What is the difference between HL7 and FHIR for EHR integration?

HL7 version 2 is a legacy messaging standard using pipe-delimited text formats. It remains common in established healthcare systems but requires specialized knowledge to implement. FHIR (Fast Healthcare Interoperability Resources) uses modern REST APIs with JSON or XML. FHIR is easier for developers to work with and provides more granular data access. Most new integrations prefer FHIR when EHR systems support it.

How long does a typical EHR integration project take?

Simple integrations using pre-built connectors can deploy within 2-4 weeks. Custom integrations requiring development work typically take 8-16 weeks. Enterprise integrations involving multiple EHR systems and complex data transformations may extend 4-6 months. Timeline factors include EHR vendor responsiveness, data mapping complexity, and testing requirements. Build buffer time for unexpected technical challenges.

Do all EHR vendors provide integration access?

Most major EHR vendors provide integration capabilities, though accessibility varies significantly. Epic and Cerner offer well-documented APIs. Smaller EHR vendors may limit integration access or charge additional fees. Some vendors require formal partnership agreements before providing API credentials. Verify integration availability and costs with your specific EHR vendor before selecting an integration platform.

What data security requirements apply to EHR integrations?

EHR integrations must comply with HIPAA requirements for protected health information. This includes encryption for data in transit and at rest. Access controls must limit data exposure to authorized users and systems. Audit logging must track all data access for compliance reporting. Business Associate Agreements are required between all parties handling PHI. Regular security assessments should validate ongoing compliance.

Can EHR integrations work in both directions?

Yes, integrations can read data from and write data to EHR systems. Read integrations pull patient demographics, appointments, clinical notes, and lab results. Write integrations push data like scheduling updates, clinical documentation, and device readings back to the EHR. Bidirectional integrations require careful data governance to prevent conflicts. Not all EHR systems support write access for all data types.

What happens to integrations when EHR systems update?

EHR updates can break existing integrations, particularly for legacy HL7 interfaces. FHIR APIs provide more stability through versioning, but breaking changes still occur. Integration platforms should monitor for changes and alert when issues arise. Vendor-supported connectors typically update automatically for major EHR releases. Custom integrations require dedicated maintenance resources. Budget for ongoing integration support rather than treating it as one-time implementation.

How do integration costs compare between platforms?

Integration platform costs vary by pricing model. Per-connection pricing works well for limited integration needs. Per-transaction pricing suits high-volume, low-connection-count scenarios. Flat-rate platforms provide predictable costs but may include unused capacity. EHR vendors may charge separate integration fees regardless of platform choice. Total cost analysis should include platform fees, EHR vendor charges, and implementation services.

EHR Integration Platforms: Comparing Approaches and Capabilities

Technical comparison of platforms connecting healthcare applications with electronic health record systems. We examine integration depth, supported EHRs, and implementation complexity.

Updated: January 16, 202611 min readBy Daniel Harper

Why EHR Integration Matters

Electronic health records contain the information healthcare applications need to function. Without EHR integration, staff manually transfer data between systems. This manual work introduces errors, wastes time, and limits what automation can accomplish. Effective EHR integration eliminates these barriers.

Integration depth varies significantly across platforms. Some connections provide read-only access to limited data. Others enable bidirectional data flow across comprehensive clinical datasets. Understanding these differences helps match platforms to specific use cases.

Data Access

Integration unlocks patient demographics, appointments, clinical notes, lab results, medications, and allergies. The specific data available depends on both the integration platform and EHR system capabilities.

Workflow Automation

Integration enables automated workflows triggered by EHR events. New appointments, lab results, or clinical documentation can trigger notifications, reminders, or data processing without manual intervention.

Integration Approaches Explained

Healthcare platforms use different approaches to EHR connectivity. Understanding these approaches helps evaluate which platforms can meet your requirements. The three primary approaches each present distinct advantages and trade-offs.

Pre-Built Connectors

Platforms like Keragon maintain libraries of ready-to-use EHR connections. These connectors handle authentication, data mapping, and common workflows. Implementation requires configuration rather than development. Connectors cover specific EHR systems, so availability for your particular EHR determines viability.

Integration Networks

Redox operates a network model where connecting once provides access to all EHRs in the network. This approach simplifies multi-EHR scenarios. Organizations building applications for multiple health systems often prefer network approaches. Pricing typically operates per connection rather than flat subscription.

Direct Integration

Some platforms build direct integrations with specific EHR vendors. OhMD maintains deep integrations with eight EHR systems. Direct integrations often provide tighter functionality but limit EHR options. This approach works well when your EHR is supported and you prioritize integration depth over flexibility.

Keragon: Broadest Connector Library

Keragon maintains pre-built connectors for over 50 EHR and healthcare systems. The platform supports both FHIR and legacy HL7 interfaces, covering modern and established systems. Healthcare organizations with multiple EHR connections often select Keragon for its comprehensive library.

