SMART Guidelines

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.

Why is this important?

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.

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.

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.

What are SMART Guidelines? 

SMART Guidelines — Standards-based, Machine-readable, Adaptive, Requirements-based, and Testable -- 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.

The five SMART guidelines layers comprise documentation, procedures, and digital health components to steer guideline localization and implementation through digital systems.

They inform:

• Guideline developers on how to translate recommendations into specifications and standards;
• Technologists on how to integrate recommendations into updatable digital systems; and
• Countries on how to localize, make interoperable, institutionalize, and update digital systems consistent with evidence-based recommendations.

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.  

What are the benefits?

SMART guidelines help countries to more efficiently and accurately adopt, and benefit from, WHO health and data recommendations through digital systems.

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.

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.

WHO SMART Guidelines are now available for antenatal care, HIV, family planning, TB, and child health in humanitarian emergencies. SMART Guidelines for STI and immunization are in development and will be released soon.  

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. 

A journal article providing an overview of the programme of work, and an accompanying presentation, are available for download here and here. 

For more information: mehlg@who.int