FHIR · TEFCA · USCDI integration
FHIR R4 ingestion and emission against EHR partners. SMART-on-FHIR auth, USCDI v3 data classes, TEFCA QHIN handshake, info-blocking-compliant access logs, consent scoping baked into the audit trail.
The problem
An EHR partner needed to ingest and emit FHIR R4 resources against multiple healthcare networks, with TEFCA QHIN handshake on the wire and SMART-on-FHIR auth on the client side. The existing integration leaked patient identifiers in error logs, lacked consent scoping in the audit trail, and would not pass an info-blocking review. Partner onboarding took weeks because every quirk leaked into business logic instead of staying in an adapter.
The approach
We built a FHIR R4 ingestion and emission layer with strict resource validation against USCDI v3 profiles. SMART-on-FHIR OAuth2 scopes are enforced at every endpoint; the TEFCA QHIN handshake is wrapped in a typed adapter so partner-specific quirks do not leak into business logic. Access logs scope every read and write to the consent record that authorized it. Patient identifiers never appear in logs; only opaque request IDs do. New partners onboard via adapter configuration, not core changes.
Stack and engineering choices
- FHIR R4 conformant resources
- SMART-on-FHIR OAuth2 scopes
- TEFCA QHIN handshake adapter
- USCDI v3 profile validation
- Consent-scoped access logs
- Partner quirks isolated in adapters
- PII never logged in clear
Outcome
The integration passed external info-blocking review without rework. Partner onboarding shrank from a multi-week handshake to a config change. The audit trail satisfies both internal compliance and external auditors with the same dataset, and the partner-specific quirks stay isolated in adapters.
See more healthcare integration work at quadevs across other engagements with similar shape.
Have a project that overlaps this work?
Send a one-paragraph brief. We reply within one business day.
hello@quadevs.com