Sync for Science (S4S) is a public-private collaboration to develop a simplified, scalable, and secure way for individuals to access and share their electronic health record (EHR) data with researchers.
S4S supports the goals of the Precision Medicine Initiative (PMI) and is a collaboration among ONC, the Harvard Medical School Department of Biomedical Informatics, and the National Institutes of Health’s All of Us Research Program.
The Technology
S4S uses and builds upon open source standards that allow researchers to securely receive EHR data from a third-party application programming interface (API) used by a patient.
S4S standards include:
- Health Level Seven International® (HL7®) Substitutable Medical Apps, Reusable Technology® (SMART®) on Fast Healthcare Interoperability Resources® (FHIR®), which helps ensure that data stored in different EHR systems can be shared in a similar and consistent way.
- OAuth 2.0, which allows an individual to securely authorize an application to receive health information from their provider’s patient portal using the individual’s existing authentication credentials.
ONC’s Inferno testing tool allows developers to test APIs and ensure that they conform to the FHIR® standard.
Ultimately, S4S makes it easier for health IT developers to participate in a mobile application ecosystem. S4S has helped accelerate and guide national priorities for individual-mediated data access and sharing through APIs.
The Pilot Project
S4S launched as a pilot project in February 2016, and participating sites were announced in 2017. Health IT developers involved in the pilot included:
- Allscripts
- Cerner
- eClinicalWorks
- Epic
Healthcare provider organizations that pilot-tested the S4S API included:
- Cedars-Sinai Health System
- Cerner Healthe Clinic
- Duke University Health System
- Partners HealthCare
- Rush University Medical Center
- University of Missouri Health Care
By participating in the pilot, provider organizations and health IT developers more quickly connected EHR systems to All of Us. The pilot activities also helped prepare provider organizations to use other emerging mobile apps that are based on HL7® FHIR®. The pilot project concluded in 2019.
Sync for Science: Participants’ Experiences
During a recent assessment, valuable lessons were learned, including how health IT developer and provider site involvement is critical to shaping the use of secure API technologies for real-world patient-directed sharing of EHR data. Read the Sync for Science Pilot Project: Participants’ Experiences [PDF - 270KB] brief.
API Privacy and Security
As part of the S4S pilot, ONC supported independent testing, analysis, and assessment of S4S API implementation for a voluntary subset of participating sites. Learn more about key privacy and security considerations for healthcare APIs.
The All of Us Research Program is a historic effort to gather data from one million or more people living in the United States to accelerate research and improve health. Participants who sign up individually as “direct volunteers” will be able to share their EHR data with the program through S4S. Learn how you can participate in the All of Us Research Program.
Expanding S4S
The Health Resources and Services Administration’s Advancing Precision Medicine funding has supported 46 health centers to participate in the All of Us direct volunteer program, which leverages S4S technology. Building on the success of the pilot, ONC worked with health IT developer NextGen Healthcare to participate in S4S, as they and other developers support health centers in the Advancing Precision Medicine program.
Advancing Interoperability and Research
The ONC and Centers for Medicare & Medicaid Services Cures Act Final Rules published in March 2020 require health IT developers and provider organizations to make it simpler for patients to access and share EHR data. The Final Rule updates existing 2015 Edition Health IT Certification Criteria for patient-facing APIs and uses the same standards and specifications that were demonstrated through the S4S pilot.
ONC plans to test additional data elements adopted under the U.S. Core Data for Interoperability as part of S4S.
The technology also supports the goals of ONC’s National Health IT Priorities for Research: A Policy and Development Agenda, released in February 2020, by improving access to interoperable electronic health data. The Agenda aims to align the clinical and research ecosystems to make research faster, better, and easier and ensure that new knowledge is available at the point of care to improve outcomes.