SMART Platform and API for Clinical Genomic Apps
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Transcript of SMART Platform and API for Clinical Genomic Apps
SMART Platform and API for Clinical Genomic Apps
Gil AlterovitzDirector, Biomedical Cybernetics LaboratoryAssistant Professor, Harvard Medical School
http://genomics-advisor.smartplatforms.org:4000/
Vendor-specific apps: calendar, calculator, etc.
Apps did not work with other systems and did not evolve much over time.
No long-tail/custom applications- e.g. family history app
Independent apps
Developer and user community is engaged
Long-tail apps available
Plug does not fit
Issues in Communicating Genetic Information
• No simple standard API (Application Programming Interface)
• Contents are essentially the sameo Sequences (ATGC..) and genetic files
• But, data are structured differently
• Different approaches of authentication
SMART Provides a Solution
• Substitutability Medical Applications Reuseable Technology
• Simple design of APIo Geared toward developers and users
• Integration with clinical data
Three Crystallizing Events
eMERGE Network (Electronic Medical Records and Genomics)
SMART Platform (Substitutable Medical Apps Reusable Technology)
CCDA/MU 2.0 (Consolidated Clinical Document Architecture/Meaningful Use 2.0)
eMERGE Network
Electronic Medical Records and Genomics (eMERGE)
What is SMART? • Substitutable Medical Apps Reusable
Technology
• Accelerate medical application innovation and research
• Develop medical app community• Remove developer roadblocks
Substitutability = Re-Use
SMART - AMIA 2012 - 04Nov2012
Got Statins?
CardiacRisk
BP Centiles
SMART-EnabledPCHR
SMART-EnabledEMR
SMART-EnabledHIE
Substitutable Apps Needs
SMART - AMIA 2012 - 04Nov2012
APIResource oriented, everything a URL
Data ModelContext (container, user, patient)Medical (problems, allergies, …)
AuthenticationConsistent delegation, web standards (OAuth)
UIStandards-based integration (HTML5)
Platform
App
SMART-Enabling i2b2
SMART - AMIA 2012 - 04Nov2012
Ontology
SMARTCell
MapperCell
i2b2 Hive
CRC
AnySMART
App
Patient-Centric View App
Add: SMART cellMapper cellPatient-Centric
View app
Cerner EMR
SMART - AMIA 2012 - 04Nov2012
Boston Children’s Hospital
16 Months
SMART Genomics API
• Enables integration of genomic data from heterogeneous sources
• Enables integration of clinical and genomic data
• Re-usability eliminates developer barriers
• Promotes the use of genetic data for research
SMART Genomics Platform
SMART Genomics Advisor App Integration 24Oct2012
Top-Level Genomics Advisor Displays
Pop-Up→
SMART Genomics Advisor App Integration 24Oct2012
Genomics Advisor: Detailed Pop-Up
SMART - AMIA 2012 - 04Nov2012
Example App: Dbear SMART EMRProblem: High cost of chronic disease management
and issues with long-term patient compliance in
diabetes, especially in pediatric cases.
Solution: Increase compliance by integrating toy
bear from Sproutel with SMART EMR for physicians
and to provide parent/child feedback.
Details: Integrated bear with the Telecare glucose
meter / pump technology to provide clinical data to
SMART EMR
* Provides kids with a “fun” way to measure glucose
and take insulin. Provide live data for
clinicians/patients to view.
* Interactive bear avatar gives feedback to patients.
* Engages patients to increases their likelihood to
comply with their diabetes treatment.
iPad Apps
DB EMR
First program to integrate genomic, device, EMR/Personal Health Record information.
First program to integrate patient, patient devices (e.g. bear/glucose meter), care giver, and physician data into a unified view to facilitate collaboration on patient care.
First mobile app to integrate genomics/sequence information and clinical information.
What is FHIR
• FHIR is an API that allows for exchange of health records
• Resources are exchanged using XMLs and JSON, for ease of parsing, and ease of implementation
• Enables document sharing, and documents can be stored on the server
• It is a draft specification undergoing development, and will ballot as a full HL7 Standard
Why Integrate into FHIR
• Faster adoption It is easier for
developers to handle XMLs and JSON without a incorporating a whole suit of libraries
• Open source, extensible API
• To create a more complete standardo FHIR is developing for
medical record exchange, and lack model representations for clinical genomics
SMART FHIR Resource Examples
• New resources to add to FHIR, with automatically generated graphs, documentation, XML and JSON objects, and backend C# and Java for server
SMART FHIR Resource Examples
SMART FHIR Resource Examples
• These newly created resources easily integrates into the existing FHIR framework
Integrating DAM to FHIR Resources
• Translates rather smoothly• Speeds up the information transfer between
the DAM Stakeholder Groups
Example - DAM
• DAM’s object model of elements contained within the genetic results message
Example - FHIR
Example - FHIR
Example - FHIR
• Automatically generated XML and JSON templates created along with example objects
• Automatically generated C# and Java for server
• Automatically created documentation
AcknowledgementsRachel Ramoni, David Kreda, Josh Mandel, Isaac Kohane, Tom Chen,
Jason Evans, Jenny Cheng, Ziou Zheng, Yao Chen, Yidan Pan, Karen Xin
Office of National Coordinator Grant:
- Strategic Health IT Advanced Research Project (Kohane)
NIH Grants:
- 5R21DA025168-02 (G. Alterovitz)
- 1R01HG004836-01 (G. Alterovitz)
- 4R00LM009826-03 (G. Alterovitz)
Email Contact: [email protected]