API Integration & Developer Platform

•10 min read • Abdus Muwwakkil – Chief Executive Officer

API Integration & Developer Platform

Modern healthcare organizations require flexible, scalable integration capabilities that extend beyond standard EHR connections. OrbDoc’s comprehensive API platform empowers development teams to build custom workflows, automate documentation processes, and seamlessly integrate voice-first clinical documentation into existing healthcare IT ecosystems.

Whether you’re building custom applications for specialty workflows, integrating with proprietary systems, or creating automated documentation pipelines, OrbDoc’s developer platform provides the tools, standards support, and security infrastructure to build enterprise-grade healthcare integrations.

Enterprise Integration Requirements

Healthcare IT environments demand integration platforms that balance technical capability with regulatory compliance. Development teams face unique challenges when building healthcare applications:

Interoperability Standards Complexity: Supporting HL7 v2, HL7 FHIR, CDA, and other healthcare data standards while maintaining performance and reliability.

Security and Compliance Requirements: Every API call, webhook event, and data exchange must maintain HIPAA compliance, audit trails, and enterprise security standards.

Clinical Workflow Integration: APIs must support real-time clinical workflows without disrupting provider productivity or introducing latency that impacts patient care.

Scale and Reliability: Enterprise healthcare systems process thousands of encounters daily. Integration platforms must handle high-volume traffic with predictable performance and uptime guarantees.

Custom Workflow Support: Specialty practices, research institutions, and multi-facility health systems require customization that extends beyond standard configurations.

OrbDoc’s API platform addresses these requirements with a developer-first approach built specifically for healthcare integration challenges.

RESTful API Overview

The OrbDoc REST API provides programmatic access to core platform functionality through a modern, well-documented interface that follows industry best practices for API design and security.

API Architecture

Built on RESTful principles, the OrbDoc API uses standard HTTP methods, JSON request/response formats, and predictable resource-oriented URLs. The architecture supports both synchronous operations for immediate responses and asynchronous workflows for long-running processes like transcription and AI analysis.

Base URL Structure: All API endpoints are accessed through https://api.orbdoc.com/v1/ with version control ensuring backward compatibility as the platform evolves.

Resource Organization: API resources mirror clinical workflows - encounters, transcriptions, notes, templates, and integrations. Each resource supports standard CRUD operations with appropriate permissions and validation.

Request/Response Format: All requests accept JSON payloads with strict schema validation. Responses return consistent JSON structures with standardized error codes and descriptive messages.

Authentication and Security

OrbDoc implements OAuth 2.0 for user-level authentication and API key authentication for system-to-system integration. All authentication methods support granular scope control, allowing developers to request only the permissions necessary for their integration.

OAuth 2.0 Flow: User-facing applications implement standard OAuth authorization code flow with PKCE extension for enhanced security. Refresh tokens enable long-lived sessions without repeatedly prompting users for credentials.

API Keys: System integrations use API keys with IP whitelisting and rate limiting. Keys can be scoped to specific resources and operations, supporting principle of least privilege access control.

Security Headers: All requests require TLS 1.3 encryption. Security headers include request signing, timestamp validation, and replay attack prevention.

Rate Limits and Quotas

The API implements tiered rate limiting based on authentication method and account type. Standard rate limits allow 1,000 requests per hour for OAuth tokens and 5,000 requests per hour for API keys. Enterprise accounts receive custom rate limits based on contracted capacity.

Rate limit information is returned in response headers (X-RateLimit-Limit, X-RateLimit-Remaining, X-RateLimit-Reset) allowing applications to implement intelligent retry logic and request pacing.

Core API Endpoints

Encounter Management: Create, retrieve, update, and manage clinical encounters. Supports encounter metadata, participant information, and encounter status workflow.

POST /v1/encounters
GET /v1/encounters/{encounter_id}
PATCH /v1/encounters/{encounter_id}
GET /v1/encounters?patient_id={id}&date_range={range}

Transcription and Documentation: Upload audio for transcription, retrieve transcription results, and access AI-generated clinical notes.

POST /v1/transcriptions
GET /v1/transcriptions/{transcription_id}
GET /v1/transcriptions/{transcription_id}/note
POST /v1/transcriptions/{transcription_id}/export

Template Management: Access, customize, and manage documentation templates programmatically.

