Figure 4 The ‘Cardiac Risk’ app, based on David McCandless’ design (released under a Creative Commons license) shown running unmodiﬁed in (A) the SMART reference container, (B) the Indivo PCHR, and (C) the i2b2 analytic platform. Research and applications Boston Cerner Millennium installation, with a goal of deploying the ‘Pediatric Blood Pressure’ app described below. Our initial approach involves loose coupling on the front-end, allowing clinicians to click a link within Cerner ’s PowerChart patient view to launch a SMART app in a new browser window. On the back- end, we have built a thin translation layer that exposes a few key J Am Med Inform Assoc 2012;19:597e603. doi:10.1136/amiajnl-2011-000622 601