MedScrub integrates with Epic using both SMART on FHIR for clinician-launched workflows and Epic Backend Services for population-level data access. Patient records flow into MedScrub’s self-hosted clinical data repository, and reviewed clinical content writes back to the Epic chart as a FHIR DocumentReference.
Integration model
OAuth 2.0 client_credentials grant with RS384-signed JWT assertions, registered on Epic’s Vendor Services. MedScrub publishes a JWK Set URL (JKU) for public key rotation. Per-customer Client IDs are mapped to an Epic background user account for auditing. PHI flows from Epic into the proxy running on the customer’s infrastructure; de-identification happens before any request reaches 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 vendorservices.epic.com as a Backend Systems app with OAuth 2.0. Choose the FHIR resources required for the deployment.
02
Customer IT provides the Interconnect base URL, location identifiers, and document-type mappings, and maps the Client ID to an Epic background user account.
03
MedScrub validates against Epic’s Vendor Services sandbox before connecting to the customer’s TST environment, then production.
04
DocumentReference.Create is enabled for clinical notes. For richer write-back (encounter creation on the fly, In Basket routing), the HL7v2 Incoming Transcriptions interface is configured per customer.
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