The SIMPLE Architectural Pattern for Integrating Patient-Facing Apps into Clinical Workflows: Desiderata and Application for Lung Cancer Screening

Abstract

In December 2022, regulations from the U.S. Office of the National Coordinator for Health IT came into effect that require electronic health record (EHR) systems to accept the connection of any patient-facing digital health app using the SMART on FHIR standard. However, little has been reported with regard to architectural patterns that can be reused to take advantage of this industry development and integrate patient-facing apps into clinical workflows. To address this need, we propose SIMPLE, short for Standards-based Implementation Maximizing Portability Leveraging the EHR. The SIMPLE architectural pattern was designed to meet several key desiderata: do not require patients to install new software; do not retain patient data outside of the EHR; leverage EHRs' existing personal health record (PHR) capabilities to optimize user experience; and maximize portability. Using this pattern, an application for lung cancer screening known as MyLungHealth has been designed and is undergoing iterative user-centered enhancement.