We build integrations around Epic, get Epic on FHIR apps registered and tested, and place interface, reporting and application analysts with health systems. Nobody touches an Epic system until we've confirmed the access agreements Epic requires are in place.
Agreement with Epic via Application for Access, per customer
release watch
Agent Factory15 Sep 2026
Art, Emmie and Penny
connects with
in short·15-second read
Cohash works around Epic for health systems.
We build HL7 and FHIR integrations, register and test apps on Epic on FHIR with SMART on FHIR and OAuth 2.0, support TEFCA exchange through Epic Nexus, and staff interface, reporting and application analysts. Epic requires consultants who aren't customer employees to have an agreement with Epic, one request per customer, so we arrange that first.
you probably need this if
A vendor app wants broad FHIR scopes and security wants to know why.
The interface team is stretched thin through an Epic upgrade.
Consultants are waiting for Epic access because nobody filed the Application for Access.
15 Sep 2026Agent Factory A platform where health systems build their own AI agents, then monitor and evaluate them. Epic showed it off at a build-a-thon. source ↗
today · Oct 22, 2026
no date yetArt, Emmie and PennyEpic's built-in AI goes by name. Clinicians get Art and patients get Emmie. Penny is the one for revenue cycle and operations.source ↗
no date yetEpic Nexus as a QHINEpic Nexus now appears on TEFCA's list of designated Qualified Health Information Networks.source ↗
no date yetThird-party access agreementsConsultants who aren't employees of an Epic customer need an agreement with Epic, arranged through an Application for Access, one request per customer.source ↗
the story · epic estate
From the first call to a setup your own team can run.
Here's what usually prompts a call about your Epic estate, what we do about it and in which order, and where you end up.
01 · where it hurts02 · what we change03 · how it runs04 · where you end up
incident board · epic estate3 open
openA vendor app wants broad FHIR scopes and security wants to know why.
recurringThe interface team is stretched thin through an Epic upgrade.
blockedConsultants are waiting for Epic access because nobody filed the Application for Access.
exposure
Epic on FHIR app integrationInterface work around EpicReporting and data feedsTEFCA and payer exchangeAI workflow reviewAnalyst staffing
Epic
startrehearsehandover
Access and agreements first
Interface and app inventory
Build and sandbox testing
Release regression and…
we are here
ready to hand over
We tie every scope to a feature and get security to sign the list.
Once we've tested the interfaces, the upgrade goes ahead.
Access plan per role, with the Epic Application for Access filed per customer
Interface inventory with owner, message spec and failure handling
chapter 01 · where it hurts
Why teams reach out
A vendor app wants broad FHIR scopes and security wants to know why.
The interface team is stretched thin through an Epic upgrade.
Consultants are waiting for Epic access because nobody filed the Application for Access.
chapter 02 · what we change
How we solve it
Epic on FHIR app integration
Interface work around Epic
Reporting and data feeds
TEFCA and payer exchange
AI workflow review
Analyst staffing
chapter 03 · how it runs
Our approach
Access and agreements first
Interface and app inventory
Build and sandbox testing
Release regression and handover
chapter 04 · where you end up
What changes
We tie every scope to a feature and get security to sign the list.
Once we've tested the interfaces, the upgrade goes ahead.
Access plan per role, with the Epic Application for Access filed per customer
Interface inventory with owner, message spec and failure handling
what we do
Our Epic work
6 kinds of Epic work, each run by engineers who have done it on live tenants.
Apps registered on Epic on FHIR, scopes kept to what each app needs, SMART on FHIR launch or backend OAuth 2.0 configured and tested in Epic's sandbox before production.
HL7 v2 and FHIR interfaces between Epic and labs, imaging, billing and third-party systems, with an owner, message spec and failure handling per interface.
Reporting extracts and data feeds from Epic into Snowflake, Databricks or Microsoft Fabric, built with the health system's Epic reporting team.
Data exchange through Epic Nexus, a designated QHIN, and the payer-facing feeds behind the CMS-0057-F APIs.
Review rules, baselines and evaluation cases for Epic AI such as Art, Emmie and Penny, and for agents built in Agent Factory.
