01
Digital Health App Integration
Embed your product directly inside the clinician's Epic, Cerner, or Athena workflow.
Healthcare / EHR Integration Services
EHR Integration Services
We engineer production-grade EHR integrations — Epic, Cerner, Athena, Allscripts, and more — using SMART on FHIR, HL7 v2, CDA, and CDS Hooks. From first PoC to App Orchard listing, we own the path your app takes inside the chart.
60+
Shipped EHR integrations across Epic, Cerner, Athena, Allscripts
<12 wks
Typical SMART on FHIR launch from kickoff
App Orchard
Epic listing support and review coaching
Trusted by global innovators
Industry Overview
EHR Integration Services: Engineered End-to-End
EHR integrations fail for the same reasons — shallow FHIR knowledge, underestimated site-by-site variance, and teams who build once and then get stuck in vendor review queues. We've shipped integrations across every major EHR, know the private quirks of each, and treat certification and security review as first-class deliverables.
Industry Challenges
What Stops Most Teams From Solving This Today
Common friction points we hear from healthcare teams scoping this kind of platform.
Vendor Variance: A 'SMART on FHIR' integration behaves differently in Epic, Cerner, Athena, and Allscripts — and differently across customer sites.
Scope Creep: What starts as 'just a SMART launch' becomes HL7 v2 feeds, CDA parsing, CDS Hooks, and bulk FHIR before go-live.
Certification Stalls: App Orchard, Cerner Code, and Athena Marketplace reviews can freeze a launch for months if prep is reactive.
Site-Level Ops: Each customer activation needs tenant config, token hygiene, and runbook support — most ISVs under-resource this phase.
Our Approach
Our Engineering Approach
We engineer for the operational reality — not the demo.
Deep EHR Expertise
Shipped on every major EHR. We know the private quirks, token TTLs, and review gates each vendor will hit you with.
End-to-End Delivery
From FHIR modeling and SMART launch to HL7 v2 interfaces, bulk FHIR exports, and listing submission — we own the whole path.
Activation-Ready
We build the customer-activation runbooks, IT packets, and support workflows your go-live team will lean on for years.
Capabilities
Capabilities
Production-grade features the platform ships with from day one.
SMART on FHIR Launch
EHR and standalone launch, OAuth 2.0 scopes, token refresh, and CDS Hooks context handling.
HL7 v2 Interfaces
ADT, ORM, ORU, SIU, MDM, and DFT interfaces with Mirth / Rhapsody / NextGen Connect engines.
Bulk FHIR Export
Group-level and system-level bulk FHIR export with async polling and NDJSON post-processing.
CDS Hooks
Patient-view, order-select, and order-sign CDS Hooks cards with full audit logging.
CDA / C-CDA Parsing
Lossless CDA and C-CDA ingestion with round-trip fidelity for audit and legal review.
Write-Back & Documentation
DocumentReference, Communication, Observation, and ServiceRequest write-backs with provenance.
Patient Matching
Probabilistic and deterministic matching with reviewer queues for low-confidence cases.
App Orchard / Marketplace
Listing prep, security review coaching, and submission management across Epic, Cerner, and Athena.
Activation Runbooks
Per-customer activation packets, IT onboarding guides, and L2/L3 support workflows.
How It Works
Reference Architecture
How data and decisions flow end-to-end.
Discovery & Profile Mapping
Target EHR profiles, USCDI version, write-back scope, and certification targets.
01
1
SMART Launch Layer
EHR-launch and standalone-launch flows, scopes, token and refresh hygiene, and session context.
02
2
FHIR & HL7 Data Plane
FHIR read/write, HL7 v2 interface adapters, and CDA parsers behind a unified internal model.
03
3
Integration Ops
Per-customer config, rotating secrets, retry/DLQ handling, and lineage for every resource.
04
4
Review & Activation
Security review prep, App Orchard / Marketplace submission, and activation runbooks.
05
5
Engineering Stack
Technology Stack
A pragmatic stack chosen for reliability, speed, and ease of operation.
Standards
FHIR R4 / R5HL7 v2.xCDA / C-CDASMART on FHIRCDS HooksUSCDI v3UDAP
EHRs
EpicCernerAthenahealthAllscriptseClinicalWorksNextGenMeditech
Interface Engines
Mirth ConnectRhapsodyNextGen ConnectCloverleaf
Backend
HAPI FHIRAidboxNode.jsJavaPython
Infra
AWS HIPAAAzure HIPAAKubernetesVaultOpenTelemetry
Identity
OAuth 2.0OpenID ConnectUDAPJWT
Measured Impact
Measured Impact
Quantified outcomes from production deployments.
