From forms to digital: enabling Smart Health Cards on Medplum

As CTO at Vinta Software, I’m sharing our latest open-source contribution: a complete demo that makes SMART Health Cards practical on Medplum today. Try it here.

The persistent intake problem

Every patient visit begins the same way: re-entering medical history, medications, allergies, and immunizations on forms, lengthy questionnaires, or clunky portals. This repetition frustrates patients, delays care, and introduces errors that can affect outcomes.

What are SMART Health Cards?

SMART Health Cards provide a standards-based solution for a quick and precise patient intake. They allow patients to carry subsets of their health records (e.g., immunizations or lab results) in secure QR codes or downloadable files. 

Built on HL7 FHIR and cryptographic signing as defined in the SMART Health Cards and Links Implementation Guide, these machine-readable credentials are tamper-proof and privacy-preserving: patients control exactly what they share.

A Global Movement Toward Digital Credentials

Governments and health organizations worldwide are embracing this approach:

• The United States CMS’s Kill the Clipboard initiative urges providers to accept QR-based patient data and eliminate redundant forms.
• The WHO Global Digital Health Certification Network (GDHCN) enables verifiable cross-border health documents.

While not SHC-based, other initiatives leverage similar principles (signed credentials, QR code representation):

• The European Union built the foundation with the EU Digital COVID Certificate, now integrated into GDHCN.
• Canada is advancing provincial digital wallets (e.g., Alberta’s mobile health card).
• China supports authentication and authorization for maternal and child health using an e-health card

Adopting SMART Health Cards now aligns your platform with these regulations and prepares you for mandatory patient-directed data exchange.

Medplum: the open-source FHIR platform powering modern health apps

Medplum delivers a complete, developer-friendly FHIR frontend and backend—including React components, React hooks, backend authentication, access policies, storage, real-time subscriptions, and Function as a Service components called Bots. Teams can self-host or use the managed cloud service, avoiding vendor lock-in while meeting compliance needs.

Our Contribution: A Production-Ready Demo

To accelerate SHC adoption in Medplum projects, we built and open-sourced the Medplum SMART Health Card Demo that you can access here.

Paired with our Kill the Clipboard TypeScript library, it demonstrates exactly how to issue compliant cards in real applications.

Technical Highlights

• 100% Medplum-native: No external servers, databases, or services required.
• React Patient frontend app lets users select and generate cards with one click.
• Implements the official $health-cards-issue custom operation defined in the HL7 SMART Health Cards and Links spec. Supports granular filtering: date ranges (_since parameter) and ValueSet restrictions to include only relevant codes.
• Deployment instructions included.

A live demo is available here on our GitHub.

Beyond cards: the power of SMART Health Links

SMART Health Cards are designed to carry a limited, static subset of records (e.g., a specific set of lab results). For applications that require access to live records or a more comprehensive dataset, the spec suggests using SMART Health Links.

SMART Health Links establish a secure, authenticated connection between the patient's credentials and a healthcare system's FHIR server that holds the health data. For more information about SMART Health Links, check this other article.

Why implement this today

Every month you delay, your patients continue pushing data through forms, while competitors can pull data from various sources. This demo removes the last technical barriers. Fork it, customize it, and ship patient-directed health data sharing this quarter.

We built these tools because we believe greater patient control is the future of interoperability. Star the repo, try the demo, and reach out if Vinta can help you integrate SMART Health Cards into your Medplum product.

Let’s replace clipboards with verifiable digital records, starting now.