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

We catalyze an ecosystem for accessing and analyzing, without special effort, data on whole populations rather than one patient at a time. We have made real progress toward this vision, working with HL7 and ONC, to define the population health analog to the SMART API—the FHIR Bulk Data Export API. The output is “Flat FHIR,” an easily consumable flat file. Currently, a provider using EHR data to meet reporting requirements on population-level quality or cost measures requires a customized and prohibitively complex process to extract, transform, and load data into a separate analytic engine.
Our vision is seamless data exchange, via an API, between provider organizations and third parties. We propose a use case of exchange of EHR and claims data and derivative metrics between a provider and a payor. Toward this end, we design, develop, and test a substitutable population health analytics app, SMART-PopHealth, which enables a payor to access permitted data and metrics on covered populations, directly through the API. We test it in a real-world Accountable Care Organization.