Category: Open & Interoperable
December 10 2015
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Imagine a world where a physician can dream up an idea for a new technology that may change medicine as we know it and then bam, in the course of a day you see the idea develop into a functioning app.

I observed that very thing, many times over, at Boston Children’s Hospital during its annual Hacking Pediatrics event. It was exhilarating to see physicians, designers, coders and entrepreneurs from the Boston Children’s community pair with world-class technology professionals and collaborate in new and interesting ways, while focused on advancing vision into actionable reality.

What especially stood out to me was the number of innovators interested in building apps that tied into the electronic health record (EHR) using application programming interfaces (APIs). Their goal was to  deliver patients more insights into their own health and provide clinicians with support at the point of care.  The fact that over half of the teams chose to build an EHR integration using SMART on FHIR only reiterated to me why Cerner has been so vocal in its position that EHRs must become open platforms. The attitude of openness has manifested in a lot of our most important initiatives such as CommonWell, HIE offerings and SMART on FHIR apps.

APIs have revolutionized other industries and as EHRs open up to become API-enabled platforms to a wide and diverse community of innovators, they are becoming a reality in health care technologies. Simply having APIs is a good start, but Cerner has taken an approach to openness that embraces standards for API development, which can be used across the industry. SMART (an application and security layer that handles the app “launch”) and FHIR (a data access layer that handles the “read and write”) are both open industry standards that are not proprietary to any one vendor. Our hope is that every health care technology provider will embrace SMART and FHIR so a developer can create an application one time with very little modification and deploy it on multiple platforms using the same standard.

This may seem like a far distant dream, but Cerner and many of our contemporaries are pushing hard to see this dream become a reality. We are involved in the Argonaut Project and directly with HL7, SMART Health IT and Healthcare Services Platform Consortium, all independent consortiums and standards organizations pushing for standards-based APIs. We have also seen interest and early success in our initial deployments of SMART on FHIR infrastructure.

Applications developed by the innovator community will better meet the needs of physicians when they are deployed at the point of care and incorporate standards like SMART and FHIR. Hackathons get these capabilities into the hands of innovators. We find that clients want to create new solutions for health care’s problems. We’re seeing a trend with more and more innovation centers connecting to large health care systems. We share our clients’ mission to motivate the developer community and educate them to  improve health care today.  

What I enjoy the most about hackathons is that you get to work side by side with clients. The events foster innovation and excitement around solving the challenges we face in health care today. Hacking Pediatrics was a beaming success, and I can’t wait to see what will become of the nearly 20 ideas showcased at this year’s event. 

Using Cerner’s SMART on FHIR API, Blake Martin, a senior resident at Boston Children’s Hospital, created Pill Square. The Best Hack winner shares his inspiration and creation process at Hacking Pediatrics:

Like most adult patients, kids often have trouble remembering to take their medications as well. As a pediatrician, it’s very challenging to know how to manage a patient with a chronic disease (for example, asthma) without knowing how often they actually receive their daily medication.

My idea for the Hacking Pediatrics event was to develop a mobile phone application that would import the patient's medication list directly from their provider and organize it into a daily schedule with automatic reminders. Then, when a patient checks whether he or she has taken a specific medication, the compliance information is fed to parents and providers. The idea is the app can help take more control of their health and enable continued supervision from their parents. It would also provide valuable feedback to providers on medication compliance. Providers can better tailor a patient's medication regimen and identify barriers to compliance.

The Hacking Pediatrics event seemed like a great place to pitch the idea. The event draws some of the most innovative individuals, providers and corporations in the pediatric sphere. After pitching the idea, I was immediately approached by several other hackers at the event who were eager to help. I was most familiar with Cerner PowerChart and recently learned more about the upcoming implementation and flexibility of SMART on FHIR at Boston Children's Hospital's Global Pediatric Innovation Summit. Therefore, it made the most sense to create the application via SMART on FHIR. We ended up with an amazing team of hackers from Baystate Health, Microsoft and Harvard Business School, as well as myself from Boston Children's. My Baystate Health colleagues expressed that they had thought about the idea at length and felt they would be able to create a solution using the SMART on FHIR functionality. 

I can't speak highly enough of the ingenuity and work ethic of our team. To go from an idea to a sleek, functional prototype application within just one day is amazing and a testament to their impressive abilities. We are hoping to continue working together as a team to develop the application over the next few months to fine-tune the design and functionalities. We're also hoping to add a bit of “gamification” to the app to better engage our pediatric patients. Once we are able to launch a small trial of the application, we hope our product can increase pediatric medication compliance, better inform prescribing providers and lead to better health outcomes for our pediatric patients.