Clinical Information

Sending and receiving clinical data.


EHR to EHR clinical information interfaces are typically used between two clinical systems looking to exchange patient-specific information. They include both the transport standards for clinical information exchange and the format and content of the information exchanged. Many of the interoperability requirements for Certified EHR Technology for Meaningful Use are covered by this section. Check out our supported standards to learn more.

Outgoing interfaces refer to interfaces in which the EMR sends the message. Incoming interfaces refer to interfaces in which the EMR receives the message.

Incoming Content

Clinical information is primarily exchanged among systems as "documents" - XML files that contain clinical information. Epic's EMR can consume any valid C-CDA or CDA document.

Outgoing Content

Clinical information is primarily exchanged among systems as "documents" - XML files that contain clinical information. Epic's EMR can create the following documents:
  • HL7/ASTM CCD (HITSP C32 Implementation)
  • HL7/IHE Consolidated CDA (CCD and Progress Notes Template)

Exchanging Clinical Documents

The process of exchanging clinical documents is handled through a series of messages exchanged via standards-based SOAP Web services. Because organizations that use Epic software are often the size of regional HIEs themselves, interoperability with the Epic EMR requires no centralized infrastructure. Instead, the EMR acts as a document repository itself for point-to-point queries. Specifically, the EMR supports IHE XCA and IHE XDS.b Query-Response. Current integrations include...
  • ACS/Xerox
  • Agilex
  • Allscripts
  • Apenimed
  • Athena
  • Caradigm
  • Care Evolution
  • Cerner, Cerner HIE
  • Certify
  • CodoniX
  • Coldwater
  • Covisint
  • eClinicalWorks
  • eHealth Data Solutions
  • dbMotion
  • GE
  • Greenway
  • Harris
  • ICA
  • Intersystems
  • Inpriva
  • Magellan
  • MDI Achieve
  • MedFx
  • Medicity
  • Mirth
  • MobileMD
  • NetSmart
  • NextGen
  • No More Clipboard
  • Optum Insight (Axolotl)
  • Orion
  • Qvera

Sending Clinical Documents (Direct)

Epic's EMR supports document exchange via the Direct protocol. Documents sent from an Epic EMR via Direct follow the XDR/XDM option, in which structured documents are sent in the message with structured metadata. Similarly, Epic receives structured documents to file to the appropriate chart. External provider directories containing Direct addresses can be imported into the Epic EHR using a standard format.While Epic software supports the full SMTP+S/MIME stack, organizations using Epic can alternatively choose to delegate duties to an external HISP. Providers use the EHR to push data using Direct, and patients can use their portal to send structured clinical summaries to any arbitrary Direct endpoint with which the organization has established trust. Current integrations include...
  • DataMotion
  • ehrDocs
  • MaxMD
  • MedAllies
  • Medicity
  • SureScripts

External Clinical Data read the specRead the technical specs

As organizations extend Epic to affiliated practices in their communities, there has been an increasing need to convert historical patient-level data from other vendors' systems into Epic. This interface allows organizations to load patient-level data from organizations that do not otherwise support standards-based data exchange.