SMART on FHIRApps for Health

Josh Mandel (Boston Children’s Hospital)

Ricky Bloomfield (Duke Medicine)

Kevin Shekleton (Cerner)

John Voith (athenahealth)

April 14, 2015

DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

SMART on FHIR: Core API Goals

Health ITSystems

>1000 Certified(VDT, 4/2015)

{authorizationauthenticationclinical dataUX

focus onDemos

Duke MedicineSMART on FHIR Demo

Ricky Bloomfield, MD

Director, Mobile Technology Strategy

April 14, 2015

DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

SMART on FHIR @ Duke Medicine

• Implementation:

– Built on latest Epic release

– MITREid Connect (OAuth 2.0 & OpenID) integrates with Duke’s standard credentials

– FHIR resources consumed:

• Patient

• Observation (vital signs)

• Medication + MedicationPrescription

• Apps integrated:

– Pediatric Growth Chart (open source HTML5 app)

– Pediatric Growth Charts by Boston Children’s Hospital (native iOS app)

– Duke Pillbox (HTML5 app)

EHR Demos

Apps

Scalable, Patient-Centered Coordination Across Care Settings

Crimson Care Management

Crimson Care Management App

Patient clinical information (including diagnoses, medications and allergies) automatically fed into EMR using FHIR

Risk score updated as diagnoses pulled in from the EMR using FHIR

Gaps in care presented to caregiver to view, act on, and update on completion

Under Development: Care notes captured during care management encounter sent back to EMR via FHIR

Crimson Care Management

©2015 The Advisory Board Company • advisory.com

A New Infrastructure for Value-Based, Population-Oriented Health Care

Leveraging the Power of Interoperability

©2015 The Advisory Board Company • advisory.com

FHIR-Based Data Queries

Crimson Care Manager

Integrating Data

Creating a comprehensive view of

patients and populations

Risk-Stratifying Patients

Prioritizing intensive interventions based on

risk factors

Automating Care Planning

Automatically customizing care to

patient need

StructuringWorkflow

Automated task creation, assignment,

and tracking

Reporting on Performance

Flexible ad hoc reporting for identifying

variance, supporting billing

Argonaut Project

athenahealth Cerner Epic SMART Advisory Board

Plugging in to a Larger Effort

Partial list of participating

organizations

Meducation® Addresses Health LiteracyMore Effective Communication

Universal Medication Schedule−Intuitive representations of times of day and

amount of medicine to be taken

Pictograms

−Reduce dosing errors

Instructions in Plain Speak

−1 line per instruction

−5th to 8th grade reading level

−Visual spacing to reduce cognitive overload

−5 font choices, up to 18 point font

−Select from more than 20 languages

Meducation® Improves Medication Adherence

Multilingual Regimen Summaries

Patient content

access via QR code

Non-adherence indicators

TimeView™ Adherence Report

Adherence Intelligence for Clinicians

TimeView™ Adherence Report

Adherence Intelligence for Clinicians

Other Prescribers

Proportion of days covered, per PQA metric for Star Ratings

Actual patient medication adherence based upon PBM, SureScripts and/or other data

Tackling Non-Adherence at the Point of Care

EHRNew functionality

integrated into existing workflows

Surescripts’ Solution Combats Non-Adherence

PBMDeep analytics,

improved adherence, and gaps in

care programs

EHRNew functionality

integrated into existing workflows

PhysicianSimple, targeted insightsprovide time efficiency

and improved patient care

PatientMore informed careand better outcomes

Reduced time-to-ValueSMART offers a reduced design complexity, helping Surescripts reach a wider audience without the cost

of significant, one-off development efforts

Improved InteroperabilitySMART provides a standardized, secure way to

integrate local data and network data, helping connect users to the power of the Surescripts

network.

Greater innovation through collaborationThe SMART specification extensions built in collaboration

with Surescripts empower our apps to provide both information-rich and visually consistent experiences for users.

Medication Adherence

on the SMART platform

Tackling Non-Adherence at the Point of Care

Our Apps Will Change Care Delivery

16

Data extracted, re-organized and presented in a user-friendly way

Workflow facilitated via clinical logic; results of analyses integrated into workflow

Decision support based on analysis of data outside and inside the EHR

Fueled by Geisinger

R+Dinvestment over

18+ yearsAdaptable

to any EHR

Highly valued by clinicians

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