Achieving Offline Capability with SMART on FHIR and Local-First Design
SMART on FHIR + Hive: Building Offline-Ready Healthcare Apps -
The development of offline-ready healthcare applications was discussed using the combination of SMART on FHIR and Hive.
Summary
This article explains how to build a fast, privacy-respecting mobile clinical record system by utilizing the SMART on FHIR standard and implementing local-first storage (Hive). It presents architectural principles for stable data access in environments requiring multiple EHR integrations or weak network connectivity.
Key Players
Details
This guide details methodology for merging speed, reliability, and privacy—elements crucial to modern healthcare applications—with interoperability via FHIR. Specifically, when aiming to integrate with major EHRs like Epic or Cerner using the SMART on FHIR R4 standard, adopting a local-first design is key. This structure ensures the app always reads from local data first, syncing securely in the background. Technically, secure authentication requires following the OAuth2 PKCE flow (generating code verifiers and challenges) and dynamically discovering endpoints via `/.well-known/smart-configuration`. For data handling, it recommends normalizing FHIR resources into lightweight domain models, storing only UI-critical fields locally while keeping raw JSON intact. Hive is suggested for mobile caching due to its speed and lightness; establishing freshness policies (Recent vs. Stale) allows instant display of cached data upon launch, while background sync jobs are queued for network recovery. Furthermore, the article emphasizes robust error handling and observability, stressing the need to differentiate between network errors and FHIR content errors, and never logging sensitive patient data.
Technology Note
FHIR（Fast Healthcare Interoperability Resources）は医療データ交換の国際標準。このエントリの関連技術: SMART ON FHIR
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