Today one of the recipients of the ONC’s Strategic Health IT Advanced Research Projects (SHARP) announced a major milestone .  Researchers at Children’s Hospital Boston and Harvard Medical School, leaders of the Healthcare Applications and Networking Platforms SHARP award, announced a major breakthrough having developed a first of  kind platform architecture to support a flexible health information technology (IT) environment and promote innovation. 

First described in a New England Journal of Medicine Perspectives article , the SMArt architecture is an “iPhone-like” health IT platform model that aims to transform the way health IT supports health care by facilitating the development of medical applications that are scalable and substitutable.

Substitutability is the capability of a system to replace one application with another of similar functionality – it allows the administrator of a system to replace one application with another without being a technical expert, without requiring re-engineering of other applications they are using, and without having to seek assistance from any of the vendors of previously or currently installed applications. Substitutability allows developers to rapidly create a large marketplace of apps for consumers to choose from.

In essence, the SMArt team is researching how medicine might learn from the successful implementation of IT in other sectors. The iPhone, for instance, uses a software platform with a published interface. This interface needs the ability to have both core components and applications. On the iPhone, core components include cameras, geolocation, networking capabilities, etc. The platform functionally separates the core components from the apps, and the apps are substitutable. For instance, The result is that a consumer can download a calendar reminder system, reject it, and easily replace it with a new one.

The SMArt team’s architecture enables a health IT environment that may to be augmented by substitutable apps constructed around shared core components.  Such architecture could should theoretically drive down health care technology development costs, support standards evolution, accommodate difference in care workflow, foster competition in the market, and accelerate innovation. While not meant to replace existing application architectures, the SMArt project researches the technical viability of an alternative model that may be appropriately integrated within the existing commercial marketplace.

To kick off the start of this new platform and to promote open innovation, the SMArt team is holding a $5,000 competition, challenging developers to create web applications that provide specific functionality for patients, physicians, or for public health.  Developers interested in learning more about the SMArt project and app challenge may visit www.smartplatforms.org/challenge for complete details.

Future developments in health IT should always be driven by empowering physicians and improving patient care.  To this end, the SHARP program is tasked with achieving breakthrough innovation to address the major barriers to health IT adoption.  I personally challenge the development community to help test the potential success of projects such as SMArt, in search of new, exciting pathways to a rich and diverse health ecosystem.