A patient-centered health system needs precise computable measurements to derive value. While validated patient-reported outcomes (PROs) are increasingly used in trials, their adoption in care remains limited and generally separated from the medical record. Further, absence of systematic processes for patient-led data submission excludes valuable data from digital devices that can potentially aid in contextualizing health status. With prior experience in developing apps for the Patient-Reported Outcomes Measurement Information System (PROMIS), we sought to make collecting patient-generated health data (PGHD) a fundamental property of health information technology at scale, and in an interoperable, standards-compliant fashion. We build upon the open SMART on FHIR (Fast Health Interoperability Resources) specification to create SMART Markers—a mobile device software framework encapsulating functionality needed for rapid deployment of both patient- and practitioner-facing PGHD apps. We refactored previously developed PROMIS apps to use SMART Markers for handling PGHD-request creation, on-device administration, and generation of a variety of PGHD types and submission of results to a FHIR server. Validation and conformance tests were performed on the generated output and app-reusability was demonstrated across two demo servers. App developers can import SMART Markers into their existing or new apps to readily leverage an interoperable PGHD capturing functionality out of the box, without having to reinvent the wheel. Our approach enables the creation of health system integrated, context-specific experiences for both patients and practitioners.

以患者为中心的卫生系​​统需要精确的可计算测量来获取价值。虽然经过验证的患者报告结果 (PRO) 在试验中越来越多地使用，但它们在护理中的采用仍然有限，并且通常与医疗记录分开。此外，缺乏以患者为主导的数据提交系统流程，导致数字设备中无法提供有价值的数据，而这些数据可能有助于了解健康状况。凭借之前为患者报告结果测量信息系统 (PROMIS) 开发应用程序的经验，我们力求使收集患者生成的健康数据 (PGHD) 成为大规模健康信息技术的基本属性，并以可互操作、符合标准的方式进行。时尚。我们以 FHIR（快速健康互操作性资源）规范上的开放 SMART 为基础，创建 SMART Markers——一种移动设备软件框架，封装了快速部署面向患者和医生的 PGHD 应用程序所需的功能。我们重构了之前开发的 PROMIS 应用程序，以使用 SMART Markers 处理 PGHD 请求创建、设备上管理、生成各种 PGHD 类型以及将结果提交到 FHIR 服务器。对生成的输出进行了验证和一致性测试，并在两个演示服务器上演示了应用程序的可重用性。应用程序开发人员可以将 SMART Markers 导入到现有或新的应用程序中，以便轻松利用开箱即用的可互操作 PGHD 捕获功能，而无需重新发明轮子。我们的方法能够为患者和从业者创建集成的卫生系统、针对具体情况的体验。