Products

Smile Health Data
Smile Digital Health
Developer Tools & APIs
Smile Digital Health's FHIR-native platform, OmniVera, provides solutions for robust data interoperability, computable compliance (OmniCompli CMS Suite), and quality measures (OmniQ dQM for HEDIS®), supporting large healthcare organizations, payers, providers, and researchers globally.

See all 1 product →

About Smile Digital Health

Smile Digital Health is a leading health information technology company dedicated to advancing global health through open standards, primarily leveraging HL7® FHIR®. The company provides an enterprise-grade, open-framework data fabric and integration platform designed to enable healthcare organizations, including providers, payers, researchers, and life sciences entities, to seamlessly ingest, transform, store, enrich, analyze, aggregate, and share health information. Their core mission is to reduce barriers between information and care, fostering true interoperability and accelerating digital transformation across the healthcare ecosystem.

For physicians, Smile Digital Health’s platform offers a robust solution for managing the increasing volume of clinical and personal health data. It facilitates the creation of unified, FHIR®-native data systems that are free of vendor lock-in, providing up-to-date, comprehensive patient records. This enables real-time, continuous care gap analysis, proactive quality measurement improvements, and enhanced access to computable industry best practices at the clinical front lines. The platform supports critical functionalities such as master data management, CDA exchange, and clinical quality intelligence, transforming data into actionable insights for better clinical and business decisions.

Furthermore, Smile Digital Health integrates artificial intelligence (AI) and machine learning capabilities to enhance healthcare delivery. This includes advanced remote monitoring tools that use AI and event-driven architecture to detect patient health decline by streaming data from various medical devices. They also apply deterministic AI, coupled with human intervention, for solutions like automated prior authorization, aiming for transparency, consistency, and auditability in clinical intelligence. This focus on AI and automation helps accelerate care, improve data-driven outcomes, and address challenges like data fragmentation and interoperability.

Focus Areas

FHIR-native Health Data Platform Interoperability Health Data Fabric Clinical Reasoning Digital Quality Measures AI/ML Capabilities Prior Authorization CMS Compliance Data Integration Health Information Exchange

Business Intelligence

Key InvestorsUPMC Enterprises, 30 North Group, FirePower Capital
PartnershipsMCG Health, Centers for Medicare & Medicaid Services (CMS) Health Tech Ecosystem
AcquisitionsAlphora (2022)
TechnologyFHIR-native Health Data Platform, HAPI FHIR (open-source reference implementation), Cloud-native, AI/ML capabilities, Clinical Quality Language (CQL), Event-driven FHIR APIs, Composable Architecture

What Physicians Need to Know

FHIR-native Health Data Platform
Smile Digital Health offers a commercial FHIR-native Health Data Platform that standardizes, structures, and makes data computable. It acts as a unified, governed data layer, transforming fragmented healthcare data into aligned, FHIR-native information.
Interoperability
As maintainers of HAPI FHIR, the world's most widely deployed open-source FHIR implementation, Smile champions open standards to build interoperable health ecosystems, free of vendor lock-in. Their platform facilitates seamless data exchange across various systems and formats (HL7v2, CDA, FHIR).
Health Data Fabric
Smile's FHIR-based health data fabric architecture optimizes data by harmonizing existing assets into a single, comprehensive data environment. This enables holistic use of data, improving operational efficacy and supporting secure, composable, and scalable data infrastructures.
Clinical Reasoning
Smile is the custodian of CQF (Clinical Quality Framework) Ruler, a decision support service that runs quality measures on clinical reasoning. They author reusable Clinical Practice Guidelines (CPGs) and contribute to Clinical Decision Support (CDS) services, using Clinical Quality Language (CQL) to express computable clinical logic.
Digital Quality Measures
Their dQM (digital Quality Measures) solution streamlines internal quality processes, reducing cost and delays by leveraging their FHIR-CQL engine. It enables real-time care gap identification and resolution at the point of care, transforming retrospective reporting into near-real-time insights.
AI/ML Capabilities
Smile is expanding its AI and Machine Learning capabilities, notably through its KALM AI tool (Knowledge Authoring Lifecycle Management). This AI accelerates the creation of deterministic computable policies for prior authorization, clinical reasoning, and quality measure evaluations, and supports advanced remote monitoring.
Prior Authorization
Smile offers real-time automated prior authorization solutions (e-Prior Auth) that significantly reduce administrative burden and accelerate decision-making. Their solutions are compliant with CMS-0057-F and leverage FHIR and Da Vinci Implementation Guides (CRD, DTR, PAS).
CMS Compliance
Smile's platform ensures compliance with CMS rules, including CMS-9115-F and CMS-0057-F, offering solutions for Patient Access APIs, Provider APIs, and Payer-to-Payer exchange. Their OmniCompli CMS Suite provides a unified rules layer for audit-ready outcomes.
Data Integration
The Health Data Platform is designed for efficient data ingestion, seamlessly integrating data from various sources like EHRs, clinical systems, mobile health apps, and legacy systems. It transforms diverse data formats (HL7v2, CDA) into standardized FHIR resources.
Health Information Exchange
Smile enables Health Information Exchanges (HIEs) to ingest, unify, enrich, elevate, store, analyze, and share health information at scale. Their FHIR-powered platform provides the foundation for next-generation HIEs, accelerating data exchange and supporting value-added services.
Physician Tip

