Standards and terminology
SMART on FHIR
SMART on FHIR is the HL7 SMART App Launch specification, which defines how an application is authorised to connect to a FHIR server using OAuth 2.0, and how it opens in context, such as on the patient a clinician is viewing.
Why it matters
Hospitals and ministries increasingly want to add applications to the record: decision support, registries, research tools. Without a standard, each one needs a custom integration and its own sign in. SMART on FHIR gives every approved application the same way to request access and to open on the right patient, while authorisation stays under the control of the system that holds the record.
Key points
- HL7 publishes it as the SMART App Launch implementation guide; the version cited here is STU 2.2, published in 2024 [1].
- It is built on OAuth 2.0, with scopes that limit what an application may read or write [1].
- Launch context lets the application open on the patient already in view, without a second search [1].
- SMART Backend Services authorise system to system clients, and the FHIR Bulk Data guide encourages their use for large exports [2].
- Scopes do not replace governance. The ministry or hospital still decides which applications are approved.
In Moana
Moana supports SMART on FHIR app launch, so an approved application can open within the record on the patient in view, with access limited to the scopes it is granted.
Sources
- SMART App Launch implementation guide, STU 2.2, HL7 International, 2024
- Bulk Data Access implementation guide, export specification, HL7 International, 2020
Read the guide: FHIR R4 explained for ministries of health: what to require
In the platform: Moana interoperability
Related terms: Fast Healthcare Interoperability Resources, FHIR Bulk Data Access, Role based access control
Updated 2026-11-03. Written under Moana’s editorial standards.