SMART on FHIR app uses machine learning to help dermatologists make diagnoses
Dermatology is finding Fast Healthcare Interoperability Resources an increasingly useful standard from HL7.
CoxHealth, a Springfield, Missouri-based health system, is using the VisualDx app that uses medical images, visualization and machine learning to help compare variations of disease to get to a more accurate diagnosis.
VisualDx is what's called a SMART on FHIR app. It is integrated into the health system's Cerner electronic health records system. Having the application integrated into the EHR saves physicians time by having it available at the bedside or with a patient in an examination room and linked to patient data.
"I primarily use the app when I'm outside of the office or not with a patient in the room," explained Louis Krenn, MD, chief medical information officer at CoxHealth. "I use it to create a differential diagnosis and then narrow the differential down. After that I review the possible conditions and details about those conditions.
"Being a SMART on FHIR app also allows it to be contextually aware regarding the patient and details about the patient including age, sex, medications and problems," he explained. "That helps narrow the differential faster. The FHIR app also allows you to click on any medication or problem and immediately start a differential search or obtain information about that medication or problem."
Having the EHR integration saves time by allowing physicians to start searching for information faster since it's already integrated into the record.
"I don't have to find another web site, pull out my smartphone, or leave the room to find information I need to care for the patient," Krenn said. "By having a quick, point-of-care reference tool that can be used from within the room, quickly, providers are more likely to use it, improving patient care."
CoxHealth has monitored the value of the app by provider usage.
"I was concerned at first that the app might be a short-term use item until the newness wore off," Krenn said. "However, we have seen sustained use over time. I think this validates that these apps are indeed solving a need for our providers that our EHR could not solve alone."
The app helps solve an important need for the health system: It's short on dermatologists, and primary care physicians end up doing a lot of dermatology exams.
"Having this app has helped our providers care for these patients more confidently," Krenn said. "I liken this type of app to smartphone apps. Apple makes great hardware and some good software, but other developers can enhance the experience by adding similar apps or in the case of these apps, extending the use of the core app."