The SMART Health IT project run out of the Boston Children’s Hospital Computational Health Informatics Program has been leading the way in demonstrating the value of creating apps that can be written once to run anywhere in the healthcare system. Now they have turned their attention to patient-generated health data.
The group, including Kenneth Mandl, M.D., M.P.H., Lead and Chair of the SMART Advisory Committee, recently published in npj Digital Medicine, an open access journal, describing their effort to develop “SMART Markers,” which they describe as a “mobile device software framework encapsulating functionality needed for rapid deployment of both patient- and practitioner-facing patient-generated health data (PGHD) apps.
Although validated patient-reported outcomes (PROs) are increasingly used in clinical trials and other healthcare settings, the SMART team noted that to date, capturing PGHD has been limited to PROs, has generally involved custom EHR integrations using non-standardized data models or a workflow entirely outside the EHR.
Through its earlier work on PROs, the SMART team realized that key functions “could be encapsulated in a common framework library that would enable app developers to readily create use-case specific PRO apps, and further, to harness mobile device-generated personal health data.”
They sought to leverage the SMART on FHIR application programming interface to develop SMART Markers to help make PGHD an integral part of both routine care and research at scale using interoperable standards. “The framework is modeled on key actions that build capacity for health systems to enable (1) PGHD requesting as an institution-wide orderable service, available to all its practitioners and (2) patients to generate data for the requested instruments on their personal devices and submit to their health systems in a seamless electronic workflow that is reviewable by practitioners at point of care.”
Although the first version developed is for iOS, an Android version is in the works, they noted. “Broader support of PGHD and devices, patient-wise survey recommendation engines, subscriptions (to be notified of PGHD-related events) in the EHR are all potentially addressable as interoperable components with open standards.”
Because this is an open source project, their goal is to enable healthcare institutions to integrate the framework into their existing apps or deploy customized versions of the reference apps in their context-specific use-cases.