Interface, reporting and application analysts for health systems, placed only where the customer and Epic's agreements allow the access the role needs.
capability 01 / 06in production
Epic
Epic on FHIR app integration
Apps registered on Epic on FHIR, scopes kept to what each app needs, SMART on FHIR launch or backend OAuth 2.0 configured and tested in Epic's sandbox before production.
HL7 v2 and FHIR interfaces between Epic and labs, imaging, billing and third-party systems, with an owner, message spec and failure handling per interface.
Interface, reporting and application analysts for health systems, placed only where the customer and Epic's agreements allow the access the role needs.
We pieced these together from Epic situations that come up a lot. They're patterns. You won't find a specific client in them.
case file 01
A vendor app asking for broad FHIR scopes
composite · not a client story
Beforethe situation
A care coordination vendor wants Epic data and has asked for broad patient-level FHIR scopes. Security wants a reason for each scope and a test plan before production.
What we dothe work
We take the vendor app feature by feature, work out which FHIR resources each one needs and cut the scope list down to that. Testing happens in Epic's sandbox first, then in the health system's non-production environment, and we check the audit logging as we go.
Afterwhere you end up
We tie every scope to a feature and get security to sign the list. That's what the app goes live with.
case file 02
Interface backlog during an Epic upgrade
composite · not a client story
Beforethe situation
An Epic upgrade is scheduled and the interface team also owns a backlog of lab and imaging changes. Two analysts are on leave, and contractors can't start until Epic access is sorted.
What we dothe work
We file the Application for Access with Epic for that customer before anything else, because nothing moves without it. Interface analysts then start in roles the client's policies allow. Regression runs against the upgrade in non-production, and the lab and imaging backlog is sequenced around the upgrade date.
Afterwhere you end up
Once we've tested the interfaces, the upgrade goes ahead. Contractors are on proper Epic agreements.
We don't start a step until the last one has produced something you can check.
step 01
Access and agreements first
Before anything else we sort out access. That means working out which roles really need Epic, filing the Application for Access with Epic for that customer and agreeing with the client where each person will sit.
step 02
Interface and app inventory
We list the HL7 interfaces, FHIR apps, scopes and reporting extracts. Nothing goes on it without an owner and a spec.
step 03
Build and sandbox testing
Apps we build against Epic on FHIR, and we test them in the sandbox. Interfaces get their testing in the client's non-production environments instead.
step 04
Release regression and handover
Every quarterly release gets a regression run on the interfaces and apps. The specs, runbooks and scope justifications are yours to keep after we've gone.
ai on epic
Where AI fits on Epic, and where it needs guardrails.
Epic's AI lives inside the EHR. Emmie is for patients, Art for clinicians and Penny for revenue cycle and operations. Agent Factory is separate. It's Epic's platform for health systems to build their own agents, then monitor and evaluate them. Early-adopter training starts in October 2026. For us, as engineers, most of the work is governance and testing, plus the integration around it.
AI agentasks for data or an action
Scoped identityonly the access it needs
MCP serverthe one door into the platform
Logged, approveda person signs off on writes
EpicEpicdoes the work
Epic doesn't currently publish an official MCP server, so outside agents should call Epic on FHIR APIs through a registered app, with SMART on FHIR backend or user-launched OAuth 2.0 and the narrowest scopes. For us that also means full audit logging. Nothing gets written to the chart until a person signs off.
Art for clinicians
Art is Epic's AI for clinicians, covering charting and documentation like drafted notes. Switching it on is Epic configuration work for your analysts. For us the job is setting review rules with clinical leaders and tracking which drafted content clinicians edit or reject.
Emmie and Penny
Emmie is Epic's AI for patients and Penny covers revenue cycle and operations. They run inside Epic, so for us the work is choosing use cases and agreeing what staff review. After that we check results against your own baseline for messages, denials or prior authorizations.
Agent Factory
Epic describes Agent Factory as its platform for health systems to build, monitor and evaluate AI agents. Training for the first early adopters begins in October 2026, and broader availability is planned for 2027. For us the work is picking a first agent, writing its evaluation cases and defining human review.
Agents outside Epic
Agents built outside Epic come in through Epic on FHIR APIs, with SMART on FHIR and OAuth 2.0. For us that means registering the app, asking for only the scopes it needs and testing in Epic's sandbox before production.
