Systems
EHR
Longitudinal record data exchanged under consent, over FHIR R4 and HL7 v2.
What this class of system is
An EHR carries a longitudinal record that can move between providers.
orophin speaks FHIR R4 and HL7 v2. In/out: consented longitudinal record data. Atlas holds the record; Cirith governs the consent.
Everything above rides one path. The on-prem orophin agent speaks the protocol on the hospital's own network and opens a single outbound mutually authenticated link to the Pensieve backend. Your network team approves egress.
On the wire
What it emits, and what carries it
The traffic
A longitudinal record crosses an organisational boundary, so the payload is a FHIR R4 Bundle rather than a message: Patient, Encounter, Condition, Observation, DiagnosticReport, and the provenance that says which system asserted each element. The exchange is authenticated at the organisation, and in India it is increasingly mediated by a consent artefact rather than by a data-sharing agreement alone.
What breaks here
Consent is the gate, and most systems treat it as a checkbox recorded once at the front desk. In Pensieve consent is a modelled object with a scope and an expiry, Cirith reads it on every access, and a withdrawal takes effect on the next read rather than at the next export. A record that arrives without a consent that covers it does not enter the store.
Protocols
The standards this class speaks
Each one is described in full on the standards register, at the anchor named here.
- HL7 v2The dominant hospital messaging standard. orophin sends and receives ADT, ORM / OMG, ORU, DFT, MDM, and SIU. India’s EHR Standards name v2.8.2.
- FHIR R4Modern REST / JSON resources: Patient, Encounter, Observation, ServiceRequest, DiagnosticReport, Claim, Coverage. Pensieve speaks FHIR R4 for record exchange, ABDM linkage, and NHCX claims.
- MLLP transportThe TCP framing HL7 v2 rides on. A start block, the message, an end block and a carriage return, over a socket. orophin’s MLLP adapter is the transport under every HL7 v2 connection.
- mTLS WebSocket bridgeThe single outbound, mutually authenticated link orophin opens to the Pensieve backend. Both ends verify a certificate, nothing listens on the hospital side, and every row in this register rides it.
- SAML SSOEnterprise sign-in for a hospital with an existing SAML identity provider.
- OIDC SSOOpenID Connect sign-in for a hospital identity provider.
- ICD-11 terminologyWHO diagnosis coding: the primary diagnosis coding surface in Atlas and at the medical-records desk.
- SNOMED / LOINC feedsClinical-term and laboratory / observation coding. An investigation resolves to LOINC and a clinical term to SNOMED CT, which is what makes two analysers comparable.
Members
Systems in this class
7 entries on the register, each at its own anchor.
- EpicFHIR R4, HL7 v2, SAML SSO. In/out: encounters, problems, results, and documents under consent.
- Oracle Health (Cerner)FHIR R4, HL7 v2, SAML SSO. In/out: encounters, results, and documents.
- MeditechHL7 v2, FHIR R4, SAML SSO. In/out: ADT, results, and documents.
- InterSystems TrakCareHL7 v2, FHIR R4, SAML SSO. In/out: ADT, results, and documents.
- athenahealthFHIR R4, OIDC SSO. In/out: encounters and results.
- Generic FHIR R4 serverFHIR R4, OIDC SSO. In/out: any FHIR R4 resource the server exposes.
- Generic HL7 v2 feedHL7 v2 over MLLP. In/out: any HL7 v2 message the feed emits or accepts.
What a name in this register means
Compatibility only. Pensieve connects to systems in this class over the protocol they speak. Naming a system describes the connection Pensieve is built to make; it implies no partnership, no certification, and no existing deployment.