Cost of implementing provider facing SMART Apps

[Siddharth Chamarthy]

Hi Cerner Community,

I am new to SMART on FHIR. I had a few fundamental questions on how a SMART app is implemented in an EHR.

What is the difference between implementing a SMART on FHIR App and an App which can access FHIR resources using OAuth2?

Is it free for the company to get resources from an EHR using a SMART App?

What is the difference between a program like Cerner's code console and the app store available at SmarthealthIT.org?

Thank you!

Looking forward to hearing from everyone here.

Best,

Sidd

[Yegor Hanov (Cerner)]

Hi, Sidd!

A few comments to your questions in purple below.

-Yegor (Cerner)

On Monday, July 15, 2019 at 10:16:23 AM UTC-5, Siddharth Chamarthy wrote:

Hi Cerner Community,

I am new to SMART on FHIR. I had a few fundamental questions on how a SMART app is implemented in an EHR.

What is the difference between implementing a SMART on FHIR App and an App which can access FHIR resources using OAuth2?

SMART is primarily a vehicle for embedding third party application into EHR workflow.  It creates an ability to launch the app within the EHR and pass through the provider and patient context to enable the app to run its logic as if it is a "native" component of the EHR.  SMART does provide capability for standalone launch as well, but integration with the EHR seems to be where majority of the developers are seeing the value.  You can read up more on SMART here - https://smarthealthit.org/ 

Is it free for the company to get resources from an EHR using a SMART App?

The answer to this question is complicated.  If you are a Cerner client, all of the API access for in-house development is free.  For third-party developers some access is free as well based on regulatory requirements.  In particular, if you are building a consumer-facing application, you can have free access to a subset of API resources that cover common clinical data set.  In our implementation that includes read-only access to the following APIs - AllergyIntolerance, Binary, CarePlan, Condition, Contract, Device, DocumentReference (limited to CCD retrieval), Goal, Immunization, MedicationStatement, Observation, Patient, Person, Procedure, RelatedPerson.  If you are building a provider-facing app or a consumer-facing app that requires more resources, you can freely use our sandbox for development, but you will have to enter into a developer program agreement with us before connecting your app to our production API.

 

What is the difference between a program like Cerner's code console and the app store available at SmarthealthIT.org?

Cerner's code console allows you to register apps, build and test them against our implementation of the standards in our hosted sandbox.  Other app stores and sandboxes are available on the internet as well, some of them are affiliated with other EHR vendors and others are community hosted.  You have to review the specific terms of service for each site to understand its capabilities and limitations. 

[Siddharth Chamarthy]

Hi Yegor,

Thank you for your answers. They helped me understand SMART a lot! Sorry for the delayed response!

Now, here is another set of questions, I wanted to know the answers for!

What if my app is a standalone implementation that uses FHIR resources to perform some logistics! 

How do we integrate with the EHR? 

Do we pay the costs per call to a production server? or does the hospital pay?

Before, we integrate with the EHRs should the app already be ready to be deployed?

Thank you for your answers once again! Looking forward to these answers too!

Best,

Sidd

[Jenni Syed (Cerner)]

Some answers below:

What if my app is a standalone implementation that uses FHIR resources to perform some logistics! 

How do we integrate with the EHR? 

If your app is standalone, and not used by a patient, and resold per client, you would need to be part of the code program. From a technical perspective, you would not be using the SMART "launch" parameters - but you would need to configure the FHIR URL that the app would use to get data. How you do this depends on your deployment model and how practitioners access your application.

 

Do we pay the costs per call to a production server? or does the hospital pay?

The costs are something typically discussed as part of the code program. The most basic approach is to use revenue sharing, but there are other options that may meet your business model.

Before, we integrate with the EHRs should the app already be ready to be deployed?

 Before you join the code program, some prerequisites are called out here: https://code.cerner.com/submit

You'll notice some of those call out knowing gaps as well as already being integrated in our public sandbox and being able to demonstrate that application. This does have an assumption that the code is deployed somewhere. Part of the validation in the program is a security evaluation, which would require code to be deployed in a production fashion as well. This is all done prior to being able to be run against a production client domain.

Regards,

Jenni