Integrations Overview

Available Integrations

Vantrexia currently supports three production integrations that together form a complete RPM data pipeline—from bedside device readings to EMR clinical records and patient notifications:

Supported Standards

All Vantrexia integrations are built on open healthcare and security standards to ensure interoperability, auditability, and vendor independence:

Integration Architecture

The following diagram illustrates the end-to-end data flow from RPM devices through Vantrexia's integration layer to the eClinicalWorks EMR. Each transition point includes validation, transformation, and audit logging:

┌─────────────────┐     ┌──────────────────┐     ┌─────────────────────────┐
│   RPM Devices   │     │  MioConnect Cloud │     │   Vantrexia Backend     │
│                 │     │                  │     │                         │
│ Blood Pressure  │────▶│  Device Gateway   │────▶│  Webhook Receiver       │
│ Pulse Oximeter  │     │  Telemetry Store  │     │  Data Validation        │
│ Weight Scale    │     │  Device Mgmt API  │     │  Observation Creation   │
│ Glucose Meter   │     │                  │     │                         │
└─────────────────┘     └──────────────────┘     └───────────┬─────────────┘
                                                             │
                                                             │ FHIR R4 Transform
                                                             ▼
┌─────────────────┐     ┌──────────────────┐     ┌─────────────────────────┐
│  Provider App   │     │  eClinicalWorks  │     │   FHIR Integration      │
│                 │     │  EMR System      │     │   Service               │
│ Dashboard       │◀───│  Patient Records  │◀───│  JWT Auth (RS384)       │
│ Triage Alerts   │     │  Observations    │     │  POST Observation       │
│ Billing         │     │  Clinical Notes  │     │  GET Patient            │
│ Reports         │     │                  │     │  Delivery Confirmation  │
└─────────────────┘     └──────────────────┘     └─────────────────────────┘

Data Flow Steps

1. Device Reading — Patient takes a measurement on their RPM device (e.g., blood pressure cuff). The device transmits data via Bluetooth to the MioConnect hub or mobile app.
2. MioConnect Relay — MioConnect's cloud platform receives the reading, normalizes the data format, and sends a webhook POST to Vantrexia's registered endpoint with an HMAC-SHA256 signature.
3. Webhook Processing — Vantrexia verifies the webhook signature, validates the payload schema, and creates an internal Observation record. Triage rules are evaluated automatically, generating alerts for out-of-range readings.
4. FHIR Transformation — The Observation is transformed into a FHIR R4 Observation resource using standardized LOINC codes (e.g., 85354-9 for blood pressure, 2708-6 for SpO2).
5. EMR Sync — A JWT client assertion is generated (RS384), exchanged for an access token at eCW's OAuth server, and the FHIR Observation is POSTed to eCW's FHIR R4 endpoint. Delivery confirmation is logged.
6. Provider Notification — If triage rules trigger an alert, a HIPAA-safe push notification is sent to the provider's mobile app via Firebase Cloud Messaging.

Integration Security

All integrations enforce multiple layers of security to protect patient health information:

• Transport Encryption — TLS 1.2+ required on all API calls and webhook deliveries. Certificate pinning is used for eCW FHIR endpoints.
• Authentication — JWT RS384 for machine-to-machine, OAuth 2.0 + PKCE for interactive flows, HMAC-SHA256 for webhook verification.
• PHI Minimization — Push notifications contain zero PHI. Webhook payloads include only device IDs and readings—patient identity is resolved server-side.
• Audit Logging — Every integration API call is logged with timestamp, user/service identity, resource type, action, and outcome. Logs are immutable and retained for 7 years per HIPAA requirements.
• Key Rotation — RSA keys and API credentials are rotated on a 90-day cycle via AWS Secrets Manager.