How SMART addresses the PCAST Report on Health IT

A couple of months ago, The President’s Council of Advisors on Science and Technology issued its Report to the President on Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans. We want to tell you how SMART fits in. At a high level:  

    1. PCAST very eloquently identifies lack of interoperability as the central problem of healthcare IT. To spark innovation, PCAST proposes a universal exchange language, with atomic data elements and a strong metadata philosophy for privacy and provenance. We wholeheartedly agree.

   2. One of PCAST’s suggestions is to eschew efforts to define universal semantics, leaving to the market the task of semantic harmonization. While we agree that the market will significantly contribute to semantic harmonization, our experience indicates that an organized initial foray into standardizing semantics for common, well-understood health data is critical to getting the ball rolling.

   3. With SMART, we are building such a universal health language — inspired by existing standards and built on existing coding systems — and empowering with it a modern, web-based application ecosystem. We specifically address PCAST recommendations of data atomicity, metadata tagging, and semantic extensibility, while simultaneously addressing what some have identified as weaknesses in the PCAST report, notably the risk of incomplete patient context when working with disaggregated atoms of data.

Now for some detail.