FHIR R4 adapters
Bidirectional read/write, custom resources, search parameter optimization, paginated bulk export, $export and $import operations.
Service · Healthcare interoperability
FHIR, HL7, DICOM, X12 — the hard part of healthcare.
The hard part of healthcare isn't usually the app. It's the 12 integrations that need to work, conform, fail gracefully, and survive the next EHR upgrade. We've shipped 60+ healthcare integrations across every major standard.
Interface engine
routingHL7v2 · ORM^O01
PID|1||MRN12345||DOE^J^M||19850412|F
FHIR · ServiceRequest
{"resourceType":"ServiceRequest", ...}
1.2M msgs / day99.97% delivered
What we build
Six things, in one engagement.
HL7v2 routing + transformation
Mirth Connect or custom interfaces. ADT, ORM, ORU, MDM, SIU lifecycles with retry queues and DLQ handling.
DICOM workflow + PACS
Imaging integrations, DICOM SR for structured reports, PACS routing, modality worklists, anonymization.
X12 claims + remittance
837 (claims), 835 (remittance), 270/271 (eligibility), 276/277 (status). Direct payer connections or via clearinghouses.
Integration platforms
Redox, Health Gorilla, 1upHealth, Mirth — we know the trade-offs and migration paths between them.
Conformance + testing harness
Touchstone, Inferno, Crucible — we run the conformance test suites and ship the results to your QA team.
Tech we work with
HL7 FHIR R4HL7v2DICOMX12CDARedoxHealth Gorilla1upHealthMirth ConnectAWS HealthLakeAzure FHIR
Compliance scope
- HIPAA Security Rule
- FHIR R4 conformance
- HL7v2 conformance
- 21st Century Cures Act / ONC certification
Our process
Predictable delivery — even when the scope isn't.
015 days
Audit & plan
We review your code, infrastructure, and compliance posture. You get a written report, architecture diagram, gap analysis, and a fixed-price roadmap.
022-week sprints
Rescue or build
Weekly demo. Live dashboard with sprint velocity, open issues, and burndown. Read access to our repo from day one.
03Continuous
QA & compliance
Automated and manual testing, security review, HIPAA-readiness check, optional third-party penetration test.
04Ongoing
Deploy & optimize
Production launch with monitoring, on-call rotation if you want it, continuing development at a steady cadence.
FAQ
Questions we get on the first call.
Should we use Redox / Health Gorilla, or build direct integrations?
Depends. Integration platforms are faster up-front and cheaper for 1-2 EHR integrations. Direct gets cheaper after 4-5+ EHRs and gives you data ownership. We've migrated teams both directions.
Can you handle ONC certification (Cures Act)?
Yes. We've shipped certified Health IT modules and run the ONC testing for both standalone modules and embedded EHR functionality.
How do you handle Epic's strict access review?
We work with App Orchard / Epic Connection Hub processes. Typically 6-10 weeks from kickoff to production-ready Epic integration including the security review on Epic's side.
Insights · Read more
Background reading for buyers.
InteroperabilityJul 23, 2019
FHIR for non-engineers: a 10-minute primer for product managers
If you're the PM on a healthcare project, you don't need to write FHIR code — but you do need to understand what your engineers mean when they say it.
Serhii Kholin · 10 min
InteroperabilityFeb 14, 2023
Surviving an Epic App Orchard review: a survival guide
The Epic review process is famously rigorous. We've been through it nine times. Here's the prep work that shortens the cycle from 4 months to 6 weeks.
Serhii Kholin · 9 min
ComplianceJun 19, 2021
What a HIPAA audit actually looks like — from the inside
Most teams build to a checklist and hope. We've sat across from the auditor — here's what they actually ask, and what surprises engineering teams.
Denis Sheremetov · 8 min
Start with the audit
5 days. Written report. No commitment.
Tell us what you're building or what's not working. We'll come back with a written audit and a fixed-price plan.