specification: FinOps Framework
specificationVersion: '1.0'
schema: https://www.finops.org/framework/
provider: SMART Health IT
providerId: smarthealthit
created: '2026-07-11'
modified: '2026-07-11'
reconciled: true
tags:
- SMART on FHIR
- FHIR
- Health IT
- Open Standards
- FinOps
- Cost Management
- FOCUS
description: >-
  FinOps view of SMART Health IT usage. There is no vendor invoice anywhere in
  the picture - the specifications are open standards, the sandboxes
  (r4.smarthealthit.org, launch.smarthealthit.org,
  bulk-data.smarthealthit.org) are free public test services, and the client
  libraries and reference servers are open source. The costs that do exist for
  an adopting team are indirect: engineering time to build against SMART App
  Launch and FHIR, your own infrastructure if you self-host the open source
  launcher or bulk data server for private testing, and - once you move to
  production - whatever terms apply in each EHR vendor's developer program,
  which is a separate provider relationship.
notes: >-
  Because there is no billing relationship with SMART Health IT, FOCUS
  columns below describe a zero-cost service entry. Track downstream EHR
  vendor API costs (if any) under those vendors, not here.
sources:
- https://smarthealthit.org/
- https://docs.smarthealthit.org/
- https://github.com/smart-on-fhir
- https://focus.finops.org/focus-specification/v1-3/
alignedWith:
  framework: FinOps Foundation Framework
  frameworkUrl: https://www.finops.org/framework/
  dataSpec: FOCUS
  dataSpecVersion: '1.3'
  dataSpecUrl: https://focus.finops.org/focus-specification/v1-3/
publisherName: SMART Health IT
serviceCategory: Healthcare Interoperability
billingModel:
  pricingCategory: Free
  billingFrequency: None
  billingCurrency: USD
  chargeCategories:
  - Usage
focusColumns:
  ServiceName: SMART Health IT Sandboxes
  ServiceCategory: Healthcare Interoperability
  ProviderName: SMART Health IT
  PublisherName: SMART Health IT
  InvoiceIssuerName: None (no billing relationship)
  BillingCurrency: USD
  ChargeCategory: Usage
  PricingCategory: Free
meters:
- name: sandbox_requests
  description: FHIR REST requests against the open sandboxes; free, tracked only for your own usage awareness.
  unit: requests
  aggregation: sum
  dimensions:
  - endpoint
  - resource_type
- name: bulk_exports
  description: Bulk Data $export jobs run against the reference server; free, sized by simulated patient count.
  unit: jobs
  aggregation: sum
  dimensions:
  - export_level
- name: self_hosted_compute
  description: Infrastructure cost of self-hosting the open source launcher or bulk data server for private testing (no SMART Health IT invoice).
  unit: hours
  aggregation: sum
  dimensions:
  - deployment
principles:
- name: Visibility
  description: SMART Health IT itself never invoices; the visible costs are engineering time and any self-hosted test infrastructure.
- name: Allocation
  description: Attribute self-hosted sandbox infrastructure and integration engineering to the product teams building SMART on FHIR apps.
- name: Optimization
  description: Use the free hosted sandboxes for development instead of standing up private test EHR environments; reserve vendor sandbox programs for conformance testing.
- name: Accountability
  description: When apps go to production, move cost tracking to each EHR vendor's developer program terms - that is where real charges, if any, appear.
maintainers:
- FN: Kin Lane
  email: kin@apievangelist.com