SMART Enabling VistA Home Page

Project Background and Overview

SMART (Substitutable Medical Apps, Re-usable Technology) is an initiative from Harvard Medical School (http://smartplatforms.org) that provides a unified mechanism for diverse applications to interact with medical record data. SMART Applications (Apps) built against the SMART API can be embedded within any SMART Container. A SMART Container is, most often, an Electronic Medical Record (EMR) system used by physicians, but might also be a Personal Health Record (PHR) used by patients, or a data-analytics platform used by researchers. A SMART App is a normal web application, embedded as a frame within the SMART Container's user interface, with access to the SMART API for interacting with health data.

The objective of the SMART VistA project was to demonstrate that a Smart container for VistA was feasible, provide a public demonstration of the VistA Smart Container and make publicly available open source code and servers that would allow developers to create Smart Applications using VistA. The project was funded via an ONC SHARP grant to the SMART consortium, led by the Harvard Medical School and conducted via a contract between the Harvard Medical School and E-cology Corp.

The VistA SMART team included: George Lilly, CIO of WorldVistA, Rob Tweed, President of M/Gateway Developments Ltd. and Joseph Dal Molin, President E-cology Corp. During the period of March to May, 2012 a prototype Smart Container for VistA was developed by George and Rob with Joseph providing project coordination. The VistA Smart Container was successfully demonstrated at the June 5, 2012 VistA Community Meeting, George Mason University. Since then, it has been demonstrated at several other forums, including NHS Hack day in England and at the Seattle VistA Expo in September. Further demonstrations are planned.

The team would like to gratefully acknowledge the support of Isaac S. Kohane and Kenneth D. Mandl, Boston Children’s Hospital, Harvard Medical School, Co-Directors of the SMART initiative; the enthusiastic support and collaboration of Rachel Ramoni, Harvard Medical School, Executive Director SMART and Joshua Mandel, Lead Architect, Boston Children’s Hospital, Harvard Medical School; and a big thank you to J. Michael Mccoy, Department of Preventive Medicine, Keck School of Medicine, University of Southern California for planting the seed which sprouted this project.

Project Documentation and Presentations

• Building a Smart Container for VistA Lessons Learned, George Lilly:PDF

• EWD SMART Container Reference Guide, Rob Tweed: PDF

Harvard, ITdotHealth Meeting Presentation, July 5th 2012

A video of the presentation which gives a quick summary of the project can be found by going to time point 1:07:10 at the following link in the section labelled SMART-Enabled Platforms, moderated by David Kreda: http://smartplatforms.org/meetings/itdothealth-ii-2012/

Software Downloads

The software has been released publicly under a GPL version 2 or greater license and can be found on the WorldVistA trac server at this address:

https://trac.opensourcevista.net/browser/smart

The VistA Smart Container has also been included fully configured in the latest dEWDrop 3 virtual machine, which allows developers to use it right away without the effort of installation and configuration. The dEWDrop virtual machine can be downloaded free of charge from the Fourth Watch Software website at this address:

http://www.fourthwatchsoftware.com/

Relevant Links

The Harvard SMART initiative home page: http://smartplatforms.org/

The SMART App Gallery: http://smartplatforms.org/smart-app-gallery/

SMART related journal publications:

Kohane, I. S., and Mandl, K. D. Escaping the EHR Trap — The Future of Health IT . N Engl J Med 2012 Jun 14;366(24):2240-2. PDF

Mandl KD, Mandel JC, Murphy SN, Bernstam EV, Ramoni RL, Kreda DA, McCoy JM, Adida B, Kohane IS. The SMART Platform: early experience enabling substitutable applications for electronic health records. J Am Med Inform Assoc. 2012 Jul-Aug;19(4):597-603. PDF

Mandl KD, Kohane IS. No small change for the health information economy. N Engl J Med. 2009 Mar 26;360(13):1278-81 [1]