For physicians, Smile Digital Health's solutions translate into significantly reduced administrative burden, particularly with automated prior authorizations and streamlined quality reporting. The FHIR-native platform ensures access to a unified, real-time 'golden record' of patient data, leading to more informed clinical decisions and improved care coordination. Their clinical reasoning and digital quality measures capabilities provide proactive insights and support adherence to best practices, ultimately enhancing patient outcomes and enabling participation in value-based care models. The integration of AI/ML also promises faster, more accurate policy application and advanced remote monitoring for patient safety.

Smile Digital Health's platform is built on open standards (HL7 FHIR, CQL) to ensure broad interoperability and avoid vendor lock-in. It supports seamless integration with existing healthcare ecosystems, including Electronic Health Records (EHRs), legacy systems (via FHIR Gateway for non-FHIR formats like HL7v2 and CDA), and third-party applications (including SMART on FHIR apps). The platform is designed for cloud deployment (e.g., AWS, Microsoft Azure) and offers modular flexibility to integrate specific solutions as needed.

Products by Smile Digital Health

1 product in the directory

Smile Health Data
Smile Digital Health
Developer Tools & APIs
Smile Digital Health's FHIR-native platform, OmniVera, provides solutions for robust data interoperability, computable compliance (OmniCompli CMS Suite), and quality measures (OmniQ dQM for HEDIS®), supporting large healthcare organizations, payers, providers, and researchers globally.

Reviews & Opinions

No web reviews on file yet for Smile Digital Health. Check back later for aggregated opinions from across the web.

Videos

News, demos, and interviews about Smile Digital Health.

Loading videos...

Videos load interactively. If none appear, search YouTube for Smile Digital Health →

View all on YouTube

Press & Coverage

Smile Digital Health Press Release
Smile Digital Health Secures $15 Million in Credit Financing with FirePower Capital to Accelerate Growth and Innovation in Health Data Solutions
Smile Digital Health announced a $15 million credit financing agreement with FirePower Capital to accelerate the growth and development of its FHIRu00ae-based health data platform and expand its solutions for the healthcare sector. The company is a leading solution provider in the U.S. payer compliance market, transforming how healthcare data is managed, integrated, and shared.
2025-02
Smile Digital Health Press Release
Smile Digital Health Closes $30 Million in Series B Funding to Progress Innovation as World-Leading Health Data Fabric
Smile Digital Health secured approximately $30 million in Series B growth capital, led by existing investors including UPMC Enterprises, to expand its clinical reasoning utility and advance artificial intelligence and machine learning capabilities. This funding round brings the company's total funding to date to $51.5 million.
2023-01
Smile Digital Health Press Release
Smile Digital Health Pledges Foundational Technology Support to Power the CMS Health Tech Ecosystem
Smile Digital Health committed to supporting the Centers for Medicare & Medicaid Services (CMS) Health Tech Ecosystem initiative as a foundational technology partner. Their HL7u00ae FHIRu00ae-based data platform aims to enable payers, providers, and health tech innovators to accelerate secure, patient-centric data exchange.
2025-09
MCG Health Press Release / PR Newswire
Smile Digital Health Partners with MCG to Advance HL7u00ae FHIRu00ae-Based Prior Authorization Modernization
Smile Digital Health and MCG Health announced a strategic partnership to integrate MCG's care guidelines and compliance solution with Smile's FHIR-first Health Data Platform. This collaboration aims to streamline prior authorization processes and support compliance with the CMS Interoperability and Prior Authorization Final Rule.
2025-09
Smile Digital Health Press Release
Smile Digital Health is the First to Achieve NCQA's Digital HEDIS Validation
Smile Digital Health became the first vendor to be fully validated by NCQA for all MY2025 HEDISu00ae measures, confirming its dQM Solution successfully implements digital HEDISu00ae measures. This achievement supports the industry's shift towards digitizing healthcare quality data.
2025-07
Smile Digital Health Press Release
Smile Digital Health Reinforces Commitment to Simplifying Prior Authorization for Millions of Americans
Smile Digital Health reaffirmed its commitment to streamlining prior authorization through interoperable, standards-based solutions, aligning with initiatives endorsed by U.S. health insurers and policymakers. Smile's platform enables payers and providers to operationalize prior authorization using HL7u00ae FHIRu00ae standards and Da Vinci implementation guides.
2025-06
PMC (Journal of Biomedical Informatics)
Designing and implementing SMILE: An AI-driven platform for enhancing clinical decision-making in mental health and neurodivergence management
A study published in PMC details the design and implementation of SMILE, an AI-driven platform aimed at enhancing clinical decision-making in mental health and neurodivergence management. The platform integrates clinical decision support, professional development, and mental health intervention within a secure system.
2025-02
Newswire
Smile Digital Health Named in New Gartneru00ae Report
Smile Digital Health was named as a Sample Vendor in Gartner's Hype Cycle for Healthcare Data, Analytics and AI, 2023, as well as in reports for U.S. Healthcare Payers and APIs. This recognition highlights Smile's role as a leading FHIRu00ae health data fabric and exchange solutions provider.
2023-09

