EMR Integration Overview

Ward integrates with EMR systems to synchronize patient data and clinical documentation.

Data Flows

Inbound (EMR → Ward)

Data Type	Method	Trigger
Patient census	HL7 ADT	Admit/discharge/transfer
Observation levels	FHIR Order	Physician order change

ADT Messages: A01/A04 (admit/register), A02/A12 (transfer, cancel transfer), A03 (discharge), A06/A07 (change to inpatient/outpatient), A08 (update), A11/A13 (cancel admit/discharge), and A40 (merge). Cancels and merges are handled, and unmatched non-create events are parked for review.

Outbound (Ward → EMR)

Data Type	Method	Frequency
1:1 rounds	FHIR DocumentReference	Real-time
Vital signs	FHIR Observation	Real-time
Assessments	FHIR Observation	Real-time

Data syncs within minutes of documentation in Ward. See Code Mapping for the codes and per-vendor write acceptance.

Configuration

Configure EMR integration at Management → Integrations → Config tab.

Required Settings

Setting	Description
EMR Type	Epic, Cerner, MEDITECH, Netsmart, Alleva, or Custom
FHIR Base URL	EMR's FHIR R4 endpoint
Auth URL	OAuth2 token endpoint
Client ID	OAuth2 client identifier
Auth method	client_secret (sandboxes) or private_key_jwt (production). The matching credential (client secret or signing key) is loaded into Vault, not stored in config

Optional Settings

Setting	Description
Scopes	Required OAuth2 scopes
HL7 Version	2.4, 2.5, or 2.5.1
SMART Launch URL	For patient context launch

Ward is R4-only; the connection test confirms R4 from the server's CapabilityStatement.

Patient Matching

Ward matches patients between systems using:

Method	Fields
MRN only	Medical Record Number
MRN + DOB	MRN and Date of Birth

Configure the matching method based on your facility's policies. MRN + DOB refuses a match unless the date of birth also agrees, so it never falls back to a single-factor match.

Testing the Connection

1. Navigate to Management → Integrations
2. On the Status tab, tap Test Connection
3. Ward attempts to:
   • Authenticate with your EMR
   • Verify FHIR endpoint accessibility
   • Check required permissions
4. Results show:
   • FHIR version
   • Available resources
   • Permission status

Monitoring

Status Tab

View real-time connection status:

• Connected - Integration working normally
• Degraded - Some sync failures occurring
• Not Connected - Integration not configured
• Token Expired - Re-authentication needed

Sync Statistics

Track sync health:

• Total syncs
• Successful syncs
• Failed syncs
• Pending syncs

Sync Log

View individual sync events:

1. Navigate to Sync Log tab
2. Filter by:
   • All / Failed Only
   • Date range
3. See sync details:
   • Timestamp
   • Data type
   • Status
   • Error message (if failed)

Retrying Failed Syncs

Failed syncs retry automatically. To manually retry:

1. Find the failed sync in the log
2. Tap Retry
3. Monitor for success

ADT Log

View incoming ADT messages:

1. Navigate to ADT Log tab
2. See received messages:
   • Timestamp
   • Message type (A01, A02, A03, and the other handled ADT events)
   • Patient identifier
   • Processing status

Security

EMR credentials are:

• Encrypted at rest
• Never logged or displayed
• Transmitted only over HTTPS
• Stored encrypted in the database

See Security for details.