Corporations, academics and private citizens responded to a national developer challenge issued this spring by researchers at Children's Hospital Boston and Harvard Medical School designed to inspire innovation in health information technology (IT) and the way in which health IT supports health care. Fifteen applications were submitted to the "SMART" Platform Apps Challenge in the less than three months since its launch, and an expert judging panel of industry leaders has selected the Meducation SMART app as the winner of the $5,000 prize. Six teams received honorable mention.

Launched in March and posted to Challenge.gov, the SMART (Substitutable Medical Applications, Reusable Technologies) Platform Apps Challenge tasked developers with creating web applications that would interface with an electronic medical record (EMR) or personally controlled health record (PCHR) and demonstrate value to patients, physicians, or public health researchers. A SMART architecture and common programming interface were created and made publicly available to entrants.

The Meducation SMART app, designed by Polyglot Systems, Inc. – a health IT company with a focus on improving care and access for underserved patient populations – provides multilingual, patient-friendly instructions for medications listed in a physician's electronic medical record or the personally controlled health record of a patient. The app uses the SMART programming interface to obtain the medication list and then links out to a drug information database, which facilitates the generation of simplified medication instructions for patients, available in a dozen languages.

"This is a production quality application that brings real value to the patient and has a clean presentation," said Kenneth Mandl, MD, MPH, of the Children's Hospital Informatics Program (CHIP), Harvard Medical School (HMS), and co-lead on the SMART project.

The SMART project stems from the work of a SHARP (Strategic Health IT Advanced Research Projects) grant from the Office of the National Coordinator for Health Information Technology (ONC). SMART promotes an "iPhone-like" approach to health IT, where EMRs and PCHRs are reimagined as platforms that run substitutable medical applications that can be rapidly created and also rapidly upgraded or replaced. A significant limitation of today's health IT environment is disparate systems that are inflexible and not able to scale or be customized to meet particular needs.

"Current-stage EMRs decide if, when, and how you will view the data trapped in their systems," continued Mandl. "The SMART Platform Apps Challenge was designed to demonstrate what can happen when electronic health information becomes liberated and can be readily consumed by computer applications. iPhone and Android app developers have been very successful because the address book and GPS data in those platforms is clearly and consistently presented by the platform. Our goal is to present health data in as useful and consistent format. Based on the submissions we received, I think we have demonstrated that this approach can be successful."  

"That we had so many excellent applicants reflects the hunger and need felt in the community to deliver innovative healthcare applications directly to doctors and patients without having to learn the details of a large, monolithic EMR," said Isaac Kohane, MD, Ph.D., also of CHIP, Harvard Medical School, director of the Countway Library of Medicine at HMS, and co-lead on the SMART project.

Six teams were also awarded honorable mention for the following apps:

• "Clinical Research" – facilitates interoperability between an EMR system and a clinical electronic data capture system;
• "DxSocial"- matches patients with doctors based on their experience treating patients similar to them;
• "Medication Risk Maps" – helps identify and compare medication side effects and risk of adverse events across drugs;
• "MyNote" – provides an intuitive, interactive timeline of patient history with disease-specific schemes, and allows patients to annotate the timeline;
• "Priority Contact™" – enhances the work process of a clinician by managing contact with patients after they have left the clinic and new information relevant to their treatment plan has been obtained;
• "rxInfo" – is a suite of SMART apps to help identify patients for clinical trials, provide drug interaction information, FDA Label information about marketed drugs, and a listing of nearby federally funded health centers.

"Through this competition we showed the real power of lowering barriers to developer engagement with health IT and have shown that the desire and ability to spark creativity and innovate is there, just waiting to take off," said Mandl. "We have a tremendous opportunity to revolutionize how health IT supports and helps manage healthcare, and through SMART, aim to give the community the encouragement and tools they need to get started."

All apps submitted in the SMART Platform Apps Challenge can be viewed on Challenge.gov. A SMART "App Store" will launch in 2012. The SMART team plans to design future challenges focused on developing specific functionality.

Special thanks to the judging panel, which included Susanna Fox, director of Health Research at the Pew Internet & American Life Project; Regina Herzlinger, the Nancy R. McPherson Professor of Business Administration at the Harvard Business School; David Kibbe, director of the Center for Health Information Technology at the American Academy of Family Physicians and principal at The Kibbe Group LLC; Ben Shneiderman, professor of Computer Science at the Human-Computer Interaction Laboratory at the University of Maryland, College Park; Edward Tufte, professor emeritus of Political Science, Statistics, and Computer Science at Yale University; and Jim Walker, chief health information officer at Geisenger Health Systems.