Interoperability architecture
Reference architecture for FHIR, HL7, and SMART patterns with clear system boundaries and ownership.
Healthcare Interoperability
Healthcare interoperability services for connected clinical systems
We architect, build, and operationalize interoperability across EHR/EMR systems, FHIR R4 APIs, HL7 v2 interfaces, and SMART on FHIR apps so clinical data moves reliably where care happens.
FHIR R4HL7 v2SMART on FHIRHIPAA-Ready
Trusted by global innovators
Interoperability that ships into production
Interoperability succeeds when standards selection, integration architecture, and operations are designed together from day one.
4
Core interoperability tracks
R4
FHIR target for new integrations
24/7
Observable interface operations
What this pillar covers
One interoperability strategy, multiple standards and systems
Healthcare interoperability is the discipline of making clinical and operational data flow safely between systems without losing context, fidelity, or auditability.
Most healthcare organizations need a hybrid approach: FHIR R4 for modern APIs, HL7 v2 for existing event flows, and SMART on FHIR for app experiences inside EHR workflows. This page is the pillar that connects those implementation tracks.
Interoperability solution tracks
Explore focused interoperability solutions
Use this pillar page as your starting point, then go deeper into the specific interoperability stream your product needs first.
EHR/EMR Integration
Epic, Cerner, Athenahealth, and other provider systems integrated with realistic go-live planning.
FHIR Integration
FHIR R4 APIs, resource design, SMART-aligned access, and production-compatible data exchange.
HL7 Integration
HL7 v2 ADT/ORM/ORU/SIU flows with interface-engine architecture and reliability controls.
SMART on FHIR
Embedded EHR apps with secure launch contexts, OAuth2 flows, and in-workflow user experience.
Core capabilities
What our healthcare interoperability services include
We handle strategy, implementation, and production operations for interoperability as one integrated workstream.
EHR and EMR connectivity
Bidirectional integration with provider systems using the right mix of FHIR APIs and HL7 interfaces.
FHIR API implementation
Resource-level integration, profile-aware mapping, and secure access flows for modern health apps.
HL7 v2 message pipelines
Robust event ingestion and transformation with replay-safe queues, retries, and traceable acknowledgements.
SMART on FHIR app enablement
Launch-context support and app embedding inside clinician workflows across target EHR ecosystems.
Terminology and mapping
Clinical coding alignment across SNOMED, LOINC, ICD-10, and RxNorm for consistent downstream use.
Integration observability
Transaction-level tracing, failure alerting, and integration health dashboards for operational confidence.
Compliance-first delivery
HIPAA-ready pipelines with auditable access paths and PHI-safe operations from development through runtime.
Standards decision
When to use FHIR, HL7, or SMART on FHIR
Most healthcare products need more than one standard. Selection should follow workflow and system constraints, not trend bias.
| Standard | Primary role | Best fit |
|---|---|---|
| FHIR R4 | Resource-oriented API interoperability | Modern product integrations, patient apps, analytics pipelines |
| HL7 v2 | Event and message-based exchange | Legacy hospital systems, lab/result workflows, scheduling and admissions |
| SMART on FHIR | Secure app launch and in-EHR context | Embedded clinical tools and third-party apps inside provider workflows |
Pillar strategy: FHIR-first where possible, HL7 where required, SMART where apps run inside EHR context.
Where it applies
Interoperability use cases we support
Care coordination
Unified patient context across provider systems, care teams, and patient-facing products.
Lab and diagnostics connectivity
Reliable order/result exchange across EHRs, diagnostic systems, and downstream analytics.
Embedded clinical applications
SMART-enabled specialty workflows launched directly inside provider EHR environments.
Population and operational analytics
FHIR/HL7 ingestion streams powering quality metrics, utilization analysis, and risk modeling.
Remote and digital care platforms
Telehealth and RPM experiences synchronized with systems of record for continuity of care.
Partner ecosystem integration
Payer, pharmacy, and specialty-network data exchange with security and audit controls.
How we deliver
Healthcare interoperability delivery framework
A phased approach that de-risks standards selection, partner onboarding, and production reliability.
Step 01
System and standards assessment
Map system landscape, decide FHIR/HL7/SMART approach, and define measurable interoperability outcomes.
Step 02
Access and integration planning
Plan sandbox access, interface dependencies, and partner readiness before build commitments.
Step 03
Connector and API implementation
Build adapter-based connectors, API gateways, and message handlers aligned to canonical models.
Step 04
Validation and hardening
Run contract tests, data quality checks, and performance validation under realistic integration load.
Step 05
Go-live and observability
Deploy with phased cutovers, alerting, and runbooks for failure recovery and partner evolution.
Step 06
Continuous optimization
Improve connector reuse, reduce maintenance burden, and evolve standards support with each release.
Common blockers
Interoperability risks and mitigation
Challenge
One-off connector sprawl
Agnotic approach
Use reusable adapter patterns with canonical models so new integrations scale without full rewrites.
Challenge
Partner schema and API drift
Agnotic approach
Run version-aware contracts, compatibility checks, and rollback-safe release patterns.
Challenge
Poor production visibility
Agnotic approach
Instrument transaction-level telemetry and alerting across all interoperability paths.
Challenge
Standards chosen by preference, not fit
Agnotic approach
Apply workflow-driven standards selection with explicit FHIR, HL7, and SMART criteria.
Standards and compliance
Interoperability standards in our SDLC
FHIRHL7SMARTHIPAAHITECH
Engineered for Healthcare Compliance, Backed by Global Standards
Every Agnotic healthcare build is architected for privacy, interoperability, and regulatory readiness from the first commit — not retrofitted before launch.
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, strict access controls, and traceable audit logs.
General Data Protection Regulation
Implement lawful consent flows, data minimization, retention controls, and secure processing for sensitive reproductive and health data.
Fast Healthcare Interoperability Resources
Enable standardized health data exchange across apps, care teams, and systems through robust FHIR-ready APIs and mappings.
Health Level Seven International
Support enterprise-grade interoperability with HL7-based integrations for records, events, and clinical messaging workflows.
Health Information Trust Alliance
Align security programs to healthcare-specific controls and risk management practices trusted by providers and partners.
Health Information Technology for Economic and Clinical Health Act
Design with breach notification readiness, digital record safeguards, and operational controls that support regulated care programs.
Food and Drug Administration Software as a Medical Device
Plan software quality, traceability, and documentation pathways for products that may require SaMD review and regulatory submission.
Medical Device Regulation (European Union)
Prepare EU market-ready processes for risk classification, evidence tracking, and lifecycle governance under MDR expectations.
Substance Abuse and Mental Health Services Administration (42 CFR Part 2)
Apply confidentiality controls and consent-aware sharing models for behavioral and mental health related data experiences.
We Are Technology-Agnostic
With a diverse technology stack, we deliver solutions using a technology-Agnostic approach to meet your unique needs.
Wireframe & Ideation
User Experience
Real-Time Projects
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
Related Solutions
Frequently Asked Questions
In most environments, yes. FHIR supports modern API use cases, while HL7 v2 remains critical for legacy event feeds. We design both to coexist cleanly.
Need a realistic interoperability roadmap?
Share your system landscape and integration priorities. We'll return a phased interoperability plan with standards, sequencing, and operational guardrails.