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Symptomatic Cloud Solution @ Connectathon 26

Symptomatic has been running a FHIR enabled cloud service in the past two HL7 Connectathons that implements the Situational Awareness for Novel Epidemic Response (SANER) specification.  

We intend to participate in the upcoming SANER track during Connectathon 26, and invite the Covid19 At-Anywhere Diagnostics Design-a-thon community to participate with us. 

As part of that invitation, we are deploying our connectathon servers two months early, and will be accepting input and design suggestions from now till then.  You can find the test server here, where we will be loading in data:

We will be bringing the Pandemic Maps to the connectathon, as well as an At-Home Testing workflow, for people to upload results through a mobile app.

Connectathon 26 will be held on January 13th through 15th. 

5 min Video of Capstone Project

Elevator Pitch

Our cloud services provide mobile apps and high-fidelity quality control maps that can help fill in the gaps for at-home testing.  

Challenge Goals

- Downloadable app for entering At Home test results into the SANER reporting network..
- Data mining utilities for FHIR compliant EHR systems (~95% of the hospital market). 

- v2 to FHIR proxy routers, as needed.
- CSV to FHIR uploader utility
- A screen scraping utility to convert HTML to FHIR, for vendors who have web-only interfaces and haven’t built out HL7 v2 functionality. 
- Provenance stamping to certify reported results.
- Merging, de-duplication, and bundling functionality to aggregate reports
- Quality control tools and dashboards 


Our solutions have been validated by MITRE, which operates federally funded research and development centers for CMS and HHS, as well as directly with the CDC’s National Healthcare Safety Network (as of the September Connectathon 26).  

Our cloud services are provisioned, we’ve been through verification and validation testing (manual), our Pandemic Maps app is being registered with the Apple App Store, and we’re close to ready to bring this into production. 

Or at least test At-Home Testing reporting at the next SANER connectathon.


Our solution uses Material Design, and compiles across all major mobile platforms, to provide a consistent user experience to users (similar to Google products).  We’ve designed with haptics, ergonomics, and accessibility in mind.  Additionally, being a web technology, we support rich media content, including medical illustrations and patient education materials.  We also use FHIR throughout the entire stack and most of the stack is open-source.  With regards to health information, we believe in using standard data types and interoperability protocols, rather than inventing our own APIs.


We have all sorts of innovation going, in that we’ve been involved in the efforts to effectively rewrite the CDC National Healthcare Safety Network using Fast Healthcare Interoperability Resources.  Since FHIR qualifies for MACRA and 21st Century Cures, this gives the opportunity for lab testing to be pooled with other data from Accountable Care Organizations, to streamline Medicare reimbursements, and to report at-home results from Apple Health Records and other PHR systems.  We have a slew of products to apply to the challenge at hand and help fill in the gaps.  

Flexibility & Scalability

Our underlying platform was built on AWS with a docker infrastructure, and we have both vertical and horizontal scale-out in place (which we’ve been dry-run testing for the past 3 years).  

We support a plugin architecture, for any modules that people would like to develop and extend the network.  

 Since it’s built on isomorphic Javascript, our solution compiles to any major mobile device you can think of:  iPhone, iPad, Android phones, Microsoft Surface devices, OSX desktop, WebTV, etc.  

Since we are a 100% FHIR solution, we support connectivity to approximately >90% of all hospitals using SMART on FHIR, can fast track rollout to ~50% of the nation’s hospitals via EHR App Stores; and can begin rollout to consumers via Apple HealthRecords.

Sustainability & Extensibility

FHIR is simply healthcare data using web technologies.  So, our solution inherently has all the same sustainability and extensibility that the WWW and Internet have.  Where a web-browser can run, so can our reporting solutions.  

We feel that investing in FHIR is the same value proposition as investing in the WWW or Internet.  

Team & Collaboration

Symptomatic does a significant amount of work with the open-source Javascript/Node community, and would like to extend a sincere ‘thank you’ to the Meteor.js community.  Also, the HL7 International community and MITRE have been invaluable champions of this work.  

Additional acknowledgements to Jason Walonoski, Andrea Pitkus, James Agnew, Chris Hafey, Andrei Rusu, Sarah Sims, Keith Boone, Michael Donnelley, Reece Adamson, John Moehrke and others for helping get our product this far!

Special acknowledgement and thanks to Andrea Pitkus and Marianne Weinell for the ideas and input this past week during Design-a-thon.

Additional Comments

We are using neither Real nor MOCK data.  Rather, with the help of MITRE, we have been using synthetic data which uses real data standards (i.e. we use the FHIR specification to know what shape the data will arrive in), along with synthetically generated data derived from the Synthea data generator, which is peer-reviewed and based on clinical research and published research findings.  

You an find our paper here, in the journal of Intelligent Medicine, which was published along with MITRE:

What Team(s) contributed to this Capstone Project?

Abigail Watson - Primary Investigator

HL7 International - SANER Track Coordination
MITRE - API Review and Verification Testing, Synthetic Data Generation
CDC - NHSN Network Validation Testing
Meteor Development Group - Infrastructure and Scale-Out

If you are using patient data, are you using real patient data or mock data? Please use MOCK patient data only

MOCK data

edited on Dec 3, 2020 by Abigail Watson
Public (3)
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keyur Patel Nov 30, 2020

Is there a open access available for third party vendors to try?

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Abigail Watson Dec 1, 2020

Yes! If you use a utility like Postman, you should be able to GET and POST data on the /baseR4/MeasureReport route. So, for instance:


You can get the Postman utility here:

Attaching a screenshot as an example. Would be exciting to have somebody else confirm that they can fetch or post data.

Reply 0

Sophia B Liu Dec 8, 2020

This idea has been advanced to the current phase

People's Choice Voting Extended

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Sophia B Liu Dec 8, 2020

This idea has been advanced to the next phase

People's Choice Voting Extended

Reply 0