We build and deploy custom EHR integration solutions that connect your electronic health records with the systems your clinical teams actually use. FHIR R4, HL7 v2/v3, SMART on FHIR, CDS Hooks. Full HIPAA compliance. No middleware lock-in. You own the integration layer.
HIPAA Compliant
HL7 / FHIR Compatible
SOC 2 Type II
ISO 27001
Trusted By
Certifications and Accreditations
From FHIR-based API connections to full-scale clinical ecosystem integrations, we cover every layer of the interoperability stack.
We build RESTful FHIR R4 APIs and HL7 v2/v3 interfaces that enable structured, standards-compliant data exchange between your EHR and third-party systems. Includes resource mapping, validation, and transformation logic.
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Connect your EHR with laboratory information systems (LIS), radiology systems (RIS/PACS), pharmacy management platforms, billing systems, and practice management tools. We handle bidirectional data flow and conflict resolution at the message layer.
We build and integrate SMART on FHIR applications that launch directly inside EHR workflows. This includes OAuth 2.0 authorization scopes, CDS Hooks implementation, and EHR-contextual data access without disrupting the clinical interface.
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Connect your organization to regional, state, and national HIE networks using Direct Protocol, XCPD, XCA, and FHIR subscription feeds. We configure both query-based and event-driven data exchange models.
We integrate EHR systems with payer platforms for real-time eligibility verification, prior authorization automation, and claims data exchange using X12 EDI and FHIR-based payer APIs under the CMS Interoperability Rule.
Bi-directional healthcare API integration between your EHR and telehealth platforms or RPM devices. Patient vitals, visit notes, and encounter data flow back into the EHR record automatically.
We scope EHR integration projects in a free technical consultation - no pressure, no pitch deck.
Book a Free ConsultationMost healthcare organizations are not dealing with a single fragmented system. They are managing five to fifteen different platforms, each with its own data model and API behavior, none of which were designed to work together.
Clinical staff enter the same patient data three times across three systems. Lab results land in a separate portal the ordering physician may or may not check. Billing disputes surface two weeks after the encounter because the charge capture system never received the discharge record. Referral coordinators fax documents that should have been routed electronically.
This is not an operational inconvenience. It is a patient safety issue and a revenue loss issue running in parallel. Organizations that have moved to connected EHR software systems report significant reductions in duplicate data entry and fewer missed referrals. The path to that outcome is a correctly designed integration layer, not another middleware license.
We map your existing EHR environment, connected systems, and data exchange patterns before writing a line of integration code. Discovery outputs include a system inventory, data flow diagram, API capability review, and integration spec. This phase takes two to four weeks depending on ecosystem complexity.
We build integration using FHIR R4 (RESTful APIs, Subscriptions, Bulk Data Access), HL7 v2.x/v3 messaging, CDA document exchange, X12 EDI for payer transactions, and DICOM for imaging where applicable. We do not build proprietary connectors that break when a vendor changes their schema.
Every integration layer includes encrypted data transit (TLS 1.2+), access controls, audit logging, and data minimization practices aligned with the HIPAA Security Rule. We produce integration compliance documentation as a project deliverable.
Integration testing covers unit tests at the message level, end-to-end workflow testing in a staging environment that mirrors production, and user acceptance testing with your clinical and IT teams. We support go-live and remain available through the first 30 days of production operation. EHR system automation testing is included for workflow-critical integrations.
We offer L1/L2/L3 SLA support tiers after go-live. Your team gets named contacts, defined response windows, and a clear escalation path. We also monitor integration pipeline health on an ongoing basis for organizations on managed support agreements.
We build and maintain integration connectors for Epic (MyChart, App Orchard), Oracle Cerner (Millennium, PowerChart), athenahealth, eClinicalWorks, Allscripts, NextGen, and OpenEMR. Each connector accounts for platform-specific API behaviors and versioning.
Automated data transformation logic built on LLM-assisted field mapping tools reduces manual mapping time on large integrations. Our AI layer identifies schema mismatches, flags anomalous values, and suggests transformation rules before clinical teams validate the output.
We design integration layers that write data back to the source EHR, not just read from it. Clinical decision support results, care plan updates, and patient-generated health data from healthcare automation solutions all flow back into the EHR record in structured form.
