Connecting something to Epic happens through a small set of supported channels: HL7v2 interfaces managed inside Epic's Bridges interface engine, FHIR-based APIs for app-level access, and Epic's developer program for third-party apps, best known as App Orchard. None of those channels are something an outside vendor just plugs into. Every one of them runs through a health system's own Epic-certified analysts, which is usually where an integration project actually slows down, not the technical build itself.
HL7v2 interfaces are the oldest and still the most common path for high-volume clinical data: admissions, discharges, transfers, orders, and results. Epic's own interface engine, Bridges, is what a health system's IT team uses to configure and run these feeds. If you've heard someone on the hospital side mention an 'interface build,' this is almost always what they mean.
FHIR-based APIs are the newer, more app-friendly path. Epic supports SMART on FHIR for launching apps against structured resources like Patient, Appointment, Observation, and DocumentReference, plus Bulk FHIR for pulling data at the population level rather than one patient at a time. This is the layer most new integration work gets built against today.
App Orchard is Epic's own developer program for getting a third-party app registered, tested against sandbox data, reviewed, and eventually installed in a live Epic instance. It sits on top of the FHIR APIs rather than replacing them, it's the business and approval process around using them commercially, not a separate technical interface.
A couple of Epic-specific names show up often in searches without being integration paths at all, Epic Cosmos is a research database built from de-identified data across Epic organizations, and modules like Beacon (oncology) and Cupid (cardiology) are clinical workflow tools, not connection points. Worth knowing so you don't chase the wrong term.
Epic's FHIR APIs are genuinely documented and genuinely modern. That's not the part that slows projects down. The part that does: getting a specific health system's own analysts to approve the connection, provision credentials for their live instance, and schedule the testing window, on top of whatever Epic-level review the app itself needs to pass first.
That means the useful question usually isn't 'does Epic support this,' it almost always does in some form, but 'what's the fastest path to a working connection for this specific health system, through the channel they'll actually sign off on.' That's a different scoping conversation for a community hospital running a lean IT team than for a large academic system with its own integration department.
Once a health system grants API access for a specific workflow, we build the logic that checks referral or order status automatically and pushes an update to the referring office, instead of someone calling in to ask.
A discharge or a result landing in Epic can trigger an HL7 event most interface engines already support. We build what happens next, routing that event to a CRM, a post-acute partner, or a reporting pipeline, through the interface the health system already runs.
Tell us what access you've got and what you're trying to move, and we'll tell you honestly what's realistic to build with it.
Describe what needs to move in or out of Epic and who you're coordinating with on the hospital side, and we'll help you figure out whether that's an HL7 interface, a FHIR call, or an App Orchard build before you spend months guessing. Epic is one system in a much bigger stack for most of the organizations we work with, so if the bigger bottleneck sits somewhere else, bring that instead.
Let's talk →Both exist and serve different purposes. HL7v2 interfaces, run through Epic's Bridges engine, still carry most high-volume clinical messaging. FHIR-based APIs are the newer, app-oriented layer and are what most new integration work targets now.
The FHIR API is the technical interface, the actual endpoints and data resources. App Orchard is Epic's developer program and approval process for getting a third-party app built on that API registered, reviewed, and installed at a given health system.
No. Cosmos is a research database built from de-identified clinical data pooled across participating Epic organizations. It's used for research and benchmarking, not for building or connecting a live integration to a specific health system's Epic instance.
They're specialty clinical workflow modules built on the same underlying Epic record, Beacon for oncology, Cupid for cardiology, Healthy Planet for population health management. They're part of what a health system runs, not a separate integration path into Epic.
Not on their own. Every integration path into Epic, HL7, FHIR, or an App Orchard-listed app, ultimately requires sign-off and provisioning from that specific health system's own IT or Epic-certified team. There's no self-serve way around that step.