SMART Health Cards and Links FHIR IG, published by HL7 International / FHIR Infrastructure. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/smart-health-cards-and-links/ and changes regularly. See the Directory of published versions

Health Links User Stories

SMART Health Links support multiple patterns of sharing. While the technology is designed for flexibility and reuse in diverse contexts, the user stories below represent flows that have explicitly informed design of the protocol.

“Powerful Portals”

Alice signs in to her state’s public health portal where she can see her vaccination history and recommendations. She selects an option to “Share my records with SMART Health Links”, which prompts her to create a passcode and then generates a SMART Health Link.

Alice is presented with options that include:

• Copy the SMART Health Link to clipboard. Alice can share the link with others using any channel she chooses. For example, she could…
  • paste the SMART Health Link into a “vaccine history” form in her school’s vaccine management site as part of an online registration process
  • or share the SMART Health Link and passcode with a friend, caregiver, or healthcare provider.

  The recipient could then view Alice’s data online or automatically load the data into a SMART Health Link-enabled app. This workflow can enable integration with clinician-facing EHR systems as well as patient-facing care management apps.

• Display the SMART Health Link as a QR code. Alice can present this QR code to others. For example, she might display it to a school nurse as part of an on-site registration process.

• Open the SMART Health Link in a mobile health app. Alice can open this link in her personal health app to import her historical vaccine records.

  • Her app will prompt her for the passcode and then will automatically retrieve the set of vaccine records and recommendations for display within the app.
  • In addition, the app can periodically re-fetch the link to look for updates.

Additional use cases for “Powerful Portals”:

• Clinical Summary from a provider portal; can share during an emergency department visit while traveling
• Lab results from a pharmacy portal

“Paper+”

Alice visits Labs-R-Us, where she has blood drawn for a basic metabolic panel. The lab establishes a passcode (whether randomly, or based on a convention like birth date, or by asking Alice to designate her own), then provides Alice with a print-out including details about the test that was performed together with a QR code labeled as a “SMART Health Link.”

Alice can….

• Scan the SMART Health Link QR using a generic QR reader app. This takes her to a Labs-R-Us web-based viewer where she can enter a passcode to view her lab result. Initially she might see a “pending” result, indicating that the analysis has not been completed. Eventually she will see a “final” result with the details available.

• Scan the SMART Health Link QR using a SMART Health Link-aware health record management app. Alice’s health record app prompts her for a passcode and automatically retrieves the lab results for display within the app’s user interface. Initially this might be a “pending” result which would resolve to a “final” result after the app checks for an update at a later date.

  • Optional follow-up step: Upgrade to a long-term SMART on FHIR connection. If Labs-R-Us supports SMART on FHIR for patient access, Alice’s health record app might prompt Alice to “connect to your full Labs-R-Us record.” If she selects this option, she will be taken to the Labs-R-Us authorization screen where she can sign in or create an account and authorize long-term access to her full set of Labs-R-Us data.

• Share the SMART Health Link with a friend, caregiver, or healthcare provider. As in the “Powerful Portals” user story above, Alice can copy/paste the SMART Health Link to share this lab result with a recipient of her choice. (The passcode will be shared separately.)

  • The recipient can open the link in a web browser or in an SMART Health Link-aware health record management app, just as Alice can.
  • This workflow can enable integration with clinician-facing EHR systems as well as patient-facing care management apps.

Additional use cases for “Paper+”

• Vaccine results after a pharmacy visit
• Vision prescription after an optometrist visit
• Encounter summary after a hospital visit
• Coverage details embedded on an insurance card

“Personal Platforms”

Alice uses a personal health record app on her phone. She connects to data from various sources including clinical providers, labs, pharmacies, and others.

When she wants to share a subset of these data, she selects an option to “Share my records with SMART Health Links”, which prompts her to create a passcode and then generates a link. Using this technique, Alice can mix and match data from multiple sources to share a relevant subset of her records that might not exist within any one source.

Alice taps a “share” button and is prompted to copy the SMART Health Link to her clipboard or display the link as a QR.

Alice can now proceed to share this link as described in “Powerful Portals”, above.