Category: Blog

Getting Data to Patients: Technology + Policy

ABBI and BlueButton+

Over the past six months, I’ve had the privilege of working with the Automate Blue Button Initiative on BlueButton+ specifications for sharing data with patients.  Since ABBI’s core goal of enabling automated patient access to health data is so closely aligned with SMART’s vision, it was exciting to see the initial (Push-based) BlueButton+ specifications implemented at HIMSS 13 this month.

Progress in ABBI’s Pull Workgroup has been slower.  We’re hashing out the details of an OAuth2-based framework that puts patients in control over when and how apps can fetch health data.  An important question has been: how can we enable an ecosystem where thousands of apps connect to providers across the country in a trusted way?

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Introducing the SMART C-CDA Scorecard

The SMART team is proud to introduce the C-CDA Scorecard, a web-based tool to help vendors, providers and other health data holders produce high-quality clinical summaries for Meaningful Use Stage 2.

Get ready for Meaningful Use Stage 2

Consolidated Clinical Document Architecture (C-CDA) is the specification cited by Meaningful Use Stage 2 for creating structured clinical summary documents. C-CDA documents are required by MU2 to support transitions of care, to enable patient-driven “view/download/transmit” objectives, and to promote medical record data portability.

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Spotlight on OSEHRA

We recently posted about Ken Mandl’s participation in a panel at the OSEHRA 1st Annual Open Source EHR Summit and Workshop. Audio and slides are now available to those with OSEHRA user accounts; scroll to Day One, 3pm, “Open Source Best Practice and Business Models.”

OSEHRA logoNow we’d like to back up and talk briefly about OSEHRA itself, and share links that highlight its relationship to SMART.

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Webinar on SMART-Indivo App Challenge: Slides Posted

As Health 2.0 News recently reminded the community, the SMART-Indivo App Challenge is underway.

On August 7, a webinar provided an in-depth review of the challenge and allowed interested participants to ask questions to the challenge hosts. Slides from the webinar are available on the challenge website and hosted on Slideshare.

Advance registration for the challenge is recommended. Final submissions are due on September 28, 2012. The first place team will be awarded with $10,000. The second and third place teams will receive awards of $2,000 and $1,000, respectively.

CCD: Show me the codes!

In my 7/24/2012 post, I observed that exchanging uncoded lab results is the state of the art.

Why worry? SMART is pushing to enable third-party apps on disparate health IT systems, and codes are the glue holding meaning together. Without coded data, apps can’t tell a Hemoglobin A1c measurement from a monocyte percentage!

In the USA we have substantial infrastructure to promote the flow of coded data. So where do things break down?

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Clinical summary export: What is a CCD for?

At last week’s Redwood MedNet HIE Conference, I had the chance to attend an “Interoperability Exhibition” demonstrating the data exchange capabilities of several EHRs. Two themes emerged around clinical summary export. I’ll focus on CCDs (Continuity of Care Documents), but the themes apply to CCRs (Continuity of Care Records) as well:

  1. “What is a CCD for?” Providers use EHRs to generate the patient summary records they share with patients and other providers. But it’s unclear what (exactly) should go into these documents, and whether/how the provider should have a say.
  2. “Where are the codes?” Even though certified EHR products are capable of generating CCDs with appropriate codes (LOINC-encoded labs, for instance), this doesn’t mean that providers’ systems are configured to do so. The demonstrations I saw exchanged CCDs with uncoded labs!

Today’s post focuses on #1. In a future post, I’ll investigate the interplay between certification and meaningful use to understand where LOINC codes disappear to.

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“CCD export” doesn’t solve interoperability

Meaningful Use mandates CCD export from EMRs. Here are some reasons why we’re still querying database tables and calling vendor-specific web services to extract the data we need to fuel apps.

At yesterday’s Health 2.0 conference, Farzad Mostashari asked why SMART isn’t using CCD export (as specified by Meaningful Use) to extract data from EMR systems. This is a great question, in part because it separates out two important aspects of SMART:

  1. Getting data out of today’s EHRs
  2. Presenting those data to apps in a natural, convenient, developer-friendly way.

—and focuses on #1. (I don’t think many would argue that CCD is fit for #2. And to be clear: for developers building a SMART app, the details of #1 are almost irrelevant. SMART app developers get one clear-cut API to work with, and consistent SMART data elements)

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SMART Preview Release v0.3

The SMART team has published a new preview release (v0.3) of the SMART platform. With this release, we are rolling out a number of API changes incorporating feedback from the $5K challenge, simplifying some of the infrastructure, and adding some new data types.

The SMART team has published a new preview release (v0.3) of the SMART platform. With this release, we are rolling out a number of API changes incorporating feedback from the $5K challenge, simplifying some of the infrastructure, and adding some new data types. We have already updated the public sandbox with the v0.3 code, as well as the developer’s guide.

One of the main changes with v0.3 is that SMART apps are no longer required to have a bootstrap.html. The apps are now launched directly from index.html with the oauth tokens passed as a get parameter. For a more complete run-down on updating your SMART application code, please see: http://wiki.chip.org/smart-project/index.php/Developers_Documentation:_Changelog

We are looking forward to hearing your thoughts and suggestions about the new release.

SMART + OpenMRS: Google Summer of Code

OpenMRS has been funded for its fifth consecutive Google Summer of Code!

Among a host of exciting projects, SMART is working with OpenMRS to propose:

Enabling SMART Apps in OpenMRS