Sutura - HIPAA-Compliant Patient Data Hub over HL7 and FHIR

Dashboard, interface monitor, patient search, the unified patient record with 7 tabs, and the potential duplicates queue with side-by-side pair review.

The demo record joins Epic, Oracle Health, athenahealth, Quest, Sectra PACS and the state HIE. Every item carries a source chip and opens a provenance panel with its local and standard code.

A production replay needs a second approver who is not the requester, and merging twin or newborn records waits for a second reviewer. Every merge and replay needs a reason.

12 sources over HL7 v2, FHIR R4, C-CDA and HIE query, 6 alerts, 18 synthetic patients, 20 coded clinical items and 12 duplicate tasks.

Feeds That Fail Silently

ADT, results, orders, documents, scheduling and immunization feeds arrive as HL7 v2 over MLLP, alongside FHIR R4 pulls and HIE queries. With no shared view, a silent interface or a burst of unmapped codes went unnoticed until a result was missing on the ward.

No National Patient Identifier

The US has no national patient id, so matching relies on demographics and local MRNs. A wrong merge puts one person's results in another's chart, so uncertain pairs need a person, and twins and newborns need extra care.

Sensitive Data With Its Own Rules

Substance use disorder records are protected by 42 CFR Part 2, and state laws add rules for HIV, mental health, genetic testing, minors and reproductive health. These records had been kept out of the shared record because there was no safe way to segment them.

Access That Must Be Explained

The HIPAA Security Rule expects access controls, emergency access procedures and audit controls, and the Cures Act limits withholding data without a recognised exception. The privacy office could not produce one access report for a patient across systems.