Flagship Practice, Interoperability

The healthcare data fabric, designed and operated as one system.

A modern interoperability practice spanning strategy, architecture, engineering and operations, Epic Bridges, FHIR, HL7, TEFCA and HIE connectivity, delivered by senior integration engineers.

Practice Overview

One advisory practice for the entire healthcare data exchange lifecycle.

NexBridge interoperability engagements blend EHR-native expertise (Epic, Oracle Health) with modern API and standards engineering, so your Bridges, Care Everywhere, FHIR, HL7 and TEFCA programs run as a coherent system, not a collection of point integrations.

Strategy & Architecture

Reference architectures, standards selection, sequencing roadmaps.

Build & Engineering

Interface, FHIR API and HIE connector implementation.

Run & Operate

Tier 1-3 interface support, monitoring and continuous improvement.

Governance & Compliance

HIPAA-ready engagements, data stewardship and audit readiness.

Reference Architecture

The NexBridge healthcare data fabric.

A vendor-neutral reference model for moving clinical and administrative data across Epic, Oracle Health, regional HIEs and QHIN networks.

Source Systems
Epic / Oracle Health EHR
Ancillary & Departmental Systems
Devices & Clinical Apps
Integration Core

Interface · API · Identity

Epic Bridges / Interface Engines
FHIR R4 Gateway · SMART on FHIR
HL7 v2 · CDA · X12 Routing
EMPI · Patient Matching
OAuth · Consent · Audit
Exchange Networks
TEFCA / QHIN Networks
Regional & State HIEs
Payers · Public Health · Partners
Governance
Stewardship, policies, role-based access
Security
HIPAA-ready, encryption in transit & at rest
Audit
Provenance, consent, full message logging
Capability Pillars

Nine pillars. One coherent practice.

We staff specialized teams across each pillar, and integrate them into a single program when your roadmap demands it.

01

Epic Bridges

Interface design, build, testing and ongoing operations.

02

Care Everywhere

Network configuration, identity strategy, query optimization.

03

FHIR R4 & Bulk

API enablement, SMART on FHIR, app gallery, bulk export.

04

HL7 v2 & CDA

Legacy interface modernization and message routing.

05

TEFCA Readiness

QHIN selection, governance, participant onboarding.

06

HIE Connectivity

Regional, state and specialty HIE participation.

07

Integration Engines

Rhapsody, Mirth, Cloverleaf, Corepoint expertise.

08

Patient Matching

EMPI strategy, attribute tuning, identity governance.

09

Data Governance

Stewardship, lineage, consent and audit programs.

01
Epic Bridges

Bridges, engineered as a product.

From specification through go-live and steady-state operations, we treat your Bridges interface estate as a managed product, versioned, monitored and continuously improved.

Interface estate · greenfield to legacy modernization
Workflow
STEP 01
Discovery
Spec & data model
STEP 02
Build
Interface dev
STEP 03
Validate
Test & UAT
STEP 04
Cutover
Go-live support
STEP 05
Operate
Monitor & optimize
Interface Build

Inbound, outbound, two-way design across Epic and ancillary systems.

Test & Validate

Unit, integration, regression and pre-production parallel runs.

Operations

Monitoring, incident response and root cause analysis.

Optimization

Throughput tuning, error reduction, message rationalization.

02
Care Everywhere

A Care Everywhere program clinicians actually use.

We tune Care Everywhere from the inside out, network selection, identity matching, query workflows and clinical reception, so external records arrive where and when they're needed.

Identity · query strategy · clinical adoption
Workflow
STEP 01
Activate
Network onboard
STEP 02
Match
Identity tuning
STEP 03
Query
Auto + manual
STEP 04
Reconcile
Clinical review
Network Setup

Activation, partner enablement, agreements.

Identity & Matching

Algorithms, demographic tuning, escalation paths.

Query Workflows

Auto-query, manual workflows, reconciliation.

Clinical Adoption

Provider training, navigation, governance.

03
FHIR APIs

FHIR as a first-class integration tier.

API enablement, app gallery curation, SMART on FHIR launch flows and bulk export pipelines, built to USCDI v3 and the regulatory baseline established by the ONC certification program.

R4 · Bulk · SMART on FHIR · USCDI v3
FHIR Stack
AppsSMART · 3rd-party · Internal
AuthorizationOAuth 2.0 · Scopes · Consent
FHIR GatewayR4 endpoints · Bulk Data · Subscriptions
ProfilesUSCDI v3 · US Core · Custom
Source of TruthEpic · Oracle Health · Ancillary
API Enablement

FHIR R4 endpoint design, scopes, throttling.

Bulk Data

Backend Services, group export, $export pipelines.

SMART on FHIR

Standalone & EHR launch, OAuth, scopes, audit.

USCDI Coverage

v3 alignment, profile validation, CapabilityStatement.

04
HL7 v2 / CDA

The backbone still runs on HL7. We keep it healthy.

Most healthcare data still moves through HL7 v2. We rationalize sprawling interface estates, modernize routing, and bridge legacy CDA and X12 flows into FHIR-ready architectures.

