Integration · Epic
Live emergency department updates for Epic hospitals
EDFlow works with Epic through the HL7 v2 interfaces Epic publishes on open.epic and that Epic hospitals already run through their integration engine. FHIR R4 adds practitioner names and roles, and an optional SMART launch opens EDFlow from inside Epic.
At a glance
HL7 v2 through Bridges
Outgoing patient administration, results and orders, and imaging interfaces listed on open.epic.
FHIR R4 enrichment
Encounter, Location, Practitioner and PractitionerRole for the care team and location mapping.
SMART on FHIR
Staff open the board from Epic with the EHR launch; backend services use signed JWT client assertions.
The ED feed from Epic
Epic keeps emergency department milestones (arrival, triage, provider assignment, disposition, bed request and departure) as time-stamped events on the ED encounter. They are not a public FHIR resource, but they leave Epic through Bridges outbound triggers configured at each site, for example an ADT^A08 update when the treatment team, triage or disposition changes.[1]
| Direction | Interface | Used for |
|---|---|---|
| Outgoing | Patient Administration (ADT) | Arrival, triage, location, care team, departure |
| Outgoing | Results and Orders; Imaging Results and Orders | Order existence and status; result status only |
| Outgoing | Diet Orders | An explicit nothing-by-mouth order (never inferred) |
| Outgoing | Provider Information | Care-team names and roles (optional) |
FHIR R4 with Epic
Epic's FHIR R4 catalogue lists Encounter, Location, Practitioner, PractitionerRole, ServiceRequest, Specimen, DiagnosticReport and ImagingStudy.[2] FHIR is used for enrichment, not as the real-time census feed: Encounter search is scoped per patient, and no generally available FHIR Subscription API is listed, so polling a whole department every minute would be heavy and throttled.
Epic's CareTeam documentation notes that the hospital treatment team is returned as Encounter.participant, which is where the care team is read from.
SMART launch and Canadian interfaces
Epic supports the EHR launch from inside Epic and backend services using OAuth 2.0 client credentials with a signed JWT assertion (RS384 or ES384).[3] The optional staff launch opens the board or a patient's view from the Epic context, with no second sign-in.
Ontario Epic sites also run Canada-specific interfaces, such as the outgoing patient waiting time interface for the provincial wait-time system.[4] The timestamps that feed it (arrival, triage, physician initial assessment) are the same ones the department timeline needs.
What to confirm with your Epic team
- Which Bridges outbound triggers fire for triage, treatment team and disposition changes in your build.
- Whether lab and imaging run in Epic modules or in third-party systems (it changes the interface work).
- Whether an app registration for FHIR enrichment is needed, and which support tier applies.
- The location codes of the emergency department and its zones, for the engine's filter.
Technical documentation
- HL7 v2 adapterThe HL7 v2 adapter: supported versions and triggers per vendor, field maps and status tables.
- FHIR R4 adapterThe FHIR R4 adapter: accepted Bundle types, Subscriptions Backport notifications and resource mappings.
- SMART on FHIR launchThe optional SMART on FHIR launch for staff from inside the EHR.
Frequently asked questions
Do we need an Epic marketplace listing?
Not for a single-hospital pilot that uses the hospital's own HL7 interfaces. Using Epic's FHIR APIs for enrichment needs an app registration that the hospital activates in its own environment.
Is there a catch with Epic lab and imaging?
It depends on where lab and imaging run. With a third-party lab or radiology system, the order and result traffic to it already exists and the engine can copy it. With Epic's own lab and radiology modules, status changes stay inside Epic and a new outbound results and orders interface is usually needed. Budget analyst time for it.
Does it coexist with Epic's patient-facing tools?
Yes. EDFlow never competes with the hospital's patient portal for the same data. It shows progress and never shows results, so the portal remains the place where patients read their results under the hospital's own release rules.
Keep reading
- IntegrationOracle Health Millennium integration for real-time ED statusHow EDFlow integrates with Oracle Health Millennium and FirstNet for real-time emergency department status: outbound HL7 v2 through the integration engine, FHIR R4 CareTeam, optional Communication write-back and what to confirm with your team.
- IntegrationHL7 v2 integration: ADT, orders and result status for the EDHow EDFlow maps HL7 v2 ADT, ORM/OML and ORU messages to real-time emergency department events: triggers, OBR-25 result-status mapping, the reference integration engine channel and signing, with OBX values never read.
- ArticleIntegrating with Epic and Oracle Health for real-time emergency department statusA practical guide to real-time emergency department status from Epic and Oracle Health: HL7 v2 through the integration engine, where FHIR fits, minimization and the shadow run.
Talk to us
See it with your own emergency department in mind
We'll walk through the patient, family and staff views with synthetic data, then map them to your EHR, your workflows and what you want a pilot to prove.
Sources
- [1]HL7 v2 interfaces (opens in a new tab) · open.epic
- [2]FHIR interfaces (opens in a new tab) · open.epic
- [3]SMART App Launch: Backend Services (opens in a new tab) · HL7 International
- [4]Canada-specific interfaces (opens in a new tab) · open.epic