the stuff that moves patient data around

Healthcare integration

Moving clinical data between systems that were never meant to talk: HL7v2, FHIR, Mirth Connect, message queues, and consent. I've built this kind of plumbing at Bridge Connector, 1Putt Health, and MedHook. These are the articles I wish someone had handed me on day one.

start here: 3-part series

HL7 & Mirth from zero

  1. Healthcare Integration For Beginners: HL7v25 min read
  2. Mirth Connect: Part 1 - Getting Started with 🐳 Docker6 min read
  3. Mirth Connect: Part 2 - Adding 🐰RabbitMQ5 min read

All 13 articles

  1. 10 min readDe-Identifying Clinical Notes for LLMs: Your Overall Recall Number Is LyingPHI redaction for LLMs: score recall per Safe Harbor identifier, gate MRN and SSN at 100%, and choose a date policy on purpose.
  2. 8 min readClaude Code for FHIR and HL7v2: The Agent Doesn't Get to Say DoneClaude Code can write FHIR and HL7v2 interface code. A verification loop decides done: FHIR Validator, replay diffs, terminology checks, PHI hooks.
  3. 9 min readSMART Backend Services for AI Agents: system/ Scopes Are God ModeSMART Backend Services gives an AI agent every patient the client policy allows. Borrow a clinician's token instead, and trace chart reads to a model run.
  4. 8 min readMirth Connect, what happened? Here's What Comes Next.Mirth democratized healthcare integration. Then NextGen acquired it, and the world moved on. What the next generation of integration tooling looks like, and why the transition was inevitable.
  5. 12 min readFHIR Meets Graph Databases: Exploring Healthcare's Natural Network StructureFHIR data is a graph. Treating it as flat tables is why most healthcare AI struggles with relationships between patients, providers, and encounters. What happens when you model it the way it actually is.
  6. 6 min read5 Reasons to Solve for Adoption Before Building Your Digital Health ToolClinicians love the idea but no one's buying. That gap is a pattern, and it almost never comes down to the technology. Five adoption problems to solve before you build the product.
  7. 4 min readCDS Hooks: What Nobody Tells You Before You BuildCDS Hooks look straightforward until you try to get them working in Epic. Six months of integration reality the documentation glosses over.
  8. 10 min readHIPAA Consent: What Engineers Actually Need to KnowHIPAA documentation runs to thousands of pages. What engineers building healthcare apps need to know, and what's compliance theater.
  9. 8 min readIngesting HL7v2 with ❄️ Snowflake Part 1Snowflake's flexible compute model makes it interesting for healthcare data warehousing. A walkthrough for ingesting HL7v2 messages into Snowflake: schemas, parsing, and getting clinical data into a structure you can query.
  10. 7 min readHL7v2 Healthcare Integrations with 🫏 MulesoftThe MuleSoft Accelerator promises a unified patient view across EHRs using FHIR and HL7v2 integrations. What that looks like in practice, where it delivers, and where you'll spend your consulting budget.
  11. 11 min readHow to ingest HL7v2 Messages into Google CloudHL7v2 arrives over MLLP. Google Cloud Healthcare API converts it to FHIR. A complete walkthrough for capturing healthcare messages in Google Cloud, from DICOM stores to Pub/Sub triggers.
  12. 5 min readMirth Connect: Part 2 - Adding 🐰RabbitMQMirth Connect handles the transform. RabbitMQ handles the delivery. Together they make healthcare integrations durable and survivable when downstream systems go down. How to wire them up.
  13. 6 min readMirth Connect: Part 1 - Getting Started with 🐳 DockerMirth Connect is how most healthcare orgs still move HL7v2 messages. Setup from scratch: configuring channels, parsing message types, sending and receiving messages without losing your mind.

Common questions

How do you de-identify clinical notes before sending them to an LLM?

Layer your detectors: label-aware patterns, then NER, then a trained model. Score recall for each identifier type separately, fail the build when a structured identifier like MRN or SSN drops below 100%, and decide how to handle dates on purpose.

Does Presidio detect medical record numbers?

The current Presidio supported-entities list includes healthcare US recognizers such as NPI, MBI and health insurance member ID, but no generic medical record number entity. You write the MRN recognizer yourself, ideally a label-aware pattern, and pin the Presidio version in your benchmark.

Is date shifting allowed under HIPAA Safe Harbor?

Safe Harbor allows no date element except the year, and that includes lab report dates. The HHS guidance never endorses per-patient date shifting, so the article treats date-shifted notes as an Expert Determination question, though HHS does not state this outright.

Can I hash patient identifiers to make de-identification tokens?

Not under Safe Harbor. Re-identification codes must not be derived from patient information, and HHS says a hash with no secret key counts as an identifying code, so use random tokens and keep the map on your side. Keyed hashes can be disclosed under Expert Determination if an expert approves and the keys stay private.