Meaningful Use

After a major report by the elite JASON group citing SMART and FHIR as the fundamental building blocks for a universal API, in October 2015, CMS released a final rule that modified the requirements for participation in the Electronic Health Record (EHR) Incentive Programs for years 2015 through 2017 as well as in 2018 and beyond. Quoting from the Federal Register,

We also proposed to no longer require or allow paper-based methods to be included in the measures (80 FR 16753) and to expand the options through which providers may engage with patients under the EHR Incentive Programs. Specifically, we proposed an additional functionality, known as application programming interfaces (APIs), which would allow providers to enable new functionalities to support data access and patient exchange.

Under Meaningful Use Stage 3, patients would always be able to connect apps of their choice, without cost.

This regulation was sufficiently powerful to encourage formation of Argonaut, a consensus working group which, in its first year, marshaled the building of SMART on FHIR into all of its EHR products. Apple led the first major effort to leverage the extensive availability of SMART endpoints, and connected its Health app to hundreds of healthcare systems, giving patients access to copies of their data.