App Store for EHRs and Patients Both.

The Substitutable Medical Applications, Reusable Technologies (SMART) Platforms project ( www.smartplatforms.org ) seeks to develop an iPhone-like health information technology platform with substitutable apps constructed around core services. It is funded by a grant from the Office of the National Coordinator of Health Information Technology's Strategic Health IT Advanced Research Projects (SHARP) Program. SMART technologies enable existing electronic health records and HIT platforms to run substitutable apps. Substitutability is the capability inherent in a system of replacing one application with another of similar functionality. We created a patient-facing SMART instance using the open source Indivo personally controlled health record (PCHR). The SMART "read-only" API has been deployed on multiple systems, including the Cerner installation at Boston Children's Hospital and the World Vista EHR. We sought to SMART-enable Indivo, the open source reference PCHR upon which HealthVault and other PCHRs were modeled. PCHRs provide patients with a secure repository of their health information that can be exposed to apps across a programming interface. We updated the open source Indivo PCHR to support the SMART API, enabling Indivo to act as a patient-facing apps platform, running the same or similar versions of apps that face clinicians.