Every integration pipeline includes real-time monitoring, error alerting, and message queue management. Failed transactions are captured, logged, and routed to a resolution queue before they cause downstream data gaps.
We produce integration compliance documentation as a formal deliverable: data flow diagrams, HIPAA Security Rule checklist, API access control matrix, and audit log configuration. Your compliance team receives these at project close.
If your organization relies on outdated VPN-tunneled HL7 v2 feeds or point-to-point database connections, we migrate those interfaces to standards-based FHIR or HL7 MLLP configurations without disrupting live clinical operations.
A production EHR integration layer includes multiple components working in sequence. The diagram shows how data flows from source EHR systems through the integration middleware, transformation engine, and into the target platform.
We audit your current EHR environment, connected systems, and clinical workflows - output: integration architecture document, system map, and a fixed-scope delivery plan.
We write the full technical specification before development begins. This includes FHIR resource mapping, HL7 message schemas, data transformation rules, and access control design. Your technical team reviews and approves this before any code is committed.
Development follows the approved spec. We build API connectors, configure transformation logic, set up integration monitoring, and implement healthcare IT consulting guidance on access controls and audit logging in parallel.
End-to-end integration testing covers message-level validation, workflow simulation, edge case handling, and HIPAA compliance checks. We use a staging environment that mirrors your production configuration before any go-live occurs.
We support the production launch directly. A dedicated technical contact manages the first 30 days post-launch, monitoring pipeline performance, resolving edge cases, and confirming clinical workflow continuity before transitioning to standard support.
EHR integration costs depend on the number of systems being connected, the standards involved (FHIR R4, HL7, X12 EDI), and the complexity of clinical workflows being automated. Most mid-complexity integrations connecting two to four systems range from $15,000 to $60,000. Enterprise-scale or multi-system integration programs vary significantly. We work across different engagement structures depending on your scope. Our free consultation includes a project scope assessment and a ballpark cost range before you commit to anything.
Before committing to a vendor, organizations should understand what each path actually delivers.
| Factor | Custom EHR Integration (Citrusbug) | Off-the-Shelf Middleware | EHR Vendor Native Tools |
|---|---|---|---|
| Platform Flexibility | Any EHR, any endpoint | Limited to supported connectors | Single-vendor ecosystem only |
| FHIR R4 / SMART on FHIR | Full support, custom scope | Varies by vendor | Dependent on EHR roadmap |
| Integration Ownership | You own the integration layer | Vendor license dependency | Vendor controls updates |
| Customization | Built to your workflow spec | Configurable within limits | Minimal |
| Compliance Documentation | Delivered as part of project | Shared responsibility | Vendor-managed, limited access |
| AI-Augmented Mapping | Available | Rarely included | Not typically available |
| Cost Model | Scope-based or phased, client-owned | Annual subscription | Included but constrained |
| Post-Launch Control | Full – you modify as needed | Vendor approval required | Vendor roadmap dependent |
Choose an engagement model based on how defined your integration scope is and how much ongoing ownership you need from our team.
Best for defined-scope projects where discovery is complete and integration requirements are fully documented before development begins.
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Best for organizations with evolving requirements or phased integration roadmaps that need a dedicated team working in structured delivery cycles.
Ideal for organizations requiring a dedicated integration team across complex healthcare systems.
We produce a complete integration architecture document before development starts. No surprises mid-project. Your team reviews and approves the spec, the data flow, and the compliance controls before a single API call is written.
The engineers building your integration are introduced before the contract is signed. You know who is on the project, what they have built before, and how to reach them directly throughout the engagement.
Every integration we ship includes TLS-encrypted data transit, role-based access control, audit logging aligned with the HIPAA Security Rule, and a compliance documentation package delivered at project close.
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We use LLM-assisted tools to accelerate data field mapping across large, complex EHR schemas. This reduces mapping errors and cuts the time clinical informaticists spend validating transformation logic.
You receive complete source code for every integration component we build. No proprietary connector lock-in. Your internal team or any future vendor can maintain, extend, or modify the integration layer without coming back to us.
We offer structured L1/L2/L3 support tiers after go-live. Defined response times, named contacts, and monitored pipeline health for organizations that need ongoing integration reliability guarantees.
It covers the full process: discovery and architecture, API development (FHIR R4, HL7, or vendor-specific), data transformation, compliance configuration, testing, go-live support, and documentation. The exact scope depends on how many systems you are connecting and what data needs to flow between them.
