A novel application of SMART on FHIR architecture for interoperable and scalable integration of patient-reported outcome data with electronic health records.

MedStar author(s):
Citation: Journal of the American Medical Informatics Association. 28(10):2220-2225, 2021 09 18.PMID: 34279660Institution: MedStar Health Research Institute | MedStar Institute for InnovationDepartment: National Center for Human Factors in HealthcareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Electronic Health Records | *Health Level Seven | Humans | Patient Reported Outcome Measures | SoftwareYear: 2021Local holdings: Available online through MWHC library: 2003 - present, Available in print through MWHC library: 1999 - presentName of journal: Journal of the American Medical Informatics Association : JAMIAAbstract: CONCLUSION: Our approach and solution proved feasible, secure, and time- and resource-efficient. We offer actionable guidance for this technology to be scaled and adapted to promote adoption in diverse ambulatory care settings and across different EHRs. Copyright (c) The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: [email protected] AND METHODS: We used a standards-based approach to deploy 2 apps that source and surface PRO data in real-time for provider use within the EHR and which rely on PRO assessments from an external center to streamline app and EHR integration.OBJECTIVE: Despite a proliferation of applications (apps) to conveniently collect patient-reported outcomes (PROs) from patients, PRO data are yet to be seamlessly integrated with electronic health records (EHRs) in a way that improves interoperability and scalability. We applied the newly created PRO standards from the Office of the National Coordinator for Health Information Technology to facilitate the collection and integration of standardized PRO data. A novel multitiered architecture was created to enable seamless integration of PRO data via Substitutable Medical Apps and Reusable Technologies on Fast Healthcare Interoperability Resources apps and scaled to different EHR platforms in multiple ambulatory settings.RESULTS: The apps were developed to enable patients to answer validated assessments (eg, a Patient-Reported Outcomes Measurement Information System including using a Computer Adaptive Test format). Both apps were developed to populate the EHR in real time using the Health Level Seven FHIR standard allowing providers to view patients' data during the clinical encounter. The process of implementing this architecture with 2 different apps across 18 ambulatory care sites and 3 different EHR platforms is described.All authors: Blumenthal J, Dixit R, Dymek C, Hsiao CJ, Littlejohn R, Pruitt Z, Ratwani R, Shah S, Wesley DBOriginally published: Journal of the American Medical Informatics Association. 2021 Jul 19Fiscal year: FY2022Fiscal year of original publication: FY2022Digital Object Identifier: Date added to catalog: 2021-07-26
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 34279660 Available 34279660

Available online through MWHC library: 2003 - present, Available in print through MWHC library: 1999 - present

CONCLUSION: Our approach and solution proved feasible, secure, and time- and resource-efficient. We offer actionable guidance for this technology to be scaled and adapted to promote adoption in diverse ambulatory care settings and across different EHRs. Copyright (c) The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: [email protected].

MATERIALS AND METHODS: We used a standards-based approach to deploy 2 apps that source and surface PRO data in real-time for provider use within the EHR and which rely on PRO assessments from an external center to streamline app and EHR integration.

OBJECTIVE: Despite a proliferation of applications (apps) to conveniently collect patient-reported outcomes (PROs) from patients, PRO data are yet to be seamlessly integrated with electronic health records (EHRs) in a way that improves interoperability and scalability. We applied the newly created PRO standards from the Office of the National Coordinator for Health Information Technology to facilitate the collection and integration of standardized PRO data. A novel multitiered architecture was created to enable seamless integration of PRO data via Substitutable Medical Apps and Reusable Technologies on Fast Healthcare Interoperability Resources apps and scaled to different EHR platforms in multiple ambulatory settings.

RESULTS: The apps were developed to enable patients to answer validated assessments (eg, a Patient-Reported Outcomes Measurement Information System including using a Computer Adaptive Test format). Both apps were developed to populate the EHR in real time using the Health Level Seven FHIR standard allowing providers to view patients' data during the clinical encounter. The process of implementing this architecture with 2 different apps across 18 ambulatory care sites and 3 different EHR platforms is described.

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