A Powerful and Flexible Platform


HL7 FHIR is an emerging technology that can be used to solve all kinds of problems in modern healthcare. Smile CDR implements the rich set of functionality that FHIR specifies, and integrates a number of other useful technologies as well. Let us take care of the plumbing, while you focus on innovating.

The modular design of Smile CDR means that you can customize the system to any configuration you can dream up. We've got a few ideas below, but you probably have others.

Use Case: Hospital
Hosting SMART Apps

Smile CDR can be used as a backend for your SMART on FHIR applications. Build apps quickly or deploy apps written by other people against a backend that supports the complete SMART on FHIR specification.

You can populate Smile CDR with data from other sources by taking advantage of FHIR endpoints or by using HL7 v2.x interfaces. You can also populate other systems with data generated and/or collected by your SMART apps by means of FHIR interfaces, HL7 v2.x interfaces, or other types of exports.


Smile CDR stores and supplies the clinical data that your apps will need. It also handles the other complexities inherent in hosting a SMART app. The Smile CDR security stack includes a complete implementation of the OAuth2/OpenID Connect SMART profiles.

You can use this to provide authorization to applications in the same way that current internet applications request authorization. Think "Login with Facebook" but against a secure private backend using authorization scopes that are relevant to healthcare.


Of course, there are plenty of other ways of securing Smile CDR. You can secure your endpoints with HTTP Basic, integration with outside OAuth2 providers, or even TLS Certificates. We are happy to discuss other options, too.

Use Case: Government
Personal Health Record (PHR)

The concept of a Personal Health Record (PHR) system, which puts the patient at the center of the model instead of any one health delivery institution, is growing in popularity around the world.

Under this model, a single logical storage area is created for each participating patient – with data being collected from a wide variety of sources. Data is easy to store, easy to navigate, and easy to discover.


Smile CDR can serve as a central broker for PHR data that is coming from and going to a large variety of sources.

An appropriate inbound security module is chosen in order to facilitate integration across a wide variety of users and environments. This might take the form of a central IAM system with tokens being validated by Smile CDR, a distributed and federated LDAP directory forest, or a simple authentication scheme built within Smile CDR itself.

In order to ease integration across many sources, terminology mapping is centralized in terminology tables within Smile CDR. Data may be submitted according to multiple current standards with mapping happening after-the-fact.

Use Case: Integrator
Document Repository

Smile CDR can be used as a powerful central hub in a document indexing and storing repository scheme.

Take advantage of fulltext indexing to provide search capabilities that seamlessly index across all of your documents. Take advantage of simple yet powerful capabilities for storing structured data alongside your unstructured data.

Document Repository

Our roadmap includes plans to create adaptors for IHE XDS.d and other relevant interface layers. Please get in touch to discuss options for putting Smile CDR into your document storage mix.

Use Case: App Developer
Health App Backend

Smile CDR makes the perfect backend for your mHealth, clinical, and wellness apps. Taking advantage of the power of the FHIR data model gives you a significant head start in bringing your ideas to market quickly.

We have extensive experience in the health app development space. We have helped to build successful FHIR-based apps for the management of chronic conditions, as well as for wellness and general fitness.

Put the power of Smile CDR to work and hit the ground running!

OpenID Connect Client Modification

Security for All Needs

Powerful Authorization Layer

Authorization Manager

The Smile CDR security layer can be customized to provide users with access to perform only the actions they should be allowed to perform. You can create rules to allow users read/write access to some resources and read-only access to others. You can define rules for access to resources by FHIR compartment, by resource type or ID, or by other criteria.

You can also create rules to allow anonymous users access to certain functions within the system but not to others. For more information on the permission model used by Smile CDR, see the Roles and Permissions documentation.

Comprehensive Audit Layer

Authorization Manager

All interactions with your clinical data is recorded by Smile CDR. We keep complete audit logs recording who accessed what, where on the network they came from, and when they did it.

Audit logs are kept for all types of interactions, including:

  • FHIR reads (and searches, history interactions, etc.)
  • FHIR writes (and creates, updates, etc.)
  • FHIR operations

The Full Power of FHIR



Smile CDR is based on HAPI FHIR, which is a reference implementation of the FHIR Specification. As such, we are committed to providing a complete and compliant implementation of FHIR.

FHIR is a vastly powerful specification for application developers. Through the REST search mechanism, your applications can construct queries for data that return exactly the data you need. Smile CDR understands clinical data. It can construct precise and relevant queries for structured data (e.g. "find me abnormal lab tests for a given patient in the last month"). Smile CDR can also construct freetext queries when your data isn't well structured (e.g. "search the entire patient record for the word 'infarction' and suggest keywords that are similar to this").

Complete FHIR Version Support

Smile CDR supports current versions of FHIR as well as new ones being developed. At this time, the system supports the currently released DSTU2 version of FHIR as well as the emerging STU3 release.

We have been a member of the FHIR project since the DSTU1 release of FHIR, and the HAPI library has existed since the very early days of FHIR. We are committed to staying up-to-date with the specification as it continues to grow into the future, and we anticipate providing early access of the next version of FHIR (STU4) as quickly as possible.

Smile CDR is designed to allow you to keep your projects up-to-date with the latest FHIR models and features. A single installation may be used to support segregated databases for multiple versions of FHIR, all pointing to a single security and management infrastructure.


Management and Monitoring

Manage Smile CDR

Monitoring Charts

Smile CDR can be configured and administered through our web-based management console.

Smile CDR can also be controlled through a RESTful JSON-based API with Swagger tools baked into the platform. This API can be used to automate tasks such as monitoring, configuration, provisioning, scaling, and reporting.

Monitor Performance

Monitoring Charts

Smile CDR presents extensive and meaningful runtime statistics, including:

  • Transaction throughput
  • Transaction latency
  • Operating environment
  • Database health and performance
  • Security failures and tokens granted

Flexible Storage and Deployment Options

Storage Options

Database Icon

Smile CDR may be deployed on top of a relational data store such as PostgreSQL, Oracle, or MySQL. See the platform requirements documentation for more information on supported databases.

Smile CDR supports a wide range of deployment topologies: Need a single database to store all of your data? Pick one of the supported database platforms and you are on your way. Need multiple segregated databases with different permissions, characteristics, or FHIR attributes? You can configure that too within a single installation.

Deployment Options


Smile CDR may be deployed in a variety of ways.

Let us take care of the infrastructure: We offer a cloud-hosted version of the platform. In this model, we take care of the infrastructure and you take care of the data. Your cloud deployment of Smile CDR will have the full set of features, and it can be configured in any way you need.

If you prefer to have complete control over your infrastructure, we also offer a self-hosted version of the software. In this model, you supply Linux-based application and database servers, and you install and manage your Smile CDR deployment yourself.

Under either of these models, you are in complete control of your data.