We build integration connectors for Epic, Oracle Cerner, athenahealth, eClinicalWorks, Allscripts, NextGen, OpenEMR, and several others. If your EHR has an API or supports HL7 messaging, we can connect to it.
Yes. We build FHIR R4 RESTful APIs, implement SMART on FHIR application authorization flows, and support CDS Hooks for clinical decision support integrations. We also work with HL7 v2.x and v3 for organizations on older messaging infrastructure.
A standard integration connecting two systems typically takes six to twelve weeks from discovery to go-live. Multi-system or enterprise-scale integrations take longer. We publish a delivery timeline after the discovery phase, not before, because scope drives duration.
Data in transit is encrypted using TLS 1.2 or higher. Access controls follow the principle of least privilege. Audit logs capture all data access and modification events. We deliver a compliance documentation package, including a data flow diagram and access control matrix, at project close.
Yes. We assess what was built, identify the failure points, and either repair the existing integration or rebuild it correctly. We have taken over several stalled EHR integration projects and delivered them to production.
Yes. We work with startups that need SMART on FHIR app development, EHR App Orchard submissions, and FHIR-based patient data access for their platforms. We have experience with both the technical build and the EHR vendor review process.
Their agile way of working, competence, and friendliness are impressive.December 7, 2024
Citrusbug Technolabs handles a data extraction project for an education company. They're also responsible for managing an AI generation project for the client.
Citrusbug Technolabs has laid out and followed a clear project outline and consistently met deadlines. The team communicates well and demonstrates a strong understanding of the client's vision and goals. Their agile approach, high level of competence, and personable approach stand out.
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Their communication and ability to capture exactly what I was asking for were impressive.November 14, 2024
Citrusbug Technolabs built an automated system for a veteran medical company. The system needed to collect and store user data, generate customized letters based on surveys, and use AI to summarize reviews.
Citrusbug Technolabs delivered a functional automated system that successfully organized the client's records and auto-generated statements. The team was quick to respond, addressed all roadblocks, and communicated effectively. Overall, their ability to understand the client's needs stood out.
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They were very calm and talented, and they did bring some of their own ideas.January 28, 2025
Citrusbug Technolabs has developed an MVP for a freight and capacity marketplace. The team has created three different interfaces for three market segments.
Citrusbug Technolabs has successfully developed an effective MVP. The team has delivered the project on time and almost within budget. Moreover, their responses have been timely. Overall, the team has been calm, talented, and innovative. This has led to the client's satisfaction.
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What stood out most about them was their personalized approach and sense of ownership in every aspect of the project."February 27, 2024
Citrusbug Technolabs built a Flutter cross-platform mobile app for an education company. They also developed two web apps and an admin panel and provided DevOps support for the client's infrastructure.
Citrusbug Technolabs' support successfully boosted the client's user engagement by 8x, resulting in an 85% retention rate. The reliable team demonstrated a dedication to delivering on time and promptly responding to concerns and adjustments. Their personalized, client-centric approach stood out.
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They didn't like the phrase "impossible to do", which made them very solution-oriented.February 19, 2024
A healthcare company hired Citrusbug Technolabs to design and develop a user-friendly application. The team provided tailored assistance to meet the client's requirements.
Citrusbug Technolabs successfully delivered an application that was ready for market. The team was highly professional and well-organized; they stayed focused throughout the engagement and were receptive to changes. Overall, they stood out for their trustworthiness and commitment to excellence.
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They're 100% on time and transparent throughout each stage of the project.February 24, 2024
A financial technology company has hired Citrusbug Technolabs to build a custom web application. The team handles the development and design of the app.
The project is ongoing, but the client has been satisfied with Citrusbug Technolabs' services. The team is very professional — they always respect timelines and provide regular updates to ensure everyone's on the same page. Also, their transparent approach makes them a trustworthy partner.
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"I do believe they are exceptional at where they stand."
Citrusbug Technolabs took on a mobile app development project for a Singapore-based development house. They were provided with UX designs to execute. Currently, they're finalizing and fine-tuning the product.
Citrusbug Technolabs contributed to the successful launch of the product, which has garnered over 10,000 users in just three months. The product has also received support from investors. They consistently followed-up with their progress and delivered at a speedy rate. The team is truly stellar.
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