GET /v1/templates
POST /v1/templates
GET /v1/templates/{template_id}
PATCH /v1/templates/{template_id}

Integration Endpoints: Configure and manage external system integrations including EHR connections, webhook subscriptions, and data mappings.

GET /v1/integrations
POST /v1/integrations/ehr
GET /v1/integrations/{integration_id}/status
POST /v1/webhooks/subscribe

Analytics and Reporting: Access usage metrics, quality scores, and operational analytics.

GET /v1/analytics/usage?date_range={range}
GET /v1/analytics/quality-metrics
GET /v1/analytics/provider-productivity

Error Handling

The API returns standard HTTP status codes with detailed error responses. Error payloads include error codes, human-readable messages, and additional context for debugging.

Common error codes include authentication failures (401), authorization issues (403), resource not found (404), validation errors (422), and rate limiting (429). Server errors (500) trigger automatic alerting and include correlation IDs for support escalation.

API Versioning

OrbDoc maintains API version stability through URL-based versioning. The current production version is v1 with backward compatibility guarantees. Breaking changes are introduced through new major versions with migration guides and deprecation timelines.

HL7 and FHIR Support

Healthcare interoperability depends on standardized data formats that enable information exchange across disparate systems. OrbDoc provides comprehensive support for HL7 v2, HL7 FHIR R4, and CDA document standards.

FHIR R4 Implementation

OrbDoc implements HL7 FHIR R4 resources for clinical documentation workflows. The platform can produce and consume FHIR resources through standard RESTful interactions.

Supported FHIR Resources:

  • Patient: Demographics, identifiers, and patient administrative data
  • Encounter: Visit information, encounter type, class, and participants
  • Practitioner: Provider information and credentials
  • DocumentReference: Clinical note metadata and document links
  • DiagnosticReport: Structured documentation outputs
  • Observation: Discrete clinical data elements
  • Condition: Problem lists and diagnoses
  • MedicationStatement: Current medications and medication history
  • AllergyIntolerance: Allergy and adverse reaction documentation

FHIR API Endpoints: OrbDoc exposes FHIR resources through standard FHIR RESTful API operations including read, search, create, update, and delete operations.

GET /fhir/Patient/{id}
GET /fhir/Encounter?patient={id}&date=gt{date}
POST /fhir/DocumentReference
GET /fhir/Observation?subject={patient_id}&category=vital-signs

FHIR Search Parameters: Comprehensive search parameter support enables complex queries across FHIR resources. Supports standard search parameters including resource-specific parameters, result parameters (count, offset), and search parameter modifiers.

FHIR Bundles: Transaction and batch bundles enable efficient multi-resource operations. Document bundles support complete clinical document exchange in FHIR format.

HL7 v2 Message Support

While FHIR provides modern RESTful interfaces, many healthcare systems still rely on HL7 v2 messaging. OrbDoc supports bidirectional HL7 v2 message exchange through standard integration interfaces.

Supported Message Types:

  • ADT Messages: Patient admission, discharge, transfer, and registration updates
  • ORM Messages: Order entry and medication orders
  • ORU Messages: Results reporting and observation updates
  • MDM Messages: Medical document management for clinical notes
  • SIU Messages: Scheduling information and appointment updates

Message Processing: OrbDoc can receive HL7 v2 messages to trigger documentation workflows and generate HL7 v2 messages containing clinical documentation for downstream systems.

Transport Protocols: Support for MLLP (Minimum Lower Layer Protocol), HTTP/HTTPS endpoints, and message queue integration.

Clinical Document Architecture (CDA)

OrbDoc generates CDA-compliant clinical documents for regulatory reporting and information exchange. Supports C-CDA templates including Continuity of Care Document (CCD), Consultation Note, and Discharge Summary.

CDA Generation: Clinical notes can be automatically exported as structured CDA documents with appropriate templates, code systems, and validation.

CDA Import: Parse and extract clinical data from incoming CDA documents to pre-populate encounter information and clinical context.