How outside systems reach Epic, and under what controls
Outside apps come in through Epic on FHIR and see only what their OAuth 2.0 scopes allow. Everything else talks HL7 through the interface engine. TEFCA traffic goes through Epic Nexus, and reporting extracts end up on the data platform.
01 · Outside systems
Third-party appsSMART on FHIR · backend → Epic on FHIR · FHIR calls
These are working documents, written against your configuration, so your team can run them without us.
plan01
Access plan per role, with the Epic Application for Access filed per customer
yours to keep
inventory02
Interface inventory with owner, message spec and failure handling
yours to keep
inventory03
FHIR app register with scopes and the reason for each
yours to keep
tests04
Quarterly release regression pack for interfaces and apps
yours to keep
report05
Evaluation cases and review rules for Epic AI or Agent Factory agents
yours to keep
talent and delivery · epic
Certified engineers, wherever you need them.
Some clients want a project team, some want a couple of engineers on theirs. Either works. Onsite, nearshore or offshore, with handovers across time zones that keep things moving.
Onsite
Engineers at your sites in the US
Nearshore
Overlapping hours with US teams
Offshore
Overnight progress on your backlog
All time zones
Coverage handed over across time zones
24-hour coverage · US Central time
OnsiteUS business hours
Nearshoreoverlapping US hours
Offshoreovernight progress
Combinedhandover, not hand-off
00:0006:0012:0018:0000:00
roles we staff
Epic Bridges interface analyst
Epic Clarity and Caboodle report writer
Epic application analyst
Epic on FHIR integration developer
HL7 and FHIR interface engineer
due diligence · epic
Questions to ask any partner, including us.
Put these to anyone bidding on your Epic work. The ones who've done it answer differently from the ones who've read about it.
Q1
Has your firm filed an Application for Access with Epic for our organization?
Epic requires an agreement for any consultant who isn't a customer employee, and it's one request per customer. Until that's in place, nobody from the firm should be logging in.
Q2
Where will each consultant actually sit, and does our Epic agreement allow that?
Epic and each customer control access to Epic software and screens. Location assumptions need checking against your policies and Epic's agreements.
Q3
Which FHIR scopes does each app need, and why?
Broad scopes hand an app more patient data than it needs. Security should be signing a list where each scope sits next to the feature that uses it.
Q4
How will interfaces be retested on each quarterly release?
Epic ships quarterly. Interfaces tested only at go-live drift out of step with later releases.
Q5
What evaluation cases will an Agent Factory agent pass before it goes live?
Epic says Agent Factory lets health systems build agents, then monitor and evaluate them. The use cases themselves should come from your clinical leaders.
01Can your consultants work in our Epic system?
Only with the right agreement in place. Epic's rule is that anyone who isn't a direct employee, medical staff member or student of an Epic customer needs an agreement with Epic before logging in to that customer's Epic system, or even looking at Epic screens. The paperwork is an Application for Access, and a firm files one request per customer. Ours goes in before anyone's first day.
02Are your Epic analysts certified?
It comes from Epic, for customer staff and for consultants working under Epic's agreements. We place certified analysts where the client's access arrangements allow it. Nobody gets introduced as Epic-certified on our say-so.
03Can Epic work be done offshore?
Don't assume it can. Epic and each customer decide who may access Epic software, screens and documentation, and from where, and Epic's public contact page doesn't publish a general rule allowing offshore work. We staff Epic roles onsite or remote in the US unless the customer's policies and Epic's agreements clearly allow otherwise.
04What can you build without logging in to Epic?
Up to a point. You can build an Epic on FHIR app against Epic's public sandbox, and open.epic lists more than 1,000 API and interface specifications to work from. Production access still has to come through the customer.
05How often does Epic release?
Epic releases quarterly, but your organization picks when each release goes in. Our interface and app regression testing is scheduled back from that date.
06Do you also work on Oracle Health or InterSystems?
We do. A lot of health systems run HealthShare or Health Connect next to Epic. Some run Oracle Health at other facilities too, and we have a separate page for each.
services
Related services
Projects on Epic usually end up touching one of these, so they're worth a look.
