Clinical Track - RC21 - HealthKit, Consent, Provenance, Security Audit

Happy New Year, Meteorites!

Can you say HealthKit? Because we’re kicking off 2019 with HealthKit integration, based on the fantastic work over at rossmartin/Healthkit.

Most of the other work this past 6 months has been in implementing and testing:

  • Upgrade to Meteor 1.8
  • Collection2 Upgrade
  • Simpl-Schema
  • FHIR Safety Checklist
  • Security Audit
  • Performance Audit
  • Basic Consent Management
  • Provenance Tracking
  • Revamped HIPAA Logging
  • Desktop App (Meaningful Use Stage 2)

Release Page

Although not necessary to use the individual packages or FHIR resources, you can synchronize an app to the baselined dependency versions by running your app with the --release flag.

meteor --release clinical:METEOR@

Software Development Kit
Download the entire Clinical Meteor Software Development Kit, including examples, utilities, design documents, and other resources.

git clone --recursive
cd clinical-meteor 
git submodule update --recursive --remote --merge

HealthKit now supports HealthRecords, which are available in FHIR format. This allows patients who receive medical care at one of the 75+ institutions that support health records on iPhone to download their healthrecords, which a Meteor app can now pick up and read via the rossmartin/Healthkit cordova plugin.

A video of workflow is provided below:

HealthKit/Epic Interoperability
Clinical Meteor now supports over 60 FHIR resources; including the ~16 or so packages commonly supported by Argonaut members (a consortium of EHR vendors). Of particular interest are the following resources, which are supported by Epic, Cerner, and Allscripts AND Healthkit. These are the resources that are going to ‘go national’ first, with nationwide support across all EHR vendors.

Allergy Intolerance
Diagnostic Report
Medication Order
Medication Statement

Fast Healthcare Interoperability Resources
Meteor support for the HL7 FHIR spec can now be included in a project by adding the clinical:hl7-fhir-resources package.

meteor add clinical:hl7-fhir-resources

For individual FHIR resources, use the search command or Atmosphere.

meteor search clinical:hl7-resource
meteor add clinical:hl7-resource-patient  // to add the Patient resource

Updated Documentation

There’s a lot of new documentation circulating Clinical Meteor, some highlights which include how to:

Symptomatic SDK - Write a Plugin
Symptomatic SDK - Example Plugin - Body Mass Calculator
Clinical Track - SDK Release Notes
Clinical Track - Verification/Integration Tests

Clinical Meteor has forked the oauth and accounts-oauth package and made modifications to add SMART on FHIR support. This primarily involves a patientId field that needs to be picked up and used; and adding support for OAuth scopes based on FHIR resource types. Each application will have different needs around which scopes it needs to access and what it does with the patientId. For those reasons, it’s generally advisable to create a custom SMART on FHIR client package for each app you’re trying to write. We provide the clinical:oauth and clinical:accounts-oauth packages under an MIT license, and provide links to a sample oauth-client library which you can use to start your integration. There is also a symptomatic:smart-on-fhir-client package available for license. Contact for more details on licensing.

Packages Confirmed to Work Together
Each release, we publish a list of packages that are known to work together. As we migrate to NPM, we now have two supported package lists that we are keeping under QA. Use these two files as a baseline for which packages to use.

Atmosphere Package Reference
NPM Package Reference

Reference Implementation(s)
Meteor on FHIR
HL7 Argonaut FHIR

Validation/Verification Tests
936 validation assertions passed - Meteor on FHIR Interface Engine
67 verification & integration tests across 67 packages

Pending On Roadmap
Provider Worklist
Proximity Detection ($near)
IPFS AutoSwarm
IPFS Documentation
Open mHealth Schemas
Node/Python bindings
Tensorflow on FHIR