EHR / EMR Systems
Epic EHR Integration
Epic is the dominant electronic health record system in large US health systems and a growing presence in the UK and Europe. Integrating your product with Epic is often the single biggest unlock for selling healthcare software at scale — but it also has the steepest learning curve of any EHR. This guide covers how Epic integration actually works in practice: the FHIR R4 APIs, the SMART on FHIR launch and authorisation model, the App Orchard / Vendor Services distribution path, and the compliance posture you need before any real patient data flows.
How Epic integration works
Modern Epic integration is built on FHIR R4 secured by SMART on FHIR. Your app obtains an OAuth 2.0 access token scoped to the data and actions it needs, then reads and writes FHIR resources — Patient, Encounter, Observation, MedicationRequest, DocumentReference, and so on. Epic supports two launch contexts: provider-facing apps that launch inside Hyperspace/Hyperdrive with the clinician's context, and patient-facing apps that launch from MyChart. Older Epic deployments may still speak earlier FHIR versions (DSTU2/STU3) or rely on legacy HL7 v2 interfaces, so confirming the version and capability statement of the specific customer endpoint is step one of every project.
App Orchard, Vendor Services, and certification
Epic gates third-party integrations through its developer programs (historically App Orchard, now consolidated under Vendor Services and Showroom). Registering gives you sandbox access, documentation, and a path to listing your app so health systems can enable it. Production access to a given customer still requires that organisation to approve and configure your app, and write access typically faces more scrutiny than read-only. Budget time for this: the engineering against FHIR is often faster than the partnership, security review, and per-customer enablement that surround it.
Compliance and data handling
Epic integrations carry Protected Health Information, so HIPAA (US) and UK GDPR / NHS DSP Toolkit (UK) apply from the first sandbox token. You need a Business Associate Agreement with each covered entity, encryption in transit and at rest, least-privilege scopes, full audit logging, and careful control of where data — including anything sent to AI models — flows and is retained. Designing these controls in from the start is what lets you pass a health system's security questionnaire, which is frequently the real gate to go-live.
How to integrate with Epic
- 1
Register on Epic's developer program
Create an account on Epic's Vendor Services / developer portal to get sandbox credentials, FHIR documentation, and your client ID.
- 2
Confirm the endpoint's FHIR version & scopes
Read the customer endpoint's capability statement to confirm FHIR R4 support and which resources and SMART scopes are available.
- 3
Implement SMART on FHIR auth
Build the OAuth 2.0 / OpenID Connect launch flow (provider EHR launch or patient standalone launch) and handle token refresh and launch context.
- 4
Map and test FHIR resources
Map your data model to Epic's FHIR resources, then test reads and any writes against the sandbox with realistic data, validating against the right profile.
- 5
Complete security review & per-customer enablement
Sign the BAA, pass the health system's security review, and have each customer organisation approve and configure your app for production.
Common use cases
- Embedding an AI clinical copilot or scribe inside Epic with the clinician's patient context
- Reading problems, medications, and results to power triage or risk-stratification
- Writing structured notes or observations back into the chart after clinician sign-off
- Patient-facing apps launched from MyChart for intake, reminders, or education
Workflow example
Ambient AI scribe inside Epic
- Clinician launches the app from within Epic; SMART on FHIR passes the patient and encounter context.
- App reads the relevant FHIR resources (Encounter, Conditions, Medications) to ground the note.
- After the visit, the AI drafts a structured note; the clinician reviews and edits it.
- On sign-off, the app writes the note back as a FHIR DocumentReference into the patient's chart.
Frequently asked questions
Do I need to join Epic's App Orchard to integrate?
To build and distribute a third-party app, yes — you register through Epic's developer / Vendor Services program for sandbox access and documentation. Production access at a given site still requires that health system to approve and enable your app.
Does Epic support FHIR write-back?
Yes, for supported resources and with the right SMART scopes, apps can write data such as notes and observations back to Epic — subject to the EHR's safety checks, audit logging, and clinician sign-off. Write access typically faces more review than read-only.
Which FHIR version does Epic use?
Newer Epic deployments support FHIR R4, but some still expose DSTU2 or STU3. Always check the specific endpoint's capability statement, because the available resources and version vary by customer build.
Planning an Epic integration? We build FHIR R4 and SMART on FHIR apps that pass Epic and health-system security review. Book a discovery call to scope it.