How to Integrate Third-Party Solutions

Partnering with Epic, one of the largest and most dominant electronic health record (EHR) providers, can be a significant growth opportunity for startups in the healthcare space. However, it’s no secret that collaborating with Epic can be challenging due to its stringent requirements, complex technology stack, and the high standards it maintains for integrations. To successfully create a joint go-to-market (GTM) strategy, integration plan, and long-term partnership with Epic, startups need to approach this process with insider knowledge and strategy. Here are some industry secrets for making this collaboration work: 1. Understand Epic’s Ecosystem and Priorities • Target Key Modules: Epic has several specialized modules (e.g., EpicCare for ambulatory care, MyChart for patient engagement, and Cogito for data analytics). Startups must identify which modules align with their solution and focus on those areas. Understanding which Epic products are growing or receiving internal investment is key to aligning with Epic’s strategic priorities. • Follow Their Roadmap: Epic’s focus can shift over time based on industry trends and regulatory requirements. By tracking Epic’s product roadmap, startups can position their technology to solve emerging challenges in areas like interoperability, patient experience, or value-based care. 2. Develop an Epic-Compatible Integration Strategy • Utilize Epic’s API Ecosystem (App Orchard): Epic’s App Orchard is the official marketplace for third-party integrations. Becoming part of App Orchard is the most direct route for startups to integrate with Epic. Although the process can be time-consuming and expensive (membership fees, plus technical requirements), it’s crucial to build an Epic-compliant API integration. • Epic APIs and FHIR: Use Epic’s APIs or FHIR-based standards to connect your solution to Epic. Familiarize yourself with their documentation and stay updated on changes, as Epic is constantly evolving its API infrastructure. • Integration Testing in a Sandbox: Epic provides testing environments where developers can validate their solutions against the Epic infrastructure. Be diligent about testing in these sandboxes, as any issues discovered during a production rollout can lead to delays or severed partnerships.

This Is Where Most EHR Integrations Go Wrong (And How to Fix It) When we first set out to integrate with Epic and Cerner, we thought, “It’s just FHIR, right?” Wrong. What we learned: integrating with major EHRs isn’t just about APIs—it’s about navigating complex ecosystems, security layers, and data models that don’t always play nice. Here’s the real breakdown 👇 How to Integrate with Epic or Cerner 𝟭. 𝗦𝘁𝗮𝗿𝘁 𝘄𝗶𝘁𝗵 𝘁𝗵𝗲 “𝗪𝗵𝘆”  Know what data you need, what you’ll do with it, and who benefits. 𝟮. 𝗨𝘀𝗲 𝘁𝗵𝗲 𝗥𝗶𝗴𝗵𝘁 𝗧𝗼𝗼𝗹𝘀  • Epic: App Orchard, FHIR R4, HL7v2, OAuth 2.0  • Cerner: Ignite APIs, HealtheIntent, FHIR R4 𝟯. 𝗕𝘂𝗶𝗹𝗱 𝗠𝗶𝗱𝗱𝗹𝗲𝘄𝗮𝗿𝗲 (𝗧𝗿𝘂𝘀𝘁 𝗠𝗲) Your own translation layer is key for:  • Data mapping  • Token management  • App-to-EHR communication 𝟰. 𝗧𝗲𝘀𝘁 𝗟𝗶𝗸𝗲 𝗖𝗿𝗮𝘇𝘆 Use their sandbox. Push every edge case. Expect token issues and schema quirks. 𝟱. 𝗦𝗲𝗰𝘂𝗿𝗶𝘁𝘆 & 𝗖𝗼𝗺𝗽𝗹𝗶𝗮𝗻𝗰𝗲 HIPAA, encrypted pipes, audit logs. No shortcuts. 𝗣𝗿𝗼 𝗧𝗶𝗽: Treat integration like infrastructure, not a feature. It’s what makes your product work in the real world of healthcare. #Epic #Cerner #FHIR #EHRIntegration #SMARTonFHIR

🚀 “How do I integrate with an EHR?” This is the most common question I’m asked when mentoring new HealthTech startups. At Invene, we've done a lot of integrations, so I'm looked at as an expert. To answer this, I follow a framework I dub the “Four W’s.” Silly? Sure. Effective? Undoubtedly. Here are the Four W’s: 1️⃣ “WHY” this problem? 2️⃣ “WHAT” is this integration? 3️⃣ “WHO” are you integrating with first? 4️⃣ “WHICH” method of EMR integration? __________________________________________________ 1️⃣ “WHY” this problem? Early-stage startups often have a vision like, “improve patient care”, “chronic disease management”, or “increase patient access”, but lack details. Before integrating with an EHR, startups need to nail down three critical aspects: • Step-by-step workflow details on how the solution works • Desired customer outcomes • Who pays them 💡 Too many startups I talk with haven't figured out how to actually make money. That's the most important part! __________________________________________________ 2️⃣ “WHAT” is this integration? Once the workflow has been nailed down, it's time to start discussing specifics. This is primarily centered on push versus pull: Differences: – Pull: Retrieves data from the EMR. Generally, easier to implement. Might be able to rely on FHIR APIs instead of proprietary, internal APIs. – Push: Pushes new data to the EMR. This will trigger extra IT governance. Can sometime extend the sales cycle 3+ months. If possible, I suggest HealthTech startups start off just pulling data if possible. Getting your first customer is already hard, so no need to make it more difficult. __________________________________________________ 3️⃣ “WHO” are you integrating with first? Keyword -- first. Resources are limited in a startup. In the beginning, I suggest just focusing on integrating with one EMR. When figuring out who to integrate with, this is the priority I use, in order of importance: 1. Who your beta customer EMR – don’t have one? Get one! 2. Ease-of-integration – some EMRs are easier to work (i.e: Athena versus eClinicalWorks) 3. Market Share – each market is dominated by an EMR (BrightTree for DME, HCHB for home-health & hospice, EPIC for inpatient, etc.) with a long tail of other providers __________________________________________________ 4️⃣ “WHICH” method of EMR integration? There are 5 methods of EMR integrations. That's it. They are: • Flat file export • HL7 feed • API integration • RPA integration • Direct database connection Which one to choose is a whole other post and highly dependent on the workflow details and EMR you're integrating with. 🚫 Do not do a direct database connection unless you are absolutely, 100% sure what you are doing. __________________________________________________ Lmk if you found this framework useful! I have a lot of more details to share, especially on the later "W's".