A Quick Payoff for SMART-Enabling an EHR System

Over the summer, a European EHR vendor took quick advantage of SMART-enabling its EHR system, adding in the SMART API to enable it to offer both the SMART Pediatric Growth Chart and SMART Blood Pressure Centiles apps. Marand, provider of the Think!Med Clinical™ EHR system, adopted SMART, incorporating it into their openEHR-based system along with these initial apps, which were promptly made available for users at the 200-bed Children’s Hospital of Ljubljana University Medical Centre in Slovenia.

Before and After SMART Enablement of Think!Med Clinical: Growth Charts (click images to enlarge)
Think!Med’s built-in growth charts did not offer clinicians an ability to see more than one dimension at a time. In the left image we see only weight, while height and head circumference are hidden. By substituting the SMART Pediatric Growth Chart app (right), Think!Med achieved greater usability and functionality in this area, starting with the simultaneous display of height, weight, and head circumference.

Tomaž Gornik, Co-Founder and Vice President at Marand, voiced his enthusiasm for the implementation:

As an EHR vendor, we understood the need of our users to share data and content like order sets or clinical guidelines between applications. But sharing of (application) functionality was very difficult until the mobile computing revolution brought forth the concept of apps. We immediately started thinking of an app store concept to expand the functionality of our applications. What was missing to make this a reality was an API like SMART to standardize app access to clinical data, enabling sharing of apps between systems.

Having built Think!Med Clinical on an openEHR-based clinical data repository, we found it very easy to implement the SMART API in a matter of days. The Growth Chart app was integrated, translated and put in production in a couple of weeks. Since our clinicians use different growth charts, we also needed to add the UK1990 percentiles to the app. With more experience, integrating other apps like the BP Centiles was even quicker, clearly demonstrating the value provided by SMART Platforms.

Integrating the SMART API into Think!Med Clinical opens up our platform to innovation. We can now seamlessly run sophisticated apps built by researchers and developers from around the world inside our solution, providing great value to our customers.

Our team learned from the process as well. SMART Lead Software Engineer Nikolai Schwertner said, “Marand’s rapid integration of the Growth Charts and Blood Pressure Percentiles apps into Think!Med, including their localization to Slovenian, motivated us to design more extensive localization facility into the medical applications that we support. We revamped these apps to offer both better localization capabilities and better framing options. With these changes, both translations to new languages and integration into existing EMR user interfaces has been made far easier. The improvements are available in the latest app releases.”

SMART Translation Advisor David Kreda, product manager for the app, said, “The SMART Pediatric Growth Chart empowers Think!Med users to grasp all growth trends and deviations in one glance, which is the essential reason to chart childhood growth. A further innovation in this app is the presentation of body-mass results in a manner that aids clinician conversations with parents about childhood weight, a major family and public health challenge.”

Shortly after we were contacted by Marand, the Growth Chart app won a Red Dot Award for excellence in communication design. Fjord, the service design consultancy who designed the app, will travel to Berlin on Friday for the Red Dot Gala celebration and be featured in the International Yearbook and online exhibition.

SMART—Substitutable Medical Applications & Reusable Technology—is based at Harvard Medical School and Boston Children’s Hospital, both in Boston, MA. SMART’s goal is to create a platform across different Electronic Medical Records (EMR) systems that will allow them to offer more value to their customers by drawing upon the vast reserve of innovative third-party design and development.