Elsevier Launches SMART on FHIR Tool To Better Educate Patients

By Allison Proffitt 

September 22, 2020 | Earlier this month, Elsevier launched PatientPass, a cloud-based patient engagement platform now listed on Epic App Orchard for hospitals and health systems using the Epic Electronic Health Record (EHR) system.

The new platform will let clinicians choose and deliver evidence-based content for patients in multiple ways, John Danaher, Global President, Clinical Solutions at Elsevier, tells Clinical Research News. The platform delivers highly personalized, actionable content to patients in several formats, including on their mobile phones and via SMS alerts.

“In the past, you would have the info button and the info button would really just allow you to serve up content based on the traditional things—age, gender, and ICD 10 codes,” Danaher says, describing the way clinicians could gather educational information for their patients. That has changed, he says, thanks to FHIR—Fast Healthcare Interoperability Resources—the web standard for health interoperability. The SMART on FHIR protocol enables user-facing apps that connect to EHRs and health portals.

“The SMART on FHIR protocol allows you to pull much more meaningful information than just age, gender, ICD 10,” Danaher explains. The SMART on FHIR protocol lets clinicians combine data, for instance, on multiple comorbidities and evolving medication lists from within the EHR and deliver educational materials that take into account all of the patient’s circumstances.

PatientPass can even adjust to nurse notations within the EHR noting the patient’s reading level and how he or she learns best (animation, video, printed text), Danaher says. “We pull this information from the EHR and then create that bespoke learning. It’s content that’s very customized because we are pulling from their problem list, their medication list, their procedures, etc.”

The educational content itself is all generated and maintained by Elsevier. “What is core to Elsevier is really making sure that we always have the most evidence-based content and that it’s updated, it’s fresh, it always reflects the standard-of-care,” Danaher says. All materials are reviewed every one, two, or three years depending on the type of content. New academic publications can also trigger reviews in addition to the standard cycles. “It's very personalized, it's very bespoke and it's constantly being updated,” he adds.

But PatientPass isn’t a one-way street, Danaher emphasizes. “We are big proponents of these integration standards, of SMART on FHIR protocols, et cetera. We're big proponents at Elsevier of really making sure that our content is embedded within the EHRs but is also being facilitated by this two-way transmission of information, pulling information from the EHR and then also populating these data, back into the EHR,” he says.

It's one thing to deliver educational information based on what the literature is saying, he says, but the goal is to glean learnings about how the patient uses that education and put those back into the EHR. “In other words, how has this patient interacted with this information, be it a medication adherence, etc, on any range of topics,” he says. Danaher and Elsevier envision being able to not only deliver relevant health materials to patients, but also track how people used those materials, whether they understood them, and what impact they had on their health outcomes.

PatientPass launched this month in the US with integration with EPIC EHRs, but Elsevier will integrate eventually with all the major EHRs, Danaher says, “Allscripts, Meditech, etc.” They tool is in demand in the Middle East, Danaher reports, particularly in the United Arab Emirates and Saudi Arabia; Cerner is the lead EHR there, he said, and Elsevier is prioritizing Cerner integration as well as translation and localization of the platform for a Middle Eastern user audience. Korea is also a market of interest because of the reliance on Cerner. Elsevier is also working to localize the educational materials for other English-speaking markets including the UK, Australia, New Zealand and others.