De-Mystifying Healthcare Apps: A “SMART on FHIR” Starter Kit for Developers

By Hisham Alrashdan

Building a healthcare app is not like building a standard web app. You cannot just “login with email” and query a database. You must handle strictly regulated patient data, integrate with massive Electronic Health Record (EHR) systems (like Epic or Cerner), and strictly follow security protocols.

This high barrier to entry discourages many developers. I built the SMART on FHIR Starter Kit to lower that barrier.

This open-source repository serves as a production-grade boilerplate that handles the heavy lifting of healthcare authentication (OAuth2) and data fetching, allowing developers to focus on building the actual clinical features.

The Problem: The “Auth” Wall

The biggest hurdle in healthcare app development is the Launch Sequence.

To securely connect an app to a hospital system, you must use the SMART App Launch Framework. This involves a complex dance of redirects, handshakes, and token exchanges:

1. The app launches from inside the EHR (or standalone).
2. It redirects the user to the hospital’s Authorization Server.
3. The user logs in (as a doctor or patient).
4. The app receives an authorization code.
5. The app exchanges that code for an Access Token.
6. Finally, the app can fetch data (e.g., GET /Patient/123).

Coding this from scratch for every project is error-prone and tedious. A single mistake in the OAuth2 scope handling can break the entire integration.

The Solution: A Pre-Configured “SMART” Reactor

My SMART FHIR Starter Kit acts as a “batteries-included” foundation. It comes pre-wired with the standard SMART client libraries and React frontend logic needed to perform a successful handshake with any standard FHIR server.

Key Features

• Zero-Config Auth Flow: Handles the entire OAuth2 “Code Flow” out of the box.
• Patient Context Ready: Automatically detects the current patient ID from the EHR session and fetches their demographics.
• Sandbox Compatible: Pre-configured to work with the standard SMART Health IT Sandbox for easy testing.
• Modern Stack: Built with React.js for the frontend and the fhirclient JavaScript library for standard compliance.

Technical Implementation

The kit is designed to abstract away the protocol complexity.

1. The Launch (launch.html) When a doctor clicks your app icon in the EHR, this file triggers the FHIR.oauth2.authorize() sequence, requesting specific scopes like patient/Patient.read (permission to read the current patient’s record).

2. The Handshake (index.js) Once authorized, the React app initializes the client. I implemented a wrapper that simplifies the data fetching:

// The complex FHIR client logic is abstracted away
client.patient.read().then((patient) => {
    console.log("Patient Name:", patient.name[0].given);
    // The app state automatically updates with the patient data
    this.setState({ patient: patient });
});

3. The UI Layer The kit includes a sample dashboard that visualizes the fetched data (Name, DOB, Gender) using clean, responsive components, demonstrating how to map the complex FHIR JSON structure into a user-friendly UI.

Why This Matters

This starter kit is more than just code; it is an educational tool. It bridges the gap for standard web developers trying to enter the health-tech space. By stripping away the complexity of the initial connection, it empowers engineers to prototype solutions—like a Cardiac Risk Calculator or a Diabetes Tracker—in hours instead of weeks.

You can clone the repository, run npm start, and instantly see a working SMART app connected to a public sandbox.

Conclusion

This project demonstrates that building secure healthcare applications doesn’t have to be an insurmountable challenge. By abstracting the complexities of OAuth2 handshakes and SMART launch contexts into a reusable boilerplate, we can lower the barrier to entry for digital health innovation.

The SMART FHIR Starter Kit serves as a proof that standard web technologies like React—when paired with the right security configurations—can safely interact with enterprise EHR data. It bridges the gap between modern web development and the strict compliance requirements of the healthcare industry.

You can view the full source code, try the sandbox launch, and explore the security documentation on my GitHub.