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Developing Interoperable Healthcare Applications with SMART on FHIR

By: John Bailey


As the healthcare industry adopts full use of digital tools to increase the quality of care, interoperability remains a critical concern and an overarching goal. With many industry standards and frameworks employing a write once, run anywhere methodology to achieve information technology unison, the healthcare sector remains well poised to adopt measures to streamline workflows, exchange healthcare information, and enhance patient outcomes.

SMART on FHIR aims to do just that with a fast, secure way to make interoperability a reality.

What Is SMART on FHIR?

To understand precisely what SMART on FHIR is, first, we need to look at these two standards separately.

SMART stands for "Substitutable Medical Applications and Reusable Technologies." The standard was introduced by a group of healthcare IT experts in Boston who wanted to build a standard framework that allows standalone healthcare applications that work interchangeably with any healthcare system, mainly EHRs.

Fast Healthcare Interoperability Resources, or FHIR, is the newest standard created by HL7 International that defines how health information is stored and accessed. It ensures clinical data pieces are consistent, making common ground for healthcare software systems to talk to each other.

SMART in and of itself primarily oversees data exchanges, and using FHIR ensures the bilateral communication between two applications. They have the same objectives for health information exchanges, so aligning themselves to propagate their needs made sense. Thus, SMART on FHIR was born.

Accessing Health Information with SMART on FHIR

Ultimately, SMART on FHIR allows you to build interoperable healthcare applications that can seamlessly integrate with any medical software, such as popular EMRs like Epic, Cerner, and Veradigm formerly allscripts, to extend their functionality.

 interoperable mobile health solutions can be built using smart on fhir

Additionally, software developers can utilize APIs to connect disparate, third-party systems with existing EMRs. This integration is made possible with SMART's built-in authorization and authentication mechanisms, OAuth and OpenID. These are REST-based APIs that deal with security specifications. Using them creates a secure system with controlled access. The benefit of using them together is that users only need to enter their credentials once. Authorization happens directly through the EHR. These API also permit you to build different security levels for all users.

The Proliferation of Healthcare Apps with SMART on FHIR

smart on fhir apps facilitating interconnectivity across the healthcare continuum

SMART on FHIR marks a paradigm shift in the healthcare landscape. Proprietary healthcare vendors are opening up to third-party development on top of their platforms. Legislation has acknowledged the prolific nature of SMART on FHIR, and governments are pushing to ensure that HIT providers are SMART certified. Standardization presents an opportunity for HIT providers across the entire continuum of care to offer extensions, plugins, widgets, and apps to patients and clinicians to increase care quality and profits.


Chetu, Inc. does not affect the opinion of this article. Any mention of specific names for software, companies or individuals does not constitute an endorsement from either party unless otherwise specified. All case studies and blogs are written with the full cooperation, knowledge and participation of the individuals mentioned. This blog should not be construed as legal advice.

Chetu was incorporated in 2000 and is headquartered in Florida. We deliver World-Class Software Development Solutions serving entrepreneurs to Fortune 500 clients. Our services include process and systems design, package implementation, custom development, business intelligence and reporting, systems integration, as well as testing, maintenance and support. Chetu's expertise spans across the entire IT spectrum.

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