Rhapsody · Mirth · Cloverleaf · Corepoint
Workflow
STEP 01
Inventory
Interface census
STEP 02
Rationalize
Consolidate
STEP 03
Modernize
Engine + API
STEP 04
Operate
Run & monitor
Message Modeling

Segment design, vocabularies, downstream contracts.

Engine Migration

Cross-platform migration & consolidation.

Routing & Filters

Rules, transformations, error queues.

Observability

End-to-end monitoring and alerting.

05
TEFCA Readiness

A TEFCA-focused readiness path, not a checklist.

QHIN selection, Common Agreement alignment, participant and sub-participant onboarding, governance design and use-case sequencing, the full readiness journey for delivery networks entering TEFCA.

QHIN selection · Common Agreement · participant onboarding
Workflow
STEP 01
Assess
Readiness audit
STEP 02
Select
QHIN partner
STEP 03
Govern
Policy & roles
STEP 04
Onboard
Connect & test
STEP 05
Exchange
Production
QHIN Selection

Vendor fit, use cases, contract structure.

Governance

Policies, oversight, exchange purposes.

Onboarding

Participant / sub-participant enablement.

Use-Case Activation

TI, payment, public health, individual access.

06
HIE Connectivity

Connecting to the networks that matter to your patients.

Regional and state HIE participation, specialty exchanges (immunization, cancer registries, public health), and consolidated reporting back to internal analytics platforms.

Regional · State · Specialty HIEs
Regional HIEs
State HIEs
QHINs
Immunization Registries
Cancer Registries
Public Health
Behavioral Health
Prescription Networks
Payer Connectivity
HIE Onboarding

Connectivity, message specs, certification.

Public Health

ELR, eCR, syndromic surveillance, immunization.

Specialty Networks

Cancer, behavioral, transplant, prescription.

Reporting

Reportability response, attestation evidence.

07
Data Governance

Governance that accelerates exchange, not slows it.

A pragmatic governance operating model: stewardship councils, data domains, lineage, consent capture and audit trails, engineered alongside the integration platform, not bolted on.

Stewardship · lineage · consent · audit
Governance Stack
StrategicData Governance Council
TacticalDomain Stewards · Architecture
OperationalStewardship Workstreams
FoundationalCatalog · Lineage · Quality · Audit
Operating Model

Councils, domain owners, decision rights.

Policy Library

Use, retention, sharing, breach response.

Consent

Granular consent capture and enforcement.

Audit & Lineage

End-to-end provenance for every exchange.

08
Patient Matching

Matching that holds up across every network.

Match rates degrade quickly across HIE and TEFCA boundaries. We design identity programs that combine EMPI tuning, demographic data quality and governed escalation paths to keep records together.

EMPI · attribute tuning · identity governance
Matching Layers
DeterministicExact + composite keys
ProbabilisticWeighted attribute scoring
ReferentialThird-party identity data
StewardshipManual review & escalation
EMPI Strategy

Algorithm tuning, weights, thresholds.

Stewardship

Linkage review, merges, manual escalation.

Data Quality

Demographic completeness, standardization.

Measurement

Match rate, false-positive tracking, KPIs.

Modernization Framework

A repeatable path from interface estate to modern data fabric.

Five phases. Sequenced, value-driven, and adaptable to the realities of a live healthcare environment.

Phase 01
Discover

Interface census, capability assessment, opportunity mapping.

Phase 02
Architect

Target-state architecture, standards, sequencing roadmap.

Phase 03
Modernize

FHIR enablement, HL7 rationalization, engine consolidation.

Phase 04
Govern

Operating model, policies, stewardship workstreams.

Phase 05
Operate

Tier 1-3 support, monitoring, continuous improvement.

Compliance & Trust

HIPAA-ready engagements. Standards-aligned by default.

Every NexBridge interoperability engagement is delivered against documented HIPAA, ONC and TEFCA standards, with consultant-side controls, BAAs, and audit-ready documentation.

HIPAA-ready engagements
BAAs, role-based access, audit trail
ONC USCDI v3 alignment
Profile validation, CapabilityStatement
TEFCA-focused consulting
Common Agreement, QHIN onboarding
Encryption in transit & at rest
TLS 1.2+, KMS-managed keys
Documented data governance
Stewardship, lineage, consent
OAuth 2.0 / SMART scopes
Granular access for FHIR apps
Engagement Model

Three ways to work with us.

From a focused advisory sprint to a long-term managed interoperability practice.

01

Advisory Sprint

2-4 week assessment delivering target-state architecture and roadmap.

  • Interface census
  • Standards review
  • Sequencing plan
02

Build Engagement

Interface, FHIR or HIE build led by a senior integration team.

  • Bridges build
  • FHIR enablement
  • HIE onboarding
03

Managed Practice

Embedded interoperability team running and improving the data fabric.

  • Tier 1-3 support
  • Monitoring
  • Continuous improvement
Epic & Oracle Health expertiseNationwide consultant networkFHIR / HL7 specializationTEFCA-focused consultingHIPAA-ready engagementsRapid staffing responseInteroperability-first approach

Ready to modernize your healthcare data exchange?

From a single Bridges build to a multi-year TEFCA and FHIR program, start the conversation.