SMART Guidelines

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To date, there is no documentation of procedures for systematically translating WHO’s recommendations into digital health systems in a software-neutral manner. 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role="main" tabindex="-1"> <div id="PageContent_TD76DC2B8003_Col00" class="sf_colsIn container" data-sf-element="Container" data-placeholder-label="Container"><div class="row" data-sf-element="Row"> <div id="PageContent_TD76DC2B8004_Col00" class="sf_colsIn col-md-12" data-sf-element="Column 1" data-placeholder-label="Drop Teams widget with Team view"><div class="row" data-sf-element="Row"> <div id="PageContent_C050_Col00" class="sf_colsIn col-md-12" data-sf-element="Column 1" data-placeholder-label="Column 1"> <div class="hero-image--wrapper hero-image--high-wrapper high " data-url=""> <div class="inner responsive-background-image high-379535896"> <img sizes="(max-width: 768px) 200px, (max-width: 1024px) 700px, (max-width: 1366px) 1000px, 1920px" srcset="/images/default-source/digital-health/smart-guidelines47c54c059c8b4cbf91d499a129baf1a9.tmb-768v.jpg?Culture=en&sfvrsn=424e0013_1 768w, /images/default-source/digital-health/smart-guidelines47c54c059c8b4cbf91d499a129baf1a9.tmb-1024v.jpg?Culture=en&sfvrsn=424e0013_1 1024w, /images/default-source/digital-health/smart-guidelines47c54c059c8b4cbf91d499a129baf1a9.tmb-1366v.jpg?Culture=en&sfvrsn=424e0013_1 1366w, /images/default-source/digital-health/smart-guidelines47c54c059c8b4cbf91d499a129baf1a9.tmb-1920v.jpg?Culture=en&sfvrsn=424e0013_1 1920w" alt="SMART Guidelines" /> <div class="sf_colsIn container"> <div class="hero-image--content bg-text-light text-left"> <h1 class="title"><span>SMART Guidelines</span></h1> </div> </div> </div> </div> </div> </div> </div> </div> <div class="row" data-sf-element="Row"> <div id="PageContent_TD76DC2B8005_Col00" class="sf_colsIn col-md-12" data-sf-element="Column 1" data-placeholder-label="Main content"><div id="PageContent_C075_Col00" class="sf_colsIn container" data-sf-element="Container" data-placeholder-label="Container"><div class="row" data-sf-element="Row"> <div id="PageContent_C049_Col00" class="sf_colsIn col-md-8" data-sf-element="Column 1" data-placeholder-label="Column 1"> <div class="sf-content-block content-block" > <div ><p>WHO envisions a future where everyone in the world benefits fully and immediately from clinical, public health, and data-use recommendations. SMART Guidelines are a new approach to systematize and accelerate the consistent application of recommended, life-saving interventions in the digital age.<br></p><p><strong>Why is this important?</strong><strong></strong></p><p>WHO guidelines articulate and endorse rigorously tested recommendations for health interventions to be adopted within country programs. When applied correctly and consistently, guideline recommendations save lives.<br></p><p>Countries are investing heavily in digital systems to accelerate the adoption of these recommended clinical, public health, and data interventions. The design, functionality, and content of digital tools and systems — that collect, exchange, and use patient data to drive health practices and coordination of care within health systems — can ensure adherence to national guidelines and lead to improved quality of care.<strong></strong><br></p><p>To implement WHO recommendations in country settings, governments and technology partners must interpret and then adapt the content in line with local policies, procedures, and digital tools. The process of translating and incorporating recommendations into digital systems can be challenging, time-consuming, and prone to error. There is currently a lack of technical documentation and standards for accurate incorporation, resulting in digital implementations inconsistent with recommended data and health practices. Member States and their implementation partners need specifications for digitizing guidelines and making health investments consistent with WHO data, interoperability, and guideline recommendations.</p><p> </p><p><img src="https://cdn.who.int/media/images/default-source/digital-health/image-web-1.png?sfvrsn=1c897f8f_5&Status=Master" alt="" sf-size="258453"></p><p><strong> </strong></p><p><strong></strong><strong>What are SMART Guidelines?</strong><strong></strong> </p><p>SMART Guidelines — <strong>S</strong>tandards-based, <strong>M</strong>achine-readable, <strong>A</strong>daptive, <strong>R</strong>equirements-based, and <strong>T</strong>estable -- are a comprehensive set of reusable digital health components (e.g., interoperability standards, code libraries, algorithms, technical and operational specifications) that transform the guideline adaptation and implementation process to preserve fidelity and accelerate uptake. SMART Guidelines provide a five-step pathway to advance the adoption of best clinical and data practices, even if a country is not yet fully digital.