How Phrazer/Kitsune EMR Interchange Works


Phrazer/Kitsune EMR Interchange 

Phrazer/Kitsune facilitates easy, fast, and secure exchange of patient health data that powers CITE use cases, improving healthcare. A single connection to the secure exchange engine enables interoperation with EHRs and Phrazer/Kitsune. Data flow is managed across Phrazer/Kitsune, the exchange engine, and a health system. Those are the three places data is processed and stored within our programs.


Phrazer/Kitsune to the Exchange Engine

Phrazer/Kitsune code for all EMR exchange use cases is pre-connect to the Exchange Engine via an HTTPS webhook. The Exchange Engine sends messages to Phrazer/Kitsune’s callback URL and receive messages and queries. Phrazer/Kitsune and the Exchange Engine use standard JSON data models that represent a wide variety of patient-centric data. When data exchanges send to an endpoint, it includes a Phrazer/Kitsune encryption token in the message headers. In the event of a transmission error, the Exchange Engine automatically retries a number of times before throwing an error alert notifying Phrazer/Kitsune for escalation path and an on-call engineer to investigate further.


The Exchange Engine

Messages go through three stages of transformation to standardize into JSON specifications. First, messages are parsed according to type (HL7 v2, CCD, Custom API, etc.). Secondly, they are configured for Phrazer/Kitsune specific specifications. Finally, they are configured for the health-system-level workflow customizations that can affect these messages. At this stage, field-level filters can be applied before messages are routed to their proper destination and transmitted in the specified format.


Health System to the Exchange Engine 

Integration with health systems start by identifying the most efficient integration strategy for their unique EHR implementation. For HL7 integrations, we most commonly maintain a secure VPN tunnel for MLLP traffic. HL7 messages originating in the EHR are normally routed through an on-premise interface engine already in use in the health system before being pushed to the VPN. Conversely, the Exchange Engine pushes HL7 messages back to the EHR through this infrastructure as well. When HL7 isn’t used we work with health systems to connect to EHR-vendor-custom APIs as well as supporting DIRECT protocol.

The bottom line here is that the Exchange Engine handles the mapping and configuration of messages, making it easy and lightweight for IT teams to work with it.


Data Translation

Data consumed from an external source is transformed into our normalized data models. Although our standard system uses an HL7v2 message which is transformed into JSON, please note that a variety of other standards such as CDA, FHIR, X12, and Web Services can be both consumed and produced.  Data is safely, efficiently, accurately and seamlessly entered by patients.