Pop Health on FLAT FHIR: A SMART Approach to Universal Healthcare Reporting

Project Overview

The Office of the National Coordinator for Health Information Technology’s (ONC) Cures Act Final Rule requires certified health information technology (health IT) developers to publish application programming interfaces (APIs) that allow information to be accessed, exchanged, and used without special effort.

Substitutable Medical Applications, Reusable Technologies on Fast Healthcare Interoperability Resources (SMART on FHIR®) has defined an API so that mobile applications (apps) can be added to or deleted from electronic health records (EHRs) systems as easily as smartphone apps. A growing ecosystem of apps—many of which are exhibited in the SMART App Gallery—is leveraging this transformational approach to interoperability.

The team built upon the success of the SMART on FHIR API and prototyped an app, called SMART-PopHealth, that demonstrates the power of a shared view of EHR data between healthcare provider organizations and payors (Medicare, Medicaid, and private insurers). Through an app like this one, hospitals can demonstrate performance and value, via a constantly updated view. The model of shared payor-provider data made possible with SMART-PopHealth could create a new basis for pay-for-performance, assessment of value-based care, and approaches to quality management. The SMART-PopHealth app is an open source prototype that the community can build upon.

This project addresses the Leading Edge Acceleration Projects (LEAP) in Health IT fiscal year 2018 special area of interest 1: Expanding the Scope, Scale, and Utility of Population-Level Data-Focused APIs.

Project Dates

This project began in 2018 and will end in 2022.

Project Goals

The goals of this project are to:

  • Catalyze an ecosystem for accessing and analyzing, without special effort, data on whole populations rather than one patient at a time.
  • Continue to define the FHIR Bulk Data Export API, the population health analog to the SMART API.
  • Test a use case of exchange of EHR and claims data and derivative metrics between a provider and a payor.
  • Design and develop a substitutable population health analytics app, SMART-PopHealth, to enable a payor to access permitted data and metrics on covered populations, directly through the API.
  • Test SMART-PopHealth in a real-world accountable care organization.

Learn More

Press Release

To find out more about this project and the other 2018 LEAP in Health IT awardee, read the press release.

SMART-PopHealth App

Boston Children’s Hospital has expanded the scope, scale, and utility of population-level APIs and prototyped the SMART-PopHealth app. To learn more, read the blog post.


Please contact onc.request@hhs.gov with questions about this project.

Content last reviewed on December 21, 2020
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