Smile CDR v2024.08.PRE
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25.0.1EasyShare SMART Health Links
Experimental

 

The EasyShare module implements the SMART Health Links (SHL) specification, which can be used to provide an easy mechanism for health data sharing without any existing system-to-system connections.

SMART Health Links use a special QR code which is intended to be held and displayed by the patient, and scanned by a clinician who requires access to the health data contained within the link.

The SMART Health Link specification envisions usage for any arbitrary FHIR payload, but the current implementation in Smile CDR is specifically designed to be used for sharing International Patient Summary documents.

25.0.2Understanding SMART Health Links

 

SMART Health Links allows a user to share health information with another user by displaying and scanning a QR code.

Although there are many use cases that could be enabled by this specification, the typical use case consists of a Patient (or their delegate) presenting a SHL QR code to a clinician, allowing them to easily provide access to their health information.

In a typical example of this flow, a Patient uses a mobile application to request and display a SMART Health Link (SHL), which is represented as a standard QR Code. EasyShare has an API which can be used to generate this QR code, using a FHIR payload as input.

The request to fetch an IPS document and create a new SHL QR code for it could be performed directly by the mobile application, or could be mediated by a backend application working with the Smile CDR APIs.

This request could also happen ahead of time, or could happen on demand when the patient needs it. The data associated with any SHL QR Code is stored in a dedidated database schema by the EasyShare module.

SMART Health Links provide two mechanisms to access the data contained within them, as shown on the diagram below:

  • If the receiving user has software which natively understands SMART Health Links, such as an SHL-aware EHR, they have the option of accessing the raw FHIR payload and seamlessly importing the data.
  • If the receiving user does not have any SHL-aware software, but has access to a standard mobile device with a camera and an internet connection (e.g. a stock tablet or mobile phone), they can also access and view the SHL payload on that device.

25.0.3Architecture

 

The following diagram shows the overall architecture for the EasyShare modules for SMART Health Links support.

SMART Health Links EasyShare Architecture

EasyShare SMART Health Link support is enabled by two modules in Smile CDR:

  • The EasyShare SHL Public module is used to view SMART Health Links, as well as providing an API that applications can use to create new ones. It also handles storage of SMART Health Link data in a database.
  • The EasyShare SHL Admin module is used to manage SMART Health Links. It provides web based applications for creating and administering SMART Health Links.

25.0.4Security

 

Because they grant access to health data, SMART Health Links are very sensitive documents. They rely on the principal that the user who holds the QR code must treat it as a sensitive document (like they would if they were holding a physical copy of their health record) and only show it to someone that they trust to view the information.

SMART Health Links have two useful security features which can be helpful in designing a secure SHL-based exchange:

  • SMART Health Links can be protected by a passcode known only to the holder. In this scenario, the holder must provide the passcode to the receiver in order for the receiver to access any data. Smile CDR automatically locks a SHL QR Code if too many incorrect passcodes are attempted.
  • SMART Health Links can also be provided with an expiry when they are created.