdotHealth SMART Decisions
#smarthealthIT
@mandl
Computational Health Informatics Program
Boston Children’s
Department of Biomedical Informatics
Harvard Medical School

3. Video recording and subsequent posting
The meeting is being video recorded and, as with past ITdotHealth meetings, the keynotes, panels and panel discussions will be made available on the SMARTHealthIT website.

5. Virginia 2011

6. Earthquake detection, continued

8. Designing the App Store for Health

9. ‘API’
Can EMRs behave like iPhones or Androids in that innovators readily create and widely distribute SUBSTITUTABLE apps across thousands of installs?

10. Key enablers The SMART team jumped in to use and help develop FHIR
In an Aneesh Chopra-led charge, MU3, opened the door to API access in EHRs on the basis of patient rights to data
The Argonaut project has formed consensus around implementation of the SMART API and includes EHR Vendors, technology companies, health systems

11. Key enablers
The Precision Medicine Initiative (All of Us) is giving patients an opportunity to use a version of the SMART API to enable patients to knock on their doors
SMART/FHIR Apps Gallery creates an open directory for finding apps
21st Century Cures Act requires an API for certified HIT

13. 21st Century Cures Certification Requirement
‘has published application programming interfaces and allows health information from such technology to be accessed, exchanged, and used without special effort through the use of application programming interfaces or successor technology or standards, as provided for under applicable law, including providing access to all data elements of a patient’s electronic health record to the extent permissible under applicable privacy laws;

14. Weber, Mandl, Kohane JAMA

15. How does the genome get to the point of care?

16. The AI Twas Effect

17. Twas not a good suggestion

18. Almost there??

19. Certified HIT requires support for an open, industry standard API making accessible the preponderance of structured clinical and demographic data, diagnostic imaging, and unstructured text notes.

20. Health systems and office practices can connect any third-party app of their choice that is conformant with the API without pre-registering the app with the certified HIT vendor.

21. Patients can connect any third-party app of their choice that is conformant with the API without pre-registering the app with the certified HIT vendor.

22. Connected apps can continue accessing data for a minimum of 1 year without requiring additional user action. However, the user that connected the app may remove it’s access at any time.

23. Certified HIT must publish and update a list of the patient facing API endpoints in a computable format and update it on a minimum of a monthly basis.

24. Certified HIT must be configurable to trigger third party decision support services through an industry standard API when a patient chart is accessed.

25. Current hurdles we will address here
Thousands of software developers need more confidence to invest in this technology
Variation in API implementations
Variation in business rules for connecting apps
Need for physicians to “remember” to launch an app at the right point during a workflow
Apps more focused on read than write