As an open access project with no licensing requirement, the SMART project is not able to track which institutions have adopted the standard. Some of the health systems innovating with SMART on FHIR apps to provide clinical care in the United States include Boston Children’s Hospital, Duke Medicine, Geisinger Health, Healthcare Corporation of America, Intermountain Healthcare, Ochsner Health System, Partners Healthcare, and University of Utah Health. In the United Kingdom, Great Ormond Street Hospital has adopted SMART.
Additionally, many of the top EHR vendors have incorporated support for SMART into their products and are beginning to roll out the technology to healthcare institutions. Epic has stated that they expect a majority of their sites to be SMART enabled by the end of 2018, and Cerner has said that they expect nearly all of their in-patient sites, and many ambulatory sites to become SMART enabled in 2018. Allscripts has SMART enabled the 2017 releases of three of their EHR products. Other EHR companies are also in the process of building SMART support into their products.