</p><p> </p><p><img src="https://cdn.who.int/media/images/default-source/digital-health/image-web-2.png?sfvrsn=2c510fd6_5&Status=Master" alt="" sf-size="555051"></p><p> </p><p>The five SMART guidelines layers comprise documentation, procedures, and digital health components to steer guideline localization and implementation through digital systems.</p><p>They inform:</p><ul><li><strong>Guideline developers</strong> on how to translate recommendations into specifications and standards;</li><li><strong>Technologists</strong> on how to integrate recommendations into updatable digital systems; and</li><li><strong>Countries</strong> on how to localize, make interoperable, institutionalize, and update digital systems consistent with evidence-based recommendations.</li></ul><p><br></p><p>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. <strong> </strong><br></p><p><strong>What are the benefits?</strong><strong></strong><br></p><p>SMART guidelines help countries to more efficiently and accurately adopt, and benefit from, WHO health and data recommendations through digital systems.<br></p><p>Use of SMART guidelines results in standards-based, interoperable systems that can share accurate data and become part of stronger, more sustainable health information systems. In digital systems, they improve quality of health content and facilitate consistent, standardized collection of data, appropriate decision support, and calculation of indicators across geographies. SMART guidelines reduce the risks associated with digital investments. They lower the cost of related software development, equipping governments with SMART software specifications to ensure vendors provide a minimum of functionality and quality content, in turn reducing potential for vendor lock-in.</p><p> </p><p><img src="https://cdn.who.int/media/images/default-source/digital-health/image-web-3.png?sfvrsn=6ed29f7d_5&Status=Master" alt="" sf-size="369745"></p><p> </p><p>This WHO mechanism aims to facilitate improved global access to software and systems that interoperate across care pathways, facilities, and providers, delivering functionality and content aligned with evidence-based guidelines and recommended data standards. SMART Guidelines will be fundamental in the digital acceleration towards country health systems’ achievement of universal health coverage goals.<br></p><p>WHO SMART Guidelines are now available for <a href="/publications/i/item/9789240020306">antenatal care</a>, <a href="/publications/i/item/9789240085138">HIV</a>, <a href="/publications/i/item/9789240029743">family planning</a>, <a href="/publications/i/item/9789240086616">TB</a>, and <a href="/publications/i/item/9789240089907">child health in humanitarian emergencies</a>. SMART Guidelines for STI and immunization are in development and will be released soon.  </p><p><span style="background-color:transparent;text-align:inherit;text-transform:inherit;word-spacing:normal;caret-color:auto;white-space:inherit;">The SMART Guideline programme of work is led by the Science Division and overseen by the Department of Digital health and innovation in partnership with the Department of Quality Assurance of Norms and Standards, and supported by the Division of Data, Analytics and Delivery for Impact. </span></p><p>A journal article providing an overview of the programme of work, and an accompanying presentation, are available for download <a href="https://www.thelancet.com/journals/landig/article/PIIS2589-7500(21)00038-8/fulltext" target="_blank" data-sf-ec-immutable="">here</a> and <a href="https://cdn.who.int/media/docs/default-source/digital-health-documents/who-smart-guidelines_deckforlandingpage_final.pptx?sfvrsn=821aa3dd_14"></a><a href="https://cdn.who.int/media/docs/default-source/digital-health-documents/who-smart-guidelines_deckforlandingpage_final.pptx?sfvrsn=821aa3dd_14">here.</a> </p><p>For more information: <a href="mailto:mehlg@who.int">mehlg@who.int</a></p><p> </p><p> </p><p> </p><p> </p></div> </div> </div> <div id="PageContent_C049_Col01" class="sf_colsIn col-md-4" data-sf-element="Column 2" data-placeholder-label="Column 2"> <div class="sf-content-block content-block" > <div ><div class="arrowed-link"><a href="/teams/digital-health-and-innovation">Digital Health and Innovation</a></div><div class="arrowed-link"><a href="/teams/digital-health-and-innovation/governance">Strategy and Governance</a></div><div class="arrowed-link"><a href="/teams/digital-health-and-innovation/health-technologies">Public Digital Health Technology</a></div><div class="arrowed-link"><a href="/initiatives/behealthy">Be He@lthy, Be Mobile</a></div><div class="arrowed-link"><a href="/teams/digital-health-and-innovation/who-innovation-hub" data-sf-ec-immutable="">WHO Innovation Hub</a></div><div