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SMArt Health

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Imagine an iPhone-like "app store" for medical apps that can give a consumer, a doctor, or any healthcare practitioner the access to a wide variety of applications that can help the process of care. Imagine that this "app store" was agnostic about EMRs or other sources of patient/user data. In this fantastic (yet attainable) world, a doctor or a hospital CIO could easily pick an app from this store (just like we pick apps in the Apple App Store every day) capable of helping them understand their healthcare data, save time, achieve better outcomes, or reduce costs. They could even use an application that mixes data sets ("mash up" the data), and using analytics to unlock even deeper insights and creating greater possibilities.

A few weeks ago, Aneesh Chopra, the first Federal CTO of the United States, nominated me to serve on the advisory of the SMArt Initiative of Harvard Medical School. The initiative is lead by Dr. Zak Kohane and Dr. Ken Mandl.

SMArt stands for "Substitutable Medical Apps, reusable technologies," and the program is funded by the ONC (Office of the National Coordinator for Health Information Technology) through the SHARP (Strategic Health IT Advanced Research) program.

After speaking with the executive director of SMArt, Rachel Ramoni, and learning more about this exciting initiative, I accepted a position on the advisory board, and joined their developer meetup at Harvard Medical School in Boston last week.

The meetup brought together a bunch of stellar folks from academia, industry, and government in partnership to build the infrastructure for what they have defined as the first: "Flexible health IT environment."

In the meetup Kohane, Mandl and their team described their suggested architecture for a platform that will be the foundation for an iPhone like app-store for medical apps, based on shared basic components. Their vision is to create a developer-friendly and easy to use interface for building applications compatible with the platform, and for the resulting applications to have simple and intuitive user interfaces. A crucial part of the vision is the principal that the entire exchange can be done without regard to which EMR or PHR or other system the patient data is flowing from.

The SMArt team has presented a design for a flexible architecture that creates a user interface similar to the one found in the Apple App Store - one that allows for shared basic components to be used to build medical apps. Such a flexible architecture will allow for the scalable creation of a set of useful services and tools enabling efficient data capture, effective data retrieval, easy storage of data, and useful analytics. The Harvard team is also very mindful of maintaining the autonomy of user institutions that use different EMR system and will choose different apps, and they are also very thoughtful about safeguarding patient privacy.

Another important move made by the leadership of the SMArt initiative was the creation of an open source type platform. Under their plan, licenses to develop apps will be granted also based on the commitment of the application creators to contribute back to the development community. I strongly support this collaborative approach and think it is crucial for all of us on our quest to creating a much more efficient and effective healthcare system.

There are still many questions to be answered and many problems to be solved, from governance ("who plays Steve Jobs"), to the flow of data across platforms, to the interoperability and integration between the different containers / modules, but the SMArt team is off to a great start. I'm very excited to be involved with this project and its potential for end users, and look forward to working with the SMArt team to ensure that their compelling back-end architecture vision results in a useful and desirable solution for front end users.

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