H

Healthcare Hub

FHIR R4 · NCPDP Script · MONAI · MedGemma · cPRO · CardinalKit

Clinical Workspace

Integrated FHIR · Pharmacy · Billing · AI/CDS · PROMs workflows.

Patients

    Select a patient

    Choose a patient from the list to load their chart.

    Staff Directory

    Active practitioners on the clinic roster. HR-side integrations for time tracking, scheduling, and workforce management are recommended below — none of them require patient data.

    Planned Integrations · Roadmap

    Time tracking

    Kimai — open-source time tracker (AGPL)

    Per-practitioner activity timers with role-based access and CSV/PDF exports. Drop-in for tracking how staff allocate time across patient care, charting, peer review, and admin.

    HR + payroll

    Frappe HR — fully open-source HRMS (GPL-3.0)

    Full HRIS — employee records, benefits, leave/PTO, attendance, performance reviews — plus payroll, shift management, and expense claims. No commercial tier and no feature gating; shares the Frappe framework with ERPNext so payroll-to-GL flow is a single-system operation rather than a cross-system integration.

    Appointments

    FHIR R4 Appointment scheduling with email + SMS reminders and integrated telehealth — modeled on the OpenEMR calendar with automated reminder cascade (T-24h, T-1h, T-15m).

    Book a new appointment
    Reminders auto-fan out: confirmation · T-24h · T-1h · T-15m (video only)

    Upcoming & Recent Appointments

    Reminder Queue

    Patient Chart

    FHIR R4 chart entry powered by NLM LHC-Forms · Questionnaires render here, responses extract into Encounter / Observation / DocumentReference / Condition / AllergyIntolerance resources via SDC.

    Patient Chart History

    Laboratory

    OpenEMR-style lab orders & results · LOINC-coded test catalog · HL7 v2 ORM (orders) and ORU (results) message generation · auto-flagged abnormals against reference ranges.

    Order a lab
    ORM message auto-generated · routes to reference lab

    Active Orders

    Recent Results

    HL7 v2 Message Log · ORM (outbound) + ORU (inbound)

    E-Prescribing Workflow

    FHIR MedicationRequest → NCPDP Script → PMS dispense → medication history.

    Billing → Clearinghouse → Payer

    Eligibility check, claim submission, clearinghouse routing, adjudication.

    Clinical Decision Framework

    MONAI imaging AI → MedGemma summary → Healthcare.ai readiness → CDS synthesis → automated care plan.

    Billing & Revenue Cycle Management

    Clinic-wide billing & RCM dashboard for back-office staff · charge capture · A/R aging · denial workflow · payer mix · top-revenue procedures · gated to system/Claim.read scope. Patients are referenced by opaque account_number; demographics are resolved on demand for invoice/statement prep via /billing/account-lookup (audit-logged).

    🛠️
    Integration architecture · roadmap status: The cards below document the chosen open-source back-office stack — Akaunting (operational AR/AP), ERPNext (asset/treasury subledger + line-of-business analytics), Frappe Insights (BI dashboards), and Frappe HR (workforce — see Audit panel). Today the Healthcare Hub runs its own in-memory RCM store. Adapter code that pushes adjudicated claims and ERAs to Akaunting and ERPNext as journal entries is on the roadmap; the cards describe the contract those adapters will fulfill (REST endpoints, mapping, privacy posture).
    Planned Integration · Roadmap · General ledger / accounting

    GnuCash or Akaunting — open-source double-entry accounting

    GnuCash (GPL, desktop) is the trusted classic — many small medical practices run their general ledger on it. Akaunting Community (GPL/Apache, web/PHP) is the modern web alternative with a clean UI and self-hostable. Both consume RCM exports as journal entries — payments, write-offs, refunds, vendor AP, payroll runs from Frappe HR.

    How it plugs in: a nightly batch reads adjudicated claims and ERAs from this hub, posts each as a debit/credit pair (deposit account ↔ revenue account, with write-offs to contractual-adjustment) using the patient's account_number as the customer reference. Patient names & addresses never enter the GL — only the account number plus invoice line totals. Demographics are pulled from /billing/account-lookup only when the system actually prints an invoice or statement, keeping PHI exposure minimal.

    Planned Integration · Roadmap · Asset / treasury subledger + line-of-business analytics

    ERPNext — full open-source ERP (GPL-3.0)

    ERPNext sits alongside Akaunting as the asset/treasury subledger and the line-of-business analytics layer. In core (no paid tier), it covers everything Akaunting doesn't go deep on: cost-basis tracking, loan/mortgage amortization, scheduled transactions via Auto Repeat, multi-company consolidations, batch & serial-level lot tracking, multi-currency with automatic FX gain/loss revaluation, and asset depreciation schedules (straight-line / written-down value / double declining).