class="arrowed-link"><a href="/teams/digital-health-and-innovation/digital-channels">Digital Channels</a></div><div class="arrowed-link"><a href="/teams/digital-health-and-innovation/capacity-building">Capacity building and collaboration</a></div><div class="arrowed-link"><a href="/groups/dh-tag-membership">WHO Digital Health Technical Advisory Group</a></div></div> </div> <div class="sf-content-block content-block" > <div >   </div> </div> <div class="section-heading"> <h2>Journal articles</h2> </div> <style> .margin-top { margin-top: 16px; } </style> <div class="sf-list-vertical sf-list-vertical__bottom-border"> <a class="sf-list-vertical__item" href="https://informatics.bmj.com/content/30/1/e100691.full"> <h4 class="sf-list-vertical__title"> <span class="full-title" aria-hidden="true" style="display: none">Experiences in aligning WHO SMART guidelines to classification and terminology standards</span> <span class="trimmed">Experiences in aligning WHO SMART guidelines to classification and terminology standards</span> </h4> <div class="sf-list-vertical__date margin-top"> <span>BMJ Journals</span> </div> </a> <a class="sf-list-vertical__item" href="https://www.ghspjournal.org/content/early/2023/07/26/GHSP-D-22-00439"> <h4 class="sf-list-vertical__title"> <span class="full-title" aria-hidden="true" style="display: none">Digitalizing Clinical Guidelines: Experiences in the Development of Clinical Decision Support Algorithms for Management of Childhood Illness in Resource-Constrained Settings</span> <span class="trimmed">Digitalizing Clinical Guidelines: Experiences in the Development of Clinical Decision Support Algorithms for Management of Childhood Illness in Resource-Constrained Settings</span> </h4> <div class="sf-list-vertical__date margin-top"> <span>Global Health: Science and Practice</span> </div> </a> <a class="sf-list-vertical__item" href="https://www.ghspjournal.org/content/early/2022/02/10/GHSP-D-21-00320"> <h4 class="sf-list-vertical__title"> <span class="full-title" aria-hidden="true" style="display: none">Transitioning to digital systems: The role of World Health Organization’s digital adaptation kits in operationalizing recommendations and interoperability standards</span> <span class="trimmed">Transitioning to digital systems: The role of World Health Organization’s digital adaptation kits in operationalizing recommendations and interoperability standards</span> </h4> <div class="sf-list-vertical__date margin-top"> <span>Global Health: Science and Practice</span> </div> </a> <a class="sf-list-vertical__item" href="https://www.thelancet.com/journals/landig/article/PIIS2589-7500(21)00038-8/fulltext"> <h4 class="sf-list-vertical__title"> <span class="full-title" aria-hidden="true" style="display: none">WHO SMART guidelines: optimising country-level use of guideline recommendations in the digital age</span> <span class="trimmed">WHO SMART guidelines: optimising country-level use of guideline recommendations in the digital age</span> </h4> <div class="sf-list-vertical__date margin-top"> <span>The Lancet</span> </div> </a> <a class="sf-list-vertical__item" href="https://pubmed.ncbi.nlm.nih.gov/34450285/"> <h4 class="sf-list-vertical__title"> <span class="full-title" aria-hidden="true" style="display: none">Enhancing narrative clinical guidance with computer-readable artifacts: Authoring FHIR implementation guides based on WHO recommendations</span> <span class="trimmed">Enhancing narrative clinical guidance with computer-readable artifacts: Authoring FHIR implementation guides based on WHO recommendations</span> </h4> <div class="sf-list-vertical__date margin-top"> <span>PubMed</span> </div> </a> </div> <style> .margin-top { margin-top: 16px; } </style> <div class="sf-list-vertical sf-list-vertical__bottom-border"> <a class="sf-list-vertical__item" href="https://journals.sagepub.com/doi/10.1177/20552076221076256"> <h4 class="sf-list-vertical__title"> <span class="full-title" aria-hidden="true" style="display: none">Integration of new digital antenatal care tools using the WHO SMART guideline approach: Experiences from Rwanda and Zambia</span> <span class="trimmed">Integration of new digital antenatal care tools using the WHO SMART guideline approach: Experiences from Rwanda and Zambia</span> </h4> <div class="sf-list-vertical__date margin-top"> <span>SAGE Journals</span> </div> </a> </div> <div class="sf-content-block content-block" > <div >   </div> </div> <div class="section-heading"> <h2>Publications</h2> </div> <div class="sf-meeting-report-list sf-list-vertical sf-list-vertical__bottom-border "> <a class="sf-meeting-report-list__item sf-list-vertical__item" aria-label="8 May 2024 Digital adaptation kit for tuberculosis: operational requirements for implementing WHO recommendations in digital systems" href="/publications/i/item/9789240086616"> <div class="sf-meeting-report-list__data sf-list-vertical__data"> <span