MedScrub connects to athenahealth’s published FHIR R4 endpoint using a 2-legged OAuth flow with JWK-based client authentication. The athenahealth global FHIR endpoint serves patient data across practices, and Changed Data Subscriptions support incremental sync into MedScrub’s clinical data repository.
Integration model
OAuth 2.0 client_credentials with an RS384-signed JWT assertion, validated against MedScrub’s published JWK Set. MedScrub supports both the Preview and Production environments. Patient data flows into the customer-hosted proxy; PHI is de-identified before any request to a large language model.
Capabilities
MedScrub pulls the patient record from the EHR before the appointment and surfaces care gaps, screening recommendations, and overdue chronic-disease milestones for the loaded patient.
Drafts a structured SOAP note from the patient chart, with ICD-10 coding and E/M level analysis. After physician review and sign-off, the note writes back to the EHR as a FHIR DocumentReference.
Runs HEDIS / USPSTF / MIPS quality-measure gap analysis across patient panels — breast, cervical, colorectal, diabetes, blood pressure, and depression screening.
Batch pre-visit intelligence for the full clinic day, run overnight against the CDR, with delivery to mobile.
Automates payer chart-request response by searching the longitudinal record for measure-specific evidence.
Drafts prior-auth requests and denial appeals grounded in the patient chart, including evidence pulled from prior diagnostic reports and procedures.
Monthly chronic care management documentation for CPT 99490 / 99491 billing, generated from the longitudinal record.
2021-AMA MDM framework analysis flags under-coding opportunities with revenue-at-risk surfaced in the UI.
Data scope
Setup
01
Register MedScrub on the athenahealth developer portal and obtain a Client ID for the Preview environment.
02
MedScrub publishes a JWK Set URL (JWKS URI). athenahealth fetches the public key for JWT validation during the OAuth flow.
03
Required FHIR scopes (Patient.read, Condition.read, Observation.read, Procedure.read, Encounter.read, and additional scopes when available) are approved by athenahealth for the production tenant.
04
For high-volume practices, MedScrub configures Changed Data Subscriptions for incremental sync — appointments, patients, problems, lab results, and medications.