    Line-of-business analysis: Cost Centers + Accounting Dimensions let you tag every transaction with Service Line (Primary Care, Telehealth, Imaging, Lab, Behavioral Health, etc.), Practice Location, and Payer Type. The Profitability Analysis report then shows revenue, direct costs, allocated overhead, gross profit, and gross margin per service line — the foundation for "where do we invest next" decisions.

    How it plugs in: Akaunting handles operational AR/AP and bank reconciliation; ERPNext receives summary journal entries each period for depreciation, loan interest, FX revaluation, and inventory cost adjustments. Cross-system patients are referenced by account_number only — names never enter ERPNext's customer records.

    Planned Integration · Roadmap · BI dashboards for the analyst role

    Frappe Insights — open-source BI & dashboards (AGPL-3.0)

    Built by the same team as ERPNext. Drag-and-drop dashboards for non-technical users, SQL escape hatch for power users, cross-source joins so you can blend ERPNext financial data with Healthcare Hub operational data and Kimai time data on a single canvas.

    Designed for the Analyst role: service-line revenue trends, contribution-margin waterfalls, year-over-year procedure mix, payer-mix evolution, asset ROI on equipment loans. None of it requires patient identity — every chart aggregates by Service Line / Payer / Time / Provider, never by patient name.

    A/R Aging

    Payer Mix

    Top Procedures by Revenue

    Denial Work Queue · claims requiring follow-up

    Unbilled Encounters · encounters with no claim filed

    Patient Questionnaire

    Enrollment, e-consent, validated patient questionnaires (PHQ-9 / PROMIS-29), scoring, clinical dashboard, and EHR write-back.

    Reports

    Click any KPI card above, or pick a report below.

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    External Integrations

    Push-side adapters for the open-source back-office stack. Each card below documents what data flows where, the destination's REST contract, and the run history. Egress is currently mocked — every payload is recorded to the audit log instead of a live HTTP call. Replace _post_to_external() in backend/services/integrations.py with a real urllib / requests POST and configure each adapter's base_url + api_token to go live.

    Recent Sync Activity

    Audit Log

    Every cross-component call is logged. Most recent first.

    Planned Integration · Roadmap · Practitioner time & task tracking

    Kimai — open-source time tracker (AGPL)

    Kimai is the recommended drop-in for tracking how much time practitioners spend on tasks and patient care. It's purpose-built for time tracking (not an HR side-module), supports multi-user activity timers, role-based access, and exports to CSV/PDF for billing or payroll.

    Why Kimai over OrangeHRM: granular task-level tracking is its core product, the REST API is first-class, and user feedback is consistently strong (~4.5/5 on Capterra/G2/SourceForge). OrangeHRM Community Edition draws weaker reviews — key features (custom reports, mobile app, workflow automation) are gated behind paid tiers.

    How it plugs in: the audit stream below is the source of truth. A small adapter posts each component / action / ts / details entry to Kimai's /api/timesheets endpoint, mapping patient_id → customer, encounter type → project, action → activity. Self-host inside the same HIPAA-aligned environment as the EHR.

    Planned Integration · Roadmap · Full HRMS + payroll for clinical staff

    Frappe HR — fully open-source HRMS (GPL-3.0)

    Frappe HR covers what Kimai doesn't — full HRIS (employee records, benefits, leave/PTO, performance reviews, recruitment) plus payroll, shift management, attendance, and expense claims. No commercial tier and no feature gating: every capability ships in the open-source build.

    Why Frappe HR: most "open-source" HR alternatives use a free-Community + paid-Enterprise split that gates real features (mobile app, biometric devices, advanced reports, ACA filing) behind a paywall. Frappe HR is uniformly GPL — what you self-host is what you get, no upsell pressure. It also shares the Frappe framework with our ERPNext recommendation, so payroll runs post directly to ERPNext's GL as a same-database operation rather than a cross-system integration.

    How it plugs in: staff identity comes from this hub's /ehr/fhir/Practitioner directory, time data flows in from Kimai (or directly via Frappe HR's own attendance module), and payroll runs drop into ERPNext / Akaunting as journal entries.

    Reminder Stream · every email + SMS dispatched by the scheduling fan-out

    Live Audit Stream