Connectors handle bidirectional data flow for most systems. Patient data reads and clinical documentation writes both function through the same connector. The visual workflow builder creates automations triggered by EHR events without coding.

Keragon includes HIPAA compliance as a baseline feature. Business associate agreements cover all data handling. The platform manages the complexity of healthcare data standards, allowing teams to focus on workflow design rather than technical integration details.

Keragon Integration Strengths

50+ pre-built EHR connectors. FHIR and HL7 support. Bidirectional data flow. No-code workflow builder. HIPAA-compliant by default.

Read our complete Keragon review →

OhMD: Deep Integration with Supported EHRs

OhMD integrates with eight specific EHR systems: athenaOne, AdvancedMD, eClinicalWorks, Veradigm, ModMed, Healthie, Greenway Health, and Altera. These integrations provide deep functionality for patient communication workflows. Conversation histories automatically upload to patient charts.

The integration scope focuses on communication rather than broad data access. OhMD reads patient contact information and appointment data. Outbound messages and conversation transcripts write back to the EHR. This targeted approach enables features like automated appointment reminders and two-way texting with chart documentation.

Organizations using unsupported EHR systems cannot use OhMD's integration features. The platform functions without EHR integration but loses significant value. Verify your EHR appears on the supported list before evaluating OhMD.

EHR Compatibility Required

OhMD integrations work only with the eight supported EHR systems. Verify your specific EHR version is compatible before proceeding with evaluation.

Read our complete OhMD review →

Healthie: API-Based Integration Options

Healthie operates as a standalone EHR rather than integrating extensively with external systems. The platform provides API access for organizations that want to build custom integrations. Zapier connections enable basic data movement without custom development.

Most Healthie users do not require external EHR integration because Healthie serves as their primary clinical system. Wellness practices, nutritionists, and coaches typically use Healthie as a complete solution rather than connecting it to other EHRs.

Organizations that need Healthie to exchange data with external systems should plan for custom development. The API provides flexibility but requires technical resources. Pre-built EHR connectors do not exist. Healthie works best as a primary system rather than an add-on to existing EHR infrastructure.

Healthie Integration Context

Healthie functions as a primary EHR for wellness practices. External integration requires API development or Zapier. The platform does not provide pre-built EHR connectors.

Read our complete Healthie review →

Redox: Integration Network Model

Redox operates as an integration network rather than a traditional software platform. Healthcare applications connect to Redox once and gain access to the entire network of EHR connections. This model particularly benefits organizations building products for multiple health systems.

The network includes connections to major EHR systems like Epic, Cerner, and Allscripts. Redox handles the technical complexity of each EHR's interface, presenting a standardized API to connected applications. Updates to EHR interfaces flow through Redox without requiring changes to connected applications.

Digital health companies frequently select Redox for product development. Rather than building separate integrations for each customer's EHR, they build one Redox integration. Pricing operates per connection, making costs proportional to actual usage rather than flat subscription.

Redox Use Cases

Digital health applications requiring multi-EHR connectivity. Healthcare vendors selling into multiple health systems. Organizations preferring usage-based pricing over flat subscriptions.

Integration Capability Comparison

Comparison of EHR integration capabilities across platforms
Platform	EHR Systems	Approach	FHIR Support	Bi-Directional	Starting Price
KeragonTop Pick	50+	Pre-built connectors	Yes	Yes	$99/mo
Redox	Extensive network	Integration network	Yes	Yes	Per connection
OhMD	8	Direct integration	No	Yes	$300/mo
Healthie	Limited	API + Zapier	No	No	$19/mo

Choosing Your Integration Approach

Integration platform selection depends on your specific EHR systems, required data access, and organizational resources. The following decision framework addresses common integration scenarios.

Choose Keragon if:

You need workflow automation with EHR integration. Your EHR is among the 50+ supported systems. You prefer no-code configuration over custom development. You want a single platform for automation and integration.

Choose Redox if:

You are building a product for multiple health systems. You need network-based access to many EHRs. You prefer per-connection pricing. You have development resources to build on Redox APIs.

Choose OhMD if:

Your primary need is patient communication. Your EHR is one of the eight supported systems. You want deep integration for messaging workflows. You do not need broad data access or workflow automation.

Choose Healthie if:

You want Healthie as your primary EHR. External EHR integration is not required. You can build custom integrations if needed. Your practice focuses on wellness, nutrition, or coaching.

Confirm EHR compatibility before committing to any platform. Request documentation of specific data types and workflow capabilities for your EHR system. Test integrations during trial periods using realistic patient data scenarios.

EHR Integration Questions

Daniel focuses on healthcare data interoperability and EHR integration. His analysis covers technical implementation requirements and practical connectivity challenges across healthcare systems.

See our review methodology