Introduction to SMART on FHIR

What is FHIR?

FHIR (Fast Healthcare Interoperability Resources) is an API standard created by HL7. Unlike older HL7v2 messages (which are text-based files sent back and forth like emails), FHIR utilizes modern web technologies (RESTful APIs, JSON, OAuth). This means an application can request a specific piece of data (e.g., "Give me the last A1C result for Patient X") in real-time, just like an app on your phone requesting weather data.

What is SMART?

SMART (Substitutable Medical Applications, Reusable Technologies) is a security framework built on top of FHIR. It utilizes OAuth2 and OpenID Connect to handle user authentication. When an app is "SMART on FHIR" compatible, it means a physician can log into their EMR, click a button, and seamlessly launch a third-party app (like a specialized oncology calculator) without logging in again, and the app instantly has context of the patient currently open in the EMR.

Why Clinics Should Care

• Avoid Vendor Lock-in: If your EMR supports FHIR, you are not forced to buy their proprietary telehealth module; you can buy a better 3rd party module and plug it in.
• Patient Access: Under the 21st Century Cures Act, patients have the right to connect 3rd party apps (like Apple Health) to their medical records via FHIR APIs.

Frequently Asked Questions

Does FHIR replace HL7v2 entirely?

Not yet. HL7v2 is still heavily entrenched in lab integrations (LIS) and hospital ADT feeds. FHIR is primarily dominating the app ecosystem and patient portals.

Do I have to pay to use FHIR?

The standard is free. However, many legacy EMR vendors charge exorbitant "API Access Fees" to allow 3rd party apps to connect to your database. We negotiate these away during initial contracting.