You're building a HealthTech product and need to integrate with healthcare providers, and your enterprise prospect wants Epic integration. Your team is evaluating options: infrastructure platforms like Redox, aggregation services like Metriport and Particle Health, or building direct EHR/EMR integrations.
Each approach has distinct advantages and hidden complexities. Here's what you need to know to make the right decision for your business.
The Four Integration Approaches Explained
Infrastructure Platforms (Redox): Middleware layer that manages multiple EHR connections with custom routing, transformation, and business logic.
Aggregation Platforms (Metriport, Particle Health): Connect to multiple healthcare data sources through a unified API. Think "Plaid for healthcare data."
Direct Integration: Build connections directly to specific EHR systems (Epic, Cerner) using FHIR APIs and SMART-on-FHIR protocols.
Hybrid Approach: Combine multiple strategies based on specific use cases and requirements.
When to Choose Redox
Best for: Enterprise applications requiring complex data routing and transformation involving multiple EHRs.
Redox's strengths:
Infrastructure focus: Handles the complexity of managing multiple EHR connections
Custom transformation: Advanced data mapping and routing capabilities
Enterprise positioning: Built for large-scale healthcare organizations
Compliance infrastructure: HIPAA-compliant data processing and routing
Ideal use cases:
Health systems connecting multiple EHRs and applications
Enterprise software requiring complex data workflows
Applications needing custom business logic between systems
Organizations with dedicated healthcare IT teams
Implementation considerations:
Higher cost structure suited for enterprise budgets
Requires high technical sophistication to implement
More complex setup compared to pure aggregation platforms
Companies requiring infrastructure-level control over healthcare data routing
When to Choose Metriport
Best for: Patient data aggregation and comprehensive medical history retrieval.
Metriport's strengths:
Massive reach: Access to 300+ million patient records through CommonWell and Carequality networks
Data standardization: Automatic FHIR conversion and deduplication across sources
Open source option: Self-hosting available for compliance-sensitive organizations
Developer experience: Well-documented APIs with multi-language SDKs
Ideal use cases:
Care coordination platforms needing comprehensive patient histories
Chronic care management requiring data from multiple providers
Population health analytics with broad data requirements
Clinical decision support requiring historical context
Implementation considerations:
Primarily read-only access to patient data
3+ minute response times for comprehensive medical record summaries
Requires business relationships with HIE networks for self-hosting
Best suited for batch processing rather than real-time workflows
When to Choose Particle Health
Best for: Real-time clinical workflows and high-performance data access.
Particle Health's strengths:
Performance focus: Sub-second response times for clinical workflows
Real-time capabilities: Designed for point-of-care applications
Clinical workflow integration: Built specifically for active patient care scenarios
Established network: Strong relationships with major health systems
Ideal use cases:
Emergency medicine applications requiring immediate patient data
Telemedicine platforms needing real-time patient records during visits
Clinical decision support tools used during patient encounters
Urgent care workflows where speed is critical
Implementation considerations:
Higher costs per API call compared to other platforms
More restrictive on data usage and storage policies
Limited customization options for specialized use cases
Requires careful consideration of clinical workflow integration
When Direct Integration Makes Sense
Best for: Embedded EHR applications and specialized clinical workflows.
Direct integration advantages:
Deep embedding: Native integration within EHR-specific workflows
Bidirectional data flow: Write back clinical data, orders, and notes
Real-time collaboration: Immediate updates and provider-to-provider communication
Custom business logic: Full control over data processing and presentation
Ideal use cases:
SMART-on-FHIR apps that launch within EHR systems
Clinical documentation tools requiring write-back capabilities
Specialized medical devices needing real-time data exchange
Provider-facing applications requiring tight EHR integration
Implementation reality: Direct integration complexity often surprises engineering teams, you should expect:
Provider-specific customizations: Even Epic installations require institution-specific handling
Authentication complexity: Healthcare OAuth2 patterns beyond standard implementations
Monitoring challenges: Healthcare APIs fail silently in ways generic tools miss
Ongoing relationship management: Each provider requires separate business relationships
Platform Comparison Matrix
Platform | Best For | Data Access | Speed | Cost | Complexity |
|---|---|---|---|---|---|
Redox | Enterprise infrastructure | Read/Write | Fast | High | High |
Metriport | Broad aggregation | Read-only | Slow | Medium | Medium |
Particle Health | Real-time clinical | Read-only | Fast | High | Medium |
Direct Integration | Custom workflows | Read/Write | Variable | Variable | Very High |
Infrastructure platforms offer power but require expertise:
Complex setup and ongoing maintenance requirements
Higher cost structures designed for enterprise budgets
Need dedicated healthcare IT resources for optimal utilization
Aggregation platforms seem simple but have limitations:
Limited to read-only data access in most cases
Data freshness varies significantly by provider and network
Compliance requirements still apply to your application
Limited customization for specialized clinical workflows
Direct integration appears flexible but requires specialized expertise:
Healthcare-specific OAuth2 implementation patterns
Provider relationship management and certification processes
Custom monitoring for silent failure detection
HIPAA and SOC2 compliance implementation
What most teams underestimate: Regardless of approach, production healthcare integrations require ongoing operational overhead that scales with provider count and data volume.
Making the Right Choice for Your Business
Choose Redox if:
You're building enterprise-scale healthcare infrastructure
You need complex data routing and transformation capabilities
Your organization has dedicated healthcare IT expertise
Budget allows for premium infrastructure solutions
Choose Metriport if:
You need broad patient data aggregation
Historical medical records are more important than real-time access
Open source and self-hosting options appeal to your compliance team
Your use case fits their read-heavy data access patterns
Choose Particle Health if:
Speed and real-time access are critical to your clinical workflows
You're building point-of-care applications
You need proven performance for emergency or urgent care scenarios
Higher API costs are justified by your business model
Choose direct integration if:
You need bidirectional data exchange with EHR systems
Your application requires deep embedding within provider workflows
You're building provider-facing tools rather than patient-facing applications
You have the technical expertise and resources for ongoing provider relationship management
Consider a hybrid approach if:
Different features require different data access patterns
You want to minimize vendor risk across multiple integration types
Your business model justifies the increased complexity
Implementation Success Factors
Regardless of which approach you choose, success depends on:
Healthcare-specific expertise: Understanding FHIR, HIPAA, and provider relationship requirements that differ significantly from typical SaaS integrations.
Specialized monitoring: Healthcare integrations fail in unique ways that require domain-specific observability beyond generic APM tools.
Compliance architecture: HIPAA, SOC2, and other healthcare regulations affect every technical decision.
Provider relationship management: Even with platforms handling connections, some use cases require direct provider relationships and ongoing coordination.
The Bottom Line
There's no universally "best" choice. The right approach depends on your specific use cases, performance requirements, compliance needs, technical capabilities, and budget.
Many successful HealthTech companies end up using multiple approaches as they scale: infrastructure platforms for complex workflows, aggregation platforms for broad data access, direct integrations for specialized features, and hybrid patterns for different use cases.
The critical success factor isn't which technology you choose, but how well you implement and monitor it. Healthcare integrations have unique complexity that generic integration expertise doesn't address.
Planning your healthcare integration strategy? Whether you choose infrastructure platforms, aggregation services, direct integration, or a hybrid approach, implementation complexity and ongoing monitoring are critical success factors. Let's discuss which approach aligns with your specific use cases and help you avoid the common pitfalls that derail healthcare integration projects.