Cumulus: A Universal Sidecar for a SMART Learning Healthcare System

The SMART Health IT project team at Boston Children’s Hospital was awarded an ONC 2020 Leading Edge Acceleration Project in Health Information Technology to develop a platform based on Health Level Seven International (HL7®) Fast Healthcare Interoperability Resources (FHIR®) that leverages bulk data to support an ecosystem for research, public health and learning, called Cumulus.

Cumulus builds from existing standards and open health IT tools to offer turnkey functions to annotate FHIR data for analytics, de-identify data, and query for cohorts, enabling rapid learning within a healthcare system.

The idea is to:

  • Place a ‘listener’ within the provider’s firewall, that connects to the SMART/HL7 Bulk Data API
  • Perform key functions, including de-identification and natural language processing of notes
  • Extract data and populate an analytic FHIR environment
  • Develop push and pull models for data sharing
  • Share data with end users, including through federated networks

The SMART team is working with public health stakeholders, under funding from the CDC Foundation, to prototype a version of Cumulus that has the potential to instrument the entire healthcare system as a data source for public health surveillance and action.

Watch this space for updates.


A computable phenotype for patients with SARS-CoV2 testing that occurred outside the hospital. Lijing Wang, Amy Zipursky, Alon Geva, Andrew J. McMurry, Kenneth D. Mandl, Timothy A. Miller medRxiv 2023.01.19.23284738; doi: