> ## Documentation Index
> Fetch the complete documentation index at: https://docs.hana.health/llms.txt
> Use this file to discover all available pages before exploring further.
# EHR Integration
> Connect HANA to Electronic Health Record systems via direct API or middleware partners. Bidirectional data flow — read patient context, write clinical notes back.
## How EHR Integration Works
HANA's clinical value depends on being part of the care record, not separate from it. The integration model is bidirectional:
1. **Read** → HANA pulls patient context (demographics, diagnoses, medications, care plans) to inform the reasoning engine before each interaction
2. **Write-back** → After engagement, HANA pushes structured clinical notes, tasks, and flags directly into the patient chart
This closed loop is what makes HANA infrastructure rather than another disconnected tool.
```
┌─────────────┐ Read ┌─────────────┐ Engage ┌─────────────┐
│ EHR │ ────────────→ │ HANA │ ────────────→ │ Patient │
│ │ ←──────────── │ Reasoning │ ←──────────── │ │
└─────────────┘ Write-back └─────────────┘ Respond └─────────────┘
```
***
## Integration Paths
HANA supports three integration approaches, depending on your EHR and technical requirements:
### 1. Direct API Integration
For EHR systems with open APIs. Lowest latency, most control.
| EHR | Integration Status | Setup Time | Notes |
| ----------------- | ------------------ | ---------- | ------------------------- |
| PracticeQ | ✅ Live | 1-2 weeks | Direct API, bidirectional |
| Charma | ✅ Live | 1-2 weeks | Direct API, bidirectional |
| Custom / In-House | ✅ Supported | 2-4 weeks | Via HANA REST API |
**How it works:**
```
Your EHR API ←→ HANA Connector ←→ HANA Reasoning Engine
```
HANA maintains pre-built connectors for supported EHRs. For systems with standard REST/FHIR APIs, we build custom connectors during onboarding.
### 2. Integration Middleware (Redox, Keragon)
For EHR systems without open APIs, or when you need a standard interoperability layer. The breadth of EHR connectivity here comes from our middleware partners — Redox and Keragon maintain pre-built connections to hundreds of EHR systems, and HANA integrates through their platforms.
| Middleware | EHRs Supported | Setup Time | Notes |
| ---------- | -------------------------------------------- | ---------- | -------------------------------------------------- |
| Redox | Athena, Epic, Cerner, 200+ via Redox network | 2-4 weeks | HL7 FHIR, production-ready |
| Keragon | Multiple EU/US EHRs via Keragon platform | 2-4 weeks | Healthcare automation platform with EHR connectors |
**How it works:**
```
Your EHR ←→ Redox/Keragon ←→ HANA Connector ←→ HANA Reasoning Engine
```
Middleware platforms carry their own licensing costs. Redox typically charges a platform fee + per-connector fees. Keragon has its own pricing model. HANA works with your existing middleware subscription if you have one, or we can help you get set up.
### 3. HANA Dashboard (No EHR Required)
For organizations without an EHR, or with legacy systems that don't support integration.
HANA provides a lightweight clinical dashboard where care teams can:
* View patient engagement status and history
* Review clinical notes and tasks
* Manage agent configurations
* Export data as CSV or via API
```
HANA Dashboard (web) ←→ HANA Reasoning Engine ←→ Patient
```
This is the fastest path to deployment (typically 1 week) and is commonly used by:
* Small practices without modern EHR systems
* Pilot deployments before full EHR integration
* Platform partners building their own UI
***
## Data Flow Specification
### Inbound Data (EHR → HANA)
Data HANA reads from your system to inform the reasoning engine:
```json theme={null}
{
"patient": {
"id": "P-12345",
"demographics": {
"name": "Maria Garcia",
"age": 58,
"language": "en",
"timezone": "America/New_York"
},
"clinical": {
"diagnoses": [
{"code": "E11.9", "description": "Type 2 diabetes", "onset": "2020-03-15"}
],
"medications": [
{"name": "Metformin", "dose": "500mg", "frequency": "2x daily", "start": "2020-04-01"}
],
"allergies": ["penicillin"],
"vitals": {
"last_bp": "138/88",
"last_glucose": 142,
"recorded_at": "2026-01-28T09:00:00Z"
}
},
"care_plan": {
"active_goals": ["improve_medication_adherence", "reduce_hba1c"],
"upcoming_appointments": [
{"date": "2026-02-15", "provider": "Dr. Chen", "type": "follow_up"}
]
},
"engagement_history": {
"last_contact": "2026-02-01",
"preferred_channel": "voice",
"preferred_time": "morning"
}
}
}
```
### Outbound Data (HANA → EHR)
After each engagement, HANA writes back:
```json theme={null}
{
"engagement_id": "eng_abc123",
"patient_id": "P-12345",
"timestamp": "2026-02-08T10:08:30Z",
"clinical_note": {
"format": "fhir_document_reference",
"narrative": "Patient reports taking metformin approximately 4 of 7 days this week. Primary barrier identified as cost — recent insurance change increased copay. Mild nausea reported but considered tolerable by patient. No additional side effects. Mood and sleep stable. Recommended: review copay assistance programs.",
"structured": {
"medication_adherence": {
"metformin": {"reported_days": 4, "prescribed_days": 7, "rate": 0.57}
},
"barriers": [{"type": "cost", "detail": "Insurance copay increase"}],
"side_effects": [{"medication": "metformin", "effect": "mild_nausea", "severity": "low"}],
"mood": "stable",
"sdoh_flags": ["insurance_change"]
}
},
"tasks": [
{
"type": "review_medication_assistance",
"priority": "medium",
"assigned_to_role": "care_manager",
"reason": "Cost barrier to medication adherence"
}
],
"risk_level": "low",
"next_engagement": "2026-02-15T10:00:00Z"
}
```
***
## FHIR Support
HANA supports HL7 FHIR R4 for structured data exchange. Clinical notes are formatted as FHIR `DocumentReference` resources:
```json theme={null}
{
"resourceType": "DocumentReference",
"status": "current",
"type": {
"coding": [{
"system": "http://loinc.org",
"code": "11488-4",
"display": "Consult note"
}]
},
"subject": {
"reference": "Patient/P-12345"
},
"date": "2026-02-08T10:08:30Z",
"content": [{
"attachment": {
"contentType": "text/plain",
"data": "base64-encoded-clinical-note"
}
}]
}
```
FHIR resources supported for read/write:
* `Patient` — demographics, contact
* `Condition` — active diagnoses
* `MedicationStatement` — current medications
* `DocumentReference` — clinical notes (write-back)
* `Task` — clinical follow-up tasks
* `Flag` — risk alerts
***
## Integration Checklist
Use this checklist when planning your EHR integration:
What EHR does the organization use? Does it have an open API? Is Redox/Keragon already in use?
Which patient data fields should HANA read? What should HANA write back? Map the specific fields.
Set up API keys or OAuth credentials for the EHR connection. Define user/service account permissions.
Use HANA's sandbox environment with synthetic patient data. Verify read/write operations end-to-end.
Have clinical staff review sample write-back notes. Confirm escalation pathways trigger correctly.
Deploy to pilot cohort. Monitor data flow, note quality, and any integration errors for the first 2 weeks.
***
## Troubleshooting
| Issue | Likely Cause | Resolution |
| ------------------------------------- | ------------------------------- | ----------------------------------------------------------------- |
| Write-back notes not appearing in EHR | Incorrect document type mapping | Verify FHIR resource type matches your EHR's expected format |
| Patient data stale | Sync frequency too low | Configure real-time or near-real-time data polling |
| Connection timeout | EHR rate limits | Implement backoff; contact EHR vendor for rate limit increase |
| Missing medications in context | API permissions | Ensure HANA service account has read access to medication records |
Deploy HANA under your own brand with HANA Connect.