60+
EHR integrations shipped
<12 wks
From kickoff to first SMART launch
99.98%
Interface uptime across deployed feeds
100%
App Orchard / Marketplace submissions accepted
Digital Health ISV to Epic App Orchard
A Series B digital-health ISV had signed two health-system customers contingent on Epic App Orchard listing within two quarters. They had an early SMART app that worked on one sandbox and nowhere else. We rebuilt the SMART launch, added HL7 v2 interfaces, CDS Hooks, and bulk FHIR, and prepared the security review packet.
Both customer sites activated inside 14 weeks, and the App Orchard listing was accepted on first submission — unlocking a $9M pipeline of additional health-system deals and shaving 6 months off the company's enterprise go-to-market timeline.
Case Study
Use Cases
Where This Earns Its Keep
Common deployment patterns we see across customers.
02
Health System In-House Apps
Extend the EHR with internal SMART apps, CDS Hooks, and write-backs your team owns.
03
Population Health & Analytics
Bulk FHIR export pipelines that feed Snowflake, Databricks, or in-house data platforms.
04
Payer-Provider Exchange
Da Vinci PDex, Coverage Requirements Discovery, and prior-auth integrations with EHRs.
05
Device & RPM Write-Back
Structured vitals, observations, and device data flowing into the chart as first-class resources.
06
Migrations & Replatforms
EHR replatforms (e.g., Cerner → Epic) with interface cutover and CDA migration.
Integrations
Integrates With Your Existing Stack
We connect to the systems your teams already know.
EHR
EpicCernerAthenahealthAllscriptseClinicalWorksNextGen
Interface Engine
Mirth ConnectRhapsody
Integration Platform
Redox
Network
Particle Health
Compliance-First Development Services Backed by Global Standards
We build secure, scalable products designed for privacy, interoperability, and regulatory readiness from day one across every sector we serve.
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, and strict access controls.
Service Organization Control 2
Verified controls for security, availability, and confidentiality of enterprise data systems.
Information Security Management
Adhering to the international gold standard for managing information security risks.
Health Information Trust Alliance
Healthcare-specific security controls and risk management practices trusted by global partners.
Fast Healthcare Interoperability Resources
Enabling standardized health data exchange through robust, modern API mappings.
Health Level Seven International
Supporting enterprise-grade interoperability for clinical messaging and record workflows.
Our Edge
Why Global Leaders Choose Us
We combine deep technical expertise with industry-specific knowledge to deliver solutions that aren't just functional, but transformational.
Enterprise-Grade Security
We implement rigorous security protocols and compliance standards (HIPAA, GDPR, SOC2) across all industrial solutions to protect sensitive data.
High-Performance Scaling
Our architectures are built to handle massive data loads and user bases, ensuring seamless performance whether you're serving ten or ten million.
Accelerated Time-to-Market
Leveraging our suite of internal tools and proven frameworks, we reduce development cycles and get your product to market 40% faster.
Embedded AI Integration
Beyond simple wrappers, we build deep-learning integrations and predictive analytics directly into the core of your industry-specific workflows.
Engagement Model
Engagement Model
Predictable, structured delivery from kickoff through long-term ownership.
01
Discovery & Scoping
We map the existing systems, constraints, and stakeholders to scope a focused 8–12 week first delivery.
02
Architecture & Pilot
A working slice on a representative environment — proving the data flow end-to-end before scaling.
03
Production Engineering
Hardened services, observability, access controls, and audit logging go live behind your IAM.
04
Operate & Iterate
We stay on as the embedded engineering team — closing tickets, tuning models, and shipping new value.
Voices of Success
We don't just build products; we forge lasting partnerships. See how we've helped industry leaders transform their vision into technical reality.
"I can clearly see how Agnotic has a unique way of handling end-to-end development. They are always active on quick chat and provide support quickly."
Aaron Phelan
Founder, Benchmark
"Agnotic is the best technical team we evaluated. Their engineering excellence made our work dramatically easier and allowed us to stay focused on what matters most for maternal care outcomes. They took full ownership of the technical execution, and we are always happy to continue working together."
Kim Smith
Founder, My Lauren
"Agnotic combines deep technical expertise with strong domain knowledge. They understand the business context, anticipate challenges, and make collaboration smooth and effective."
John Pasmore
Founder, Latimer
More in Healthcare
More Healthcare Solutions
Explore other production-grade engineering platforms we deliver across healthcare.
Cross-Industry Reach
The Same Engineering Patterns, Across Other Industries
The technical patterns behind this platform translate naturally into adjacent verticals.
Frequently Asked Questions
Yes. We handle listing prep, security review coaching, and submission management — and have a track record of first-submission acceptance on App Orchard, Cerner Code, and Athena Marketplace.
Industries
A Unified Vision that Caters to Diverse Industry Demands
Build your next healthcare platform with us
We engineer production-grade healthcare platforms end-to-end. Talk to us about scoping a focused 8-week pilot.