Frequently Asked Questions

Smile Digital Health's platform, including OmniVera, is built on FHIR, enabling standardized, real-time exchange of health data across disparate systems and formats like HL7v2, C-CDA, and JSON. This approach creates a comprehensive, unified patient record, empowering clinicians with immediate access to critical information for improved decision-making and a 360-degree view of patient/member records.
Smile Digital Health's Health Data Fabric (HDF) unifies diverse health data sources into a single, accessible FHIR-native layer, ingesting data from various systems like EHRs, labs, and pharmacies. This significantly reduces the complexity and time associated with integrating fragmented data, providing a trusted foundation for downstream programs and analytics.
Smile's Clinical Reasoning engine, powered by FHIR and HL7's Clinical Quality Language (CQL), delivers automated adjudications, proactive care gap analysis, and real-time digital quality measures like HEDIS and MIPS. Their dQM solution automates the entire quality measure lifecycle, and Smile is the first vendor to achieve NCQA validation for digital HEDIS measures.
Yes, Smile Digital Health's platform integrates AI/ML capabilities, including their KALM AI tool, to significantly accelerate and automate prior authorization workflows. This allows for real-time data exchange, transparent coverage requirements, and automated PA responses, reducing administrative burden and improving efficiency.
Smile Digital Health's OmniCompli CMS Suite is designed for comprehensive compliance with CMS rules like CMS-9115-F and CMS-0057-F, offering audit-ready outcomes and secure data sharing. Their platform supports building next-gen HIEs by ingesting, harmonizing, and sharing clinical data while maintaining robust security and privacy controls.
Smile Digital Health offers comprehensive support services, including implementation assistance, managed services, and 24/7 technical support. They cultivate strategic partnerships with technology providers like AWS and MCG Health, and are founding members of initiatives like FHIRBall, to expand their ecosystem and deliver integrated solutions.
Founded in 2016, Smile Digital Health has grown rapidly, securing significant Series B funding to expand AI/ML capabilities. They are maintainers of HAPI FHIR, contribute to numerous HL7 working groups, and have over 160 global FHIR implementations, demonstrating a strong commitment to open standards and long-term innovation in health data interoperability.

Related Companies

Visiopharm is a leading provider of AI-driven precision pathology software, catering to both research and diagnostic applications. For physicians, Visiopharm offers advanced tools that transform pathology through image analysis, aiming to enhance precision and productivity in pathology labs. The company has developed nine diagnostic algorithms cleared under IVDR for EU and UK customers, which provide […]

TSI (Transworld Systems Inc.) is a long-standing company primarily known for its debt collection and business process outsourcing services. While they serve various industries, including healthcare, their core offering is focused on accounts receivable management and collections rather than healthcare-specific AI development. They provide solutions to help healthcare providers manage patient accounts, improve cash flow, […]

TrialX is a healthcare AI company specializing in clinical research and space health informatics. The company develops platforms designed to connect patients with clinical trials and facilitate research data collection. Their offerings include an enterprise patient recruitment platform (iConnect) that provides a clinical trials finder (Dory), study website builders, pre-screeners, referral tracking, and volunteer registries. […]

Thinkitive is a global IT services and solutions company that specializes in digital transformation, enterprise application services, outsourced product development, and a testing center of excellence. For physicians, Thinkitive offers a range of AI-driven healthcare solutions designed to streamline clinical and administrative workflows, enhance patient care, and improve operational efficiency. Their services include custom healthcare […]

Taction Software is a U.S.-based healthcare IT and custom software development company specializing in HIPAA-compliant solutions. They build AI-powered applications for healthcare, ranging from rapid clinical AI prototypes to production-grade systems with EHR integration, ambient documentation, and predictive analytics. The company focuses on transforming healthcare delivery through secure, compliant, and innovative software solutions that aim […]

SUPERWISE offers an enterprise AI governance and operations platform designed to help organizations, including those in healthcare, deploy and manage autonomous AI systems with oversight and control. The platform addresses governance, compliance, and operational challenges associated with AI and machine learning deployments. It features real-time guardrails for AI systems, model observability capabilities, and compliance automation, […]

AI Tool Finder
AI-powered search. Results may not be comprehensive.