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SMART Platform and API for Clinical Genomic Apps
Gil AlterovitzDirector, Biomedical Cybernetics LaboratoryAssistant Professor, Harvard Medical School
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100 Most Influential People of the Millennium
1 Johann Gutenberg (mass media- movable type) 2 Isaac Newton (gravity) 3 Martin Luther (Protestant Reformation) 4 Charles Darwin (evolutionist writer) 5 William Shakespeare (Renaissance playwright) 6 Christopher Columbus (explorer) 7 Karl Marx (19th c. political writer) 8 Albert Einstein (physicist) 9 Nicolaus Copernicus (astronomy) 10 Galileo Galilei (astronomy)
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Movable type
• Allows for large populations to be able to absorb knowledge via books, newspapers, etc.
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Vendor-specific apps: calendar, calculator, etc.
Apps did not work with other systems and did not evolve much over time.
No long-tail/custom applications- e.g. family history app
Independent apps
Developer and user community is engaged
Long-tail apps available
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Plug does not fit
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Issues in Communicating Genetic Information
• No simple standard API (Application Programming Interface)
• Contents are essentially the sameo Sequences (ATGC..) and genetic files
• But, data are structured differently
• Different approaches of authentication
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SMART Provides a Solution
• Substitutability Medical Applications Reuseable Technology
• Simple design of APIo Geared toward developers and users
• Integration with clinical data
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What is SMART? • Substitutable Medical Apps Reusable
Technology
• Accelerate medical application innovation and research
• Develop medical app community
• Remove developer roadblocks
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Substitutability = Re-Use
SMART - AMIA 2012 - 04Nov2012
Got Statins?
CardiacRisk
BP Centiles
SMART-EnabledPCHR
SMART-EnabledEMR
SMART-EnabledHIE
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Substitutable Apps Needs
SMART - AMIA 2012 - 04Nov2012
APIResource oriented, everything a URL
Data ModelContext (container, user, patient)Medical (problems, allergies, …)
AuthenticationConsistent delegation, web standards (OAuth)
UIStandards-based integration (HTML5)
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Platform
App
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SMART-Enabling i2b2
SMART - AMIA 2012 - 04Nov2012
Ontology
SMARTCell
MapperCell
i2b2 Hive
CRC
AnySMART
App
Patient-Centric View App
Add: SMART cellMapper cellPatient-Centric
View app
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Cerner EMR
SMART - AMIA 2012 - 04Nov2012
Boston Children’s Hospital
16 Months
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SMART Genomics API
• Enables integration of genomic data from heterogeneous sources
• Enables integration of clinical and genomic data
• Re-usability eliminates developer barriers
• Promotes the use of genetic data for research
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SMART Genomics Platform
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SMART Genomics Advisor App Integration 24Oct2012
Top-Level Genomics Advisor Displays
Pop-Up→
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SMART Genomics Advisor App Integration 24Oct2012
Genomics Advisor: Detailed Pop-Up
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SMART - AMIA 2012 - 04Nov2012
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Example App: Dbear SMART EMRProblem: High cost of chronic disease management
and issues with long-term patient compliance in
diabetes, especially in pediatric cases.
Solution: Increase compliance by integrating toy
bear from Sproutel with SMART EMR for physicians
and to provide parent/child feedback.
Details: Integrated bear with the Telecare glucose
meter / pump technology to provide clinical data to
SMART EMR
* Provides kids with a “fun” way to measure glucose
and take insulin. Provide live data for
clinicians/patients to view.
* Interactive bear avatar gives feedback to patients.
* Engages patients to increases their likelihood to
comply with their diabetes treatment.
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iPad Apps
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DB EMRFirst program to integrate genomic, device, EMR/Personal Health Record information.
First program to integrate patient, patient devices (e.g. bear/glucose meter), care giver, and physician data into a unified view to facilitate collaboration on patient care.
First mobile app to integrate genomics/sequence information and clinical information.
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Genomics Advisor
• Another app using the SMART API
• Gives analysis based on genetics