Safety Improvement for SMART on FHIR Apps with Data Quality by Contract

Initiatives leveraging the emerging SMART on FHIR standard are promising healthcare system improvements while reducing information technology costs with reusable system components. Previously closed Electronic Medical Record systems are gradually opened to third party applications through FHIR-enabled APIs. While this allows for technical interoperability, patient safety concerns from data quality issues with the underlying system data remain unsolved. We propose to apply a “Data Quality by Contract” approach to pre- and post-conditions of data use cases to assure safe operation of SMART on FHIR apps. We demonstrate how a cardiac risk scoring app could leverage data quality probes to validate several data quality concerns.