Through a grant from the Office of the National Coordinator for Health Information Technology(ONC), researchers at Children's Hospital Boston and Harvard Medical School have developed a first-of-its kind platform architecture to support a flexible health information technology (IT) environment and promote innovation. The SMArt (Substitutable Medical Applications, reusable technologies) platform and interface are being made publicly available today to kick off the start of a $5,000 competition challenging developers to create web applications that provide specific functionality for patients, physicians, or for public health.

First described in a March 2009 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; that will drive competition, innovation, and increased efficiency in the functionality of technology for improved health care.

ONC awarded $15 million to the project in April 2010 through the Strategic Health IT Advanced Research Projects (SHARP) program. The SMArt project will enable the equivalent of an iTunes App Store for health and support an ecosystem of applications ranging from medication managers for patients at home to e-prescribing applications and decision support for physicians in the office.

"The goal of this model is to enable a substantial shift towards technologies that are flexible and able to quickly adapt to meet the various needs of their users on a variety of devices," said Kenneth Mandl, MD, MPH, of the Children's Hospital Informatics Program and Harvard Medical School, and co-lead on the SMArt project. "As developers begin to compete on quality, value and usability, we expect to see the introduction of an array of innovative functions and a drop in the cost of healthcare technology. Just as staple applications of the iPad, Android, and Blackberry platforms constantly evolve and compete to meet user demands, the SMArt platform will enable health IT to do the same."

In August, Mandl and Isaac Kohane, MD, PhD, also of CHIP, Harvard Medical School and co-lead on the SMArt project, held a SMArt Developer Meeting which included more than 60 representatives from academia, government and business. Multiple prototypes of the SMArt platform were presented and feedback was collected from software developers and the health IT community. Following that meeting, the team built the SMArt platform architecture and interface that is being made publicly available today.