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Insights / FIELD NOTES

Healthcare integration insights

Standards breakdowns and architecture notes on FHIR, TEFCA, USCDI, HEDIS, clinical data platforms, and medical document pipelines. Written from systems we run in production, not from other articles.

Everything here comes out of the healthcare integration practice: the standards questions clients ask before a build, and the architecture decisions that turned out to matter after one. Each piece links to the production case it was learned on.

INSIGHT·INTEROP

TEFCA vs FHIR: what each one actually does

TEFCA is a trust framework for network exchange, FHIR is the API standard the data rides on. How they differ, where they meet, and what you build for each.

9 min read Read
INSIGHT·INTEROP

USCDI and FHIR: data classes vs the API that moves them

USCDI defines which data elements must be exchangeable, US Core maps them onto FHIR R4 resources. The versions, the mapping, and the gaps engineers hit.

8 min read Read
INSIGHT·COMPLIANCE

FHIR AuditEvent: an audit trail that survives review

How the FHIR AuditEvent resource works, what an access trail must prove under review, and the patterns that keep PHI out of logs while keeping evidence in.

8 min read Read
INSIGHT·DATA

Clinical data aggregation: architecture that scales

What a clinical data aggregation platform does, the hub pattern that stops every consumer re-integrating every source, and the failure modes to design against.

9 min read Read
INSIGHT·DATA

Clinical data warehouse: design notes from production

What separates a clinical data warehouse from a generic one: history-preserving normalization, idempotent ETL, forward-only migrations, and read replicas.

8 min read Read
INSIGHT·DOCUMENTS

Medical document OCR: an intake-to-record pipeline

The stages of a medical document OCR pipeline: capture, enhancement, classification, extraction, and routing, with the failure modes each stage exists to stop.

9 min read Read
INSIGHT·DOCUMENTS

OCR fallback and barcodes in document pipelines

What an OCR fallback path is, when barcodes beat text recognition entirely, and how confidence scoring decides which route a document takes through a pipeline.

7 min read Read
INSIGHT·QUALITY

HEDIS automation: a pipeline auditors can reproduce

How a HEDIS measurement pipeline automates intake, classification, and measure calculation so numerators and denominators reproduce on demand for NCQA audit.

8 min read Read
INSIGHT·GROWTH

Healthcare schema markup that earns rich results

The schema.org types that matter on clinical sites: MedicalClinic, Physician, MedicalProcedure, FAQPage, and the implementation details search engines check.

8 min read Read

Up against one of these standards right now?

Describe the system and where it hurts. The engineer who answers is the engineer who ships it.