1. SMART on FHIR Apps for Health
Josh Mandel (Boston Children’s Hospital)
Ricky Bloomfield (Duke Medicine)
Kevin Shekleton (Cerner)
John Voith (athenahealth)
April 14, 2015
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2. SMART on FHIR: Core API Goals
Health IT
Systems
>1000 Certified
(VDT, 4/2015) {
authorization
authentication
clinical data UX

3. focus on
Demos

4. Duke Medicine SMART on FHIR Demo
Ricky Bloomfield, MD
Director, Mobile Technology Strategy
April 14, 2015
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

5. SMART on FHIR @ Duke Medicine
Implementation:
Built on latest Epic release
MITREid Connect (OAuth 2.0 & OpenID) integrates with Duke’s standard credentials
FHIR resources consumed:
Patient
Observation (vital signs)
Medication + MedicationPrescription
Apps integrated:
Pediatric Growth Chart (open source HTML5 app)
Pediatric Growth Charts by Boston Children’s Hospital (native iOS app)
Duke Pillbox (HTML5 app)

6. EHR Demos

7. Apps

8. Crimson Care Management App
Scalable, Patient-Centered Coordination Across Care Settings
Crimson Care Management App
Risk score updated as diagnoses pulled in from the EMR using FHIR
Patient clinical information (including diagnoses, medications and allergies) automatically fed into EMR using FHIR
Gaps in care presented to caregiver to view, act on, and update on completion
Under Development: Care notes captured during care management encounter sent back to EMR via FHIR x
©2015 The Advisory Board Company • advisory.com

9. Leveraging the Power of Interoperability
A New Infrastructure for Value-Based, Population-Oriented Health Care
Plugging in to a Larger Effort
Argonaut Project
FHIR-Based Data Queries
athenahealth
Cerner
Epic
SMART
Advisory Board
Crimson Care Manager
Partial list of participating organizations x
Integrating Data
Creating a comprehensive view of patients and populations
Risk-Stratifying Patients
Prioritizing intensive interventions based on risk factors
Automating Care Planning
Automatically customizing care to patient need
Structuring Workflow
Automated task creation, assignment, and tracking
Reporting on Performance
Flexible ad hoc reporting for identifying variance, supporting billing
©2015 The Advisory Board Company • advisory.com

10. Meducation® Addresses Health Literacy
More Effective Communication
Universal Medication Schedule
Intuitive representations of times of day and amount of medicine to be taken
Pictograms
Reduce dosing errors
Instructions in Plain Speak
1 line per instruction
5th to 8th grade reading level
Visual spacing to reduce cognitive overload
5 font choices, up to 18 point font
Select from more than 20 languages
Everything from Polyglot is about improving medication adherence. The solutions that I’ve shown so far have been about improving medication adherence, by addressing low health literacy, by making medication and medical instructions engaging and easy to understand.
TimeView is slightly different in that it is not for patients. It’s for you. Using Surescripts prescription fill or other data sources, TimeView provides a longitudinal view a patient’s adherence history, across all prescribers, displayed in an intuitive, “gantt chart” format, permitting interventions to be tailored quickly and appropriately. The Meducation® TimeView™ Report shows
Visual representation of all medications that a patient has filled over the last 6 months,
Identification of gaps in adherence, as well as “overfill” indicators,

11. Meducation® Improves Medication Adherence
Multilingual Regimen Summaries
Patient content access via QR code
Everything from Polyglot is about improving medication adherence. The solutions that I’ve shown so far have been about improving medication adherence, by addressing low health literacy, by making medication and medical instructions engaging and easy to understand.
TimeView is slightly different in that it is not for patients. It’s for you. Using Surescripts prescription fill or other data sources, TimeView provides a longitudinal view a patient’s adherence history, across all prescribers, displayed in an intuitive, “gantt chart” format, permitting interventions to be tailored quickly and appropriately. The Meducation® TimeView™ Report shows
Visual representation of all medications that a patient has filled over the last 6 months,
Identification of gaps in adherence, as well as “overfill” indicators,

12. Adherence Intelligence for Clinicians
TimeView™ Adherence Report
Non-adherence indicators
Everything from Polyglot is about improving medication adherence. The solutions that I’ve shown so far have been about improving medication adherence, by addressing low health literacy, by making medication and medical instructions engaging and easy to understand.
TimeView is slightly different in that it is not for patients. It’s for you. Using Surescripts prescription fill or other data sources, TimeView provides a longitudinal view a patient’s adherence history, across all prescribers, displayed in an intuitive, “gantt chart” format, permitting interventions to be tailored quickly and appropriately. The Meducation® TimeView™ Report shows
Visual representation of all medications that a patient has filled over the last 6 months,
Identification of gaps in adherence, as well as “overfill” indicators,

13. Adherence Intelligence for Clinicians
TimeView™ Adherence Report
Proportion of days covered, per PQA metric for Star Ratings
Other Prescribers
Actual patient medication adherence based upon PBM, SureScripts and/or other data
Everything from Polyglot is about improving medication adherence. The solutions that I’ve shown so far have been about improving medication adherence, by addressing low health literacy, by making medication and medical instructions engaging and easy to understand.
TimeView is slightly different in that it is not for patients. It’s for you. Using Surescripts prescription fill or other data sources, TimeView provides a longitudinal view a patient’s adherence history, across all prescribers, displayed in an intuitive, “gantt chart” format, permitting interventions to be tailored quickly and appropriately. The Meducation® TimeView™ Report shows
Visual representation of all medications that a patient has filled over the last 6 months,
Identification of gaps in adherence, as well as “overfill” indicators,

14. Tackling Non-Adherence at the Point of Care
EHR New functionality integrated into existing workflows
EHR New functionality integrated into existing workflows
Physician Simple, targeted insights provide time efficiency and improved patient care
PBM Deep analytics, improved adherence, and gaps in care programs
Patient More informed care and better outcomes
Surescripts’ Solution Combats Non-Adherence

15. Medication Adherence on the SMART platform
Tackling Non-Adherence at the Point of Care
Reduced time-to-Value
SMART offers a reduced design complexity, helping Surescripts reach a wider audience without the cost of significant, one-off development efforts
Greater innovation through collaboration
The SMART specification extensions built in collaboration with Surescripts empower our apps to provide both information-rich and visually consistent experiences for users.
Improved Interoperability
SMART provides a standardized, secure way to integrate local data and network data, helping connect users to the power of the Surescripts network.
Medication Adherence on the SMART platform

16. Our Apps Will Change Care Delivery
Fueled by Geisinger R+D investment over 18+ years
Adaptable to any EHR
Data extracted,
re-organized and presented in a user-friendly way
Workflow facilitated via clinical logic; results of analyses integrated into workflow
Decision support based on analysis of data outside and inside the EHR
Highly valued by clinicians
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