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OAuth 2.0 + OpenID Connect profile for FHIR apps. Defines launch flows (standalone, EHR-embedded), scopes (patient/*.read, user/*.write), and the capability statement extensions.
SMART on FHIR is how a patient-facing or clinician-facing app gets a per-user access token to an EHR's FHIR API without seeing the user's password.
Two launch modes:
1. Standalone launch — your app lives at its own URL; user signs in via the EHR's OAuth.
2. EHR launch — your app is embedded in the EHR (Epic AppMarket, Cerner Code, etc.) and gets a launch token.
Scope syntax: patient/Observation.read, user/MedicationRequest.write, launch/patient, offline_access.
For Cohort 00 builders: Medplum's sandbox supports SMART out of the box. For real EHRs, register at Epic's fhir.epic.com or Cerner's Code Console.