Most healthcare integrations fail—not because the technology is flawed, but because the assumptions were wrong from the start.
Integration has become the backbone of healthcare operations—connecting patient data, care delivery, scheduling, and revenue cycle management into a single ecosystem. But when integrations are built on shaky foundations, they create more friction than value.
During the Beyond the EHR webinar, Provisions Group’s technical experts and healthcare leaders unpacked why so many integration projects fall short—and how to build smarter, more sustainable systems that actually scale.
Middleware sits at the heart of every integration, but not all middleware is built to support long-term growth.
As Tim Sinard, Sr. Salesforce Architect at Provisions Group, shared, “Organizations sometimes try to avoid middleware and go point-to-point. That means your CRM calls directly into your EHR—and it causes massive scalability problems.”
Choosing middleware should never be a budget-based decision. Some tools charge per endpoint, others limit API calls, and many “drag-and-drop” platforms simplify the interface at the cost of capability.
Avoid it: Evaluate middleware based on long-term architecture—not convenience. If it looks too easy, it probably is.
APIs are the bridges between systems—and not every EHR offers one that’s stable, modern, or well-documented.
Tim noted, “We had a client where the EHR didn’t have a general API available. We had to wait for their vendor to release one mid-project. It delayed the timeline by months.”
Without solid API access, integration becomes guesswork. Workarounds create data inconsistencies, compliance gaps, and security risks.
Avoid it: Confirm API availability, structure, and update frequency before scoping. If the EHR vendor controls your API timeline, build that into your plan.
Integrations don’t fail loudly—they fail silently. And without monitoring, those failures ripple into patient profiles, reporting, workflows, and even billing.
“Error recovery is often skipped because people assume it’ll just work,” said Tim. “But integrations never run perfectly. Even the best-built systems need mechanisms for auditing and recovery.”
Avoid it: Treat monitoring as core infrastructure. Build alerts, retries, dashboards, and audit logs from day one.
Even the most elegant integration will break down without governance.
Michael Justice, CTO at Viva Eve, shared, “Documentation is painful to do after the fact. The people who designed the system might not even be there later.”
When workflows evolve but documentation doesn’t, institutional knowledge disappears—taking efficiency and compliance with it.
Avoid it: Document everything. Define systems of record, maintain version control, and revisit governance quarterly.
Technology doesn’t fix broken processes—it magnifies them.
As Karen Raimondi, Sr. Salesforce Consultant, emphasized, “Organizations should allow their internal processes to evolve with technology, not expect technology to bend to their old processes.”
Successful integration is as much about organizational mindset as it is about middleware and APIs.
Avoid it: Map workflows before implementation. Identify system ownership. Train teams on new processes, not just new tools.
Organizations that consistently succeed with integration treat it as a discipline—not a deliverable. Their systems share five traits:
1. Clear Sources of Truth
Every data type has a defined system owner.
2. Active Monitoring & Recovery
Dashboards, alerts, retries, and audit logs keep integrations healthy.
3. Data Contracts
Teams agree on formats, fields, expectations, and versioning.
4. Scalable Middleware
Middleware is chosen based on architecture—not budget or convenience.
5. Documentation & Governance
Workflows, APIs, and decision logs are documented and revisited quarterly.
When these foundations are in place, integrations don’t just work—they evolve.
Every healthcare organization wants clean data, coordinated systems, and full visibility into the patient journey. The ones that achieve it do one thing differently: they treat integration as an ongoing strategy.
As Tim summed it up, “Integrations are like cars—they need maintenance, tuning, and check-ins to stay compliant and performant.”
Healthcare integration isn’t just about connecting software. It’s about connecting people, processes, and patients through the systems you already use.
When done right, it enables better decisions, reduces burnout, accelerates revenue, and improves care. When done poorly, it becomes another bottleneck.
Provisions Group helps healthcare organizations design, implement, and govern integrations that actually work—securely, efficiently, and for the long haul. From architecture and middleware selection to documentation and change management, our team has been there, fixed that, and built better.
Integration fails when it’s treated as a task instead of a strategy.
Connect with our Healthcare Integration Team to start your roadmap.