class="timestamp">8 May 2024 </span> </div> <h4 class="sf-meeting-report-list__title sf-list-vertical__title"> <span id="1a533ec3-0ee8-4cc4-adc6-689e73ae12fc" class="full-title" aria-hidden="true" style="display: none">Digital adaptation kit for tuberculosis: operational requirements for implementing WHO recommendations in digital systems</span> <span class="trimmed">Digital adaptation kit for tuberculosis: operational requirements for implementing WHO recommendations in digital systems</span> </h4> </a> <a class="sf-meeting-report-list__item sf-list-vertical__item" aria-label="1 May 2024 Digital adaptation kit for child health (‎0-59 months)‎ in humanitarian emergencies: operational requirements for implementing WHO recommendations in digital systems" href="/publications/i/item/9789240089907"> <div class="sf-meeting-report-list__data sf-list-vertical__data"> <span class="timestamp">1 May 2024 </span> </div> <h4 class="sf-meeting-report-list__title sf-list-vertical__title"> <span id="274f1d94-bfb8-43dd-bdc4-14e6592139a6" class="full-title" aria-hidden="true" style="display: none">Digital adaptation kit for child health (‎0-59 months)‎ in humanitarian emergencies: operational requirements for implementing WHO recommendations in digital systems</span> <span class="trimmed">Digital adaptation kit for child health (‎0-59 months)‎ in humanitarian emergencies: operational requirements for implementing WHO recommendations in digital systems</span> </h4> </a> <a class="sf-meeting-report-list__item sf-list-vertical__item" aria-label="7 February 2024 Digital adaptation kit for HIV, second edition" href="/publications/i/item/9789240085138"> <div class="sf-meeting-report-list__data sf-list-vertical__data"> <span class="timestamp">7 February 2024 </span> </div> <h4 class="sf-meeting-report-list__title sf-list-vertical__title"> <span id="e635153c-fad8-4b9d-b8d9-5be66b65decd" class="full-title" aria-hidden="true" style="display: none">Digital adaptation kit for HIV, second edition</span> <span class="trimmed">Digital adaptation kit for HIV, second edition</span> </h4> </a> <a class="sf-meeting-report-list__item sf-list-vertical__item" aria-label="25 June 2021 Digital Adaptation Kit for Family Planning: Operational requirements for implementing WHO recommendations in digital systems" href="/publications/i/item/9789240029743"> <div class="sf-meeting-report-list__data sf-list-vertical__data"> <span class="timestamp">25 June 2021 </span> </div> <h4 class="sf-meeting-report-list__title sf-list-vertical__title"> <span id="dd06e94f-02dc-43b6-9f0a-c349677456bf" class="full-title" aria-hidden="true" style="display: none">Digital Adaptation Kit for Family Planning: Operational requirements for implementing WHO recommendations in digital systems</span> <span class="trimmed">Digital Adaptation Kit for Family Planning: Operational requirements for implementing WHO recommendations in digital systems</span> </h4> </a> <a class="sf-meeting-report-list__item sf-list-vertical__item" aria-label="17 February 2021 Digital Adaptation Kit for Antenatal Care: Operational requirements for implementing WHO recommendations in digital systems" href="/publications/i/item/9789240020306"> <div class="sf-meeting-report-list__data sf-list-vertical__data"> <span class="timestamp">17 February 2021 </span> </div> <h4 class="sf-meeting-report-list__title sf-list-vertical__title"> <span id="d2f989c5-9e2c-47d5-9b06-75524e335be1" class="full-title" aria-hidden="true" style="display: none">Digital Adaptation Kit for Antenatal Care: Operational requirements for implementing WHO recommendations in digital systems</span> <span class="trimmed">Digital Adaptation Kit for Antenatal Care: Operational requirements for implementing WHO recommendations in digital systems</span> </h4> </a> </div> <div class="sf-content-block content-block" > <div >   </div> </div> <div class="section-heading"> <h2>Related links</h2> </div> <div class="sf-content-block content-block" > <div ><div class="arrowed-link"><a href="/teams/digital-health-and-innovation/smart-guidelines/fhir-based-smart-guidelines">Enabling FHIR-based SMART guidelines natively on Android devices</a></div><div class="arrowed-link"><a href="https://www.srhr.org/antenatalcare/#Tools" target="_blank" data-sf-ec-immutable="">Antenatal Care SMART Guidelines</a></div><div class="arrowed-link"><a href="https://cdn.who.int/media/docs/default-source/digital-health-documents/who_dak_twopager_l5.pdf?sfvrsn=1f75b771_5">Two-page summary of Digital Adaptation Kits</a></div></div> </div> </div> </div> </div> </div> </div> </div> </section>   <footer id="sf-footer"> <div class="main-footer"> <div id="Footer_TD9F2A204001_Col00" class="sf_colsIn container" data-sf-element="Container" data-placeholder-label="Container"><div class="row" data-sf-element="Row"> <div 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