WHO SMART guidelines - standards-based, machine-readable, adaptive, requirements-based, and testable – comprise of documentation, procedures, and digital health components to steer localisation and implementation of evidence-based recommendations through digital systems. Use of SMART guidelines results in standards-based, interoperable services and applications that can share accurate data and become part of stronger, more sustainable health information enterprises. In digital systems, SMART Guidelines improve quality of health content and facilitate consistent, standardized collection of data, appropriate decision support, and calculation of indicators across geographies. SMART guidelines content is, by design, software-neutral, formulated for adaptation into whichever software platforms a country has elected to use, within an exchanged digital health enterprise architecture.
To support the adoption of WHO normative guidance, including evidence-based recommendations, with fidelity in digital systems. SMART guidelines are a package of content tools, which distill WHO guidelines into a format that facilitates translation of clinical, public health, and data recommendations into digital systems. They also leverage open interoperability standards to support adoption of those standards in countries' digital systems.
There are 5 layers of the SMART Guidelines components:
- L1: Narrative - Narrative Guidelines: Evidence-based recommendations and accompanying implementation and data guidance.
- L2: Operational - Digital Adaptation Kits: “Human readable” software-neutral documentation of operational and functional requirements (e.g. personas, workflows, relevant metadata, transparently documented algorithms, minimum data sets, priority metrics, listing of relevant health interventions, functional requirements).
- L3: Machine readable - Machine readable recommendations: Structured software-neutral specifications, code, terminology and interoperability standards.
- L4: Executable - Reference software: Software that are able to execute static algorithms and interoperable digital components to deliver the operational and functional requirements.
- L5: Dynamic - Precision health model: Executable dynamic algorithms that are trained and optimized with advanced analytics to achieve prioritized outcomes.
The primary users of the SMART Guidelines content are health programme managers, business analysts and technologists who are looking to integrate recommendations into digital systems and Ministries of Health who are responsible for localizing WHO global recommendations into national policies, and operationalization of those policies into digital systems.
English, Spanish, French
Content
Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence
D2 | D2 Data interchange and interoperability
C11 | C11 Terminology and classification systems
A2 | A2 Community-based information systems
A5 | A5 Electronic medical record systems
D6 | D6 Health management information systems (HMIS)
E2 | E2 Public health and disease surveillance system
SMART Guidelines are intended for a global audience and have reach to all countries. They have also been localized, adapted and implemented at a global scale across various regions and countries.
Countries that we are aware of, that have included or referenced the content as part of their Digital Health strategy or related framework, digital transformation roadmaps, or have begun the adoption of SMART Guidelines content into their digital health systems, or have included the content as part of training programs include: Zambia, Zimbabwe, Malawi, Nigeria, Kenya, Ethiopia, Ghana, Rwanda, Iraq, Cameroon, India, Burkina Faso and Brazil. In addition, we are aware that 96 countries have adopted the Digital Documentation of COVID-19 Certificates guidance.
The content includes information on health standards in the form of the WHO guidelines and publications. The content also includes information on interoperability standards for data exchange, specifically WHO-FIC (including ICD-11), HL7 FHIR, SNOMED GPS and LOINC and supports conformance testing of IHE workflows and profiles, namely mADX.
All WHO SMART Guidelines are reviewed by health content experts (i.e. individuals who developed the WHO Guidelines) within a clinical or public health domain. Similar to all guidance development processes, WHO SMART Guidelines are also reviewed by external reviewers (e.g., health experts from other agencies) and/or experts in health interoperability standards.
ADX, HL7 FHIR, ICD-11, LOINC, SNOMED
Not Applicable
All maturity model assessments are self-reported by the funded organization leading the content development of the global good.
https://www.who.int/teams/digital-health-and-innovation/smart-guidelines
WHO SMART Guidelines SMART Implementation Guide Starter Kithttps://github.com/WorldHealthOrganization/smart-ig-starter-kit/wiki
Digital Adaptation Kit for HIVhttps://www.who.int/publications/i/item/9789240054424
Digital Adaptation Kit for Family Planning Digital Adaptation Kit for Antenatal CareThe SMART Guideline community includes 200+ technology developers and technology partners who have contributed to building tools to author SMART Guidelines content, as well as the community of developers contributing to the SMART ecosystem related to country uptake and adaptation. It consists of WHO experts, technology developers, representatives from international organizations and donors, and individuals across the globe including individuals from United States, Canada, Switzerland, Nigeria, India, South Africa, Kenya, Indonesia, Ethiopia, Ghana, Cameroon, Zambia and many others.
The community is intended to inform and provide feedback to WHO on the mechanisms of authoring and implementing SMART Guidelines. Further, the community is intended to share lessons learned with each other on the challenges and paths forward for authoring SMART Guidelines.
Please contact [email protected] for more information.
All WHO SMART Guidelines are considered official WHO publications and normative guidance. WHO Headquarters is in Geneva, Switzerland, and WHO has regional and country offices around the world. The creation of content is supported through grant funding. The implementation of content is supported through a combination of donor funding and implementation funding. Over the past 5 years, the key funders/ investors include Bill & Melinda Gates Foundation, United Nations Population Fund, The Global Fund, Rockefeller Foundation, Botnar Fondation, US Centers for Disease Control and Prevention, GAVI and USAID.
