Open standard · draft 1.0

SMART Health Check-in

Before a visit, patients are often asked to write out their allergies, medications and insurance details again, on a clipboard or a web form. SMART Health Check-in lets the patient answer from a health app of their own choosing instead: an app that already has their records, and that can help them answer the clinic's other questions too. The patient decides what to share, and the clinic's page receives it directly from the app.

It is a draft open standard. A health app installed on the phone is reached through the W3C Digital Credentials API, the browser feature that is also used for digital driver's licenses; a health app that runs as a website works in any browser. This project publishes reference code and test apps, but no health app that patients use today supports it yet.

How it works

How check-in works, in three steps A clinic's check-in page asks for three things: allergies, an insurance card, and two questions about mood. In a health app of their choice, the patient shares the allergies from their records, answers the mood questions in the app, and decides not to send the insurance card. The page gets back a sealed answer: the allergy list and the patient's answers received, and the insurance card marked declined, with nothing sent. 1 The clinic asks Its check-in page lists what the visit needs. CHECK-IN PAGE Allergies From your health records Insurance card A copy of your card Two mood questions A short form to fill in 2 The patient chooses In a health app of their choice, item by item. PATIENT’S HEALTH APP Allergies Share from my records Insurance card Not this time Two mood questions Answer in the app 3 The page gets the answer Sealed so only this page can open it. WHAT THE PAGE GETS Allergies The allergy list received Insurance card Nothing sent declined Two mood questions The patient's answers received
How check-in works, in three steps A clinic's check-in page asks for three things: allergies, an insurance card, and two questions about mood. In a health app of their choice, the patient shares the allergies from their records, answers the mood questions in the app, and decides not to send the insurance card. The page gets back a sealed answer: the allergy list and the patient's answers received, and the insurance card marked declined, with nothing sent. 1 The clinic asks Its check-in page lists what the visit needs. CHECK-IN PAGE Allergies From your health records Insurance card A copy of your card Two mood questions A short form to fill in 2 The patient chooses In a health app of their choice, item by item. PATIENT’S HEALTH APP Allergies Share from my records Insurance card Not this time Two mood questions Answer in the app 3 The page gets the answer Sealed so only this page can open it. WHAT THE PAGE GETS Allergies The allergy list received Insurance card Nothing sent declined Two mood questions The patient's answers received

The patient's health app, called a wallet in the specification, is an app that already holds their health information: records it has collected from their doctors' and hospitals' patient portals, and cards such as an insurance card. It can also show the clinic's questionnaires and help the patient answer them. It can be an app on their phone or a website that opens in a browser tab. The clinic's page doesn't need to know which one the patient uses; the phone or browser lets the patient pick, and tells the app which website is asking.

The app shows the patient each item the clinic asked for. Nothing is sent until they approve, and they can share some items and decline others. The clinic learns which items were declined, so staff know what is still left to ask at the front desk.

For each request the clinic's page creates a one-time key, and the app encrypts its answer to that key, so only that page can read it. The records arrive in FHIR, the standard format for health data that clinic record systems already use. The Request and response explainer shows the data sent at each step.

Try it

The demos check in a made-up patient at a pretend clinic. The patient's side is one of this project's test apps: a demo web wallet, the SMART Testing Wallet, or the reference Android wallet.

Online

Check in from a phone

The clinic's page asks the wallet apps installed on your phone, so you need a test wallet such as the reference Android wallet. On a computer, the browser shows a QR code so you can finish on your phone.

Try it → In person

Check in at a kiosk

For a shared screen at the front desk, which has no wallet of its own. You scan its QR code, approve on your phone, and the answer goes back to the screen.

Try it → Any browser

Check in with a web wallet

Nothing to install. A demo wallet opens in a new tab, shows you what the clinic asked for, and sends back what you approve.

Try it →

Next steps

  • Build a check-in page

    For developers of clinic websites, patient portals and electronic health record systems. A tutorial that builds a working check-in page with this project's JavaScript library.

  • Build a wallet

    For developers of patient health apps. How a wallet receives a clinic's request, shows it to the patient, and sends back the answer.

    For a wallet that runs in a browser tab: Web wallets

  • Read the spec

    For implementers and anyone reviewing the standard. The Request and response explainer walks through the data of one check-in.

    The specification itself: SMART Health Check-in 1.0

Connectathon: an online testing event where developers connect their software and patients and clinic staff try it. Date to be announced. Join us.