Terminology and Code Systems

OrbDoc supports standard healthcare terminologies and maintains mappings across code systems:

  • SNOMED CT: Clinical terminology for problems, procedures, and findings
  • LOINC: Laboratory and clinical observation identifiers
  • RxNorm: Medication terminology and drug codes
  • ICD-10-CM: Diagnosis coding
  • CPT: Procedure coding
  • CVX: Vaccine codes

The platform includes terminology services for code lookup, validation, and mapping between code systems.

Webhooks and Real-Time Events

Modern healthcare workflows require real-time notification of clinical events and documentation status changes. OrbDoc’s webhook system enables event-driven architectures that respond immediately to platform events without polling.

Webhook Architecture

Webhooks deliver HTTP POST requests to developer-specified URLs when subscribed events occur. Each webhook includes event type, timestamp, resource identifiers, and relevant payload data.

Event Delivery Guarantees: OrbDoc implements at-least-once delivery with automatic retry logic. Failed deliveries retry with exponential backoff for up to 24 hours.

Webhook Security: All webhook requests include HMAC signatures for payload verification. Requests originate from documented IP ranges supporting firewall whitelisting.

Idempotency: Webhook payloads include unique event IDs enabling idempotent processing. Applications can safely handle duplicate deliveries without side effects.

Available Webhook Events

Encounter Events:

  • encounter.created: New encounter initiated
  • encounter.updated: Encounter metadata modified
  • encounter.completed: Encounter finalized
  • encounter.deleted: Encounter removed

Transcription Events:

  • transcription.started: Audio upload received and processing initiated
  • transcription.completed: Transcription finished and available
  • transcription.failed: Transcription processing error
  • note.generated: AI-generated clinical note available
  • note.signed: Provider signed and finalized note

Integration Events:

  • ehr.sync.completed: EHR synchronization finished
  • ehr.sync.failed: EHR integration error
  • integration.error: General integration failure requiring attention

System Events:

  • user.created: New user account provisioned
  • user.updated: User profile or permissions modified
  • quota.warning: API usage approaching rate limits
  • system.maintenance: Scheduled maintenance notification

Webhook Configuration

Developers configure webhooks through the API or administrative dashboard:

POST /v1/webhooks/subscribe
{
  "url": "https://your-app.com/webhooks/orbdoc",
  "events": ["transcription.completed", "note.generated"],
  "secret": "webhook_signing_secret",
  "active": true
}

Event Filtering: Subscribe to specific event types or use wildcard subscriptions (encounter.*, transcription.*) for event categories.

Webhook Management: List active webhooks, update configurations, temporarily disable subscriptions, and view delivery logs through webhook management endpoints.

Webhook Payload Example

{
  "event_id": "evt_1a2b3c4d5e6f",
  "event_type": "transcription.completed",
  "timestamp": "2025-10-02T14:30:45Z",
  "data": {
    "transcription_id": "trans_abc123",
    "encounter_id": "enc_xyz789",
    "duration_seconds": 420,
    "word_count": 856,
    "status": "completed",
    "confidence_score": 0.96,
    "note_available": true
  },
  "links": {
    "transcription": "/v1/transcriptions/trans_abc123",
    "note": "/v1/transcriptions/trans_abc123/note",
    "encounter": "/v1/encounters/enc_xyz789"
  }
}

Use Cases for Webhooks

Automated Workflow Triggers: Launch downstream processes when notes are completed - quality review workflows, billing code validation, or automated faxing to specialists.

Real-Time Dashboard Updates: Push encounter status to administrative dashboards without constant polling, providing live visibility into documentation workflows.

Integration Orchestration: Coordinate multi-system workflows where OrbDoc note completion triggers updates to scheduling systems, billing platforms, or patient portals.

Audit and Compliance: Stream all clinical documentation events to security information and event management (SIEM) systems for real-time audit logging.

Custom Notifications: Build specialized alerting for specific clinical scenarios - critical lab values mentioned in documentation, specific diagnosis codes, or high-complexity encounters.

Case Study: Multi-Specialty Health System Custom Integration

A 12-hospital health system operating 200+ specialty clinics across three states needed to integrate OrbDoc’s voice documentation platform with their custom-built clinical workflow management system while maintaining connections to their Epic EHR implementation.

Integration Requirements

The health system’s IT architecture included:

  • Epic EHR as system of record for clinical data
  • Custom workflow management platform handling specialty-specific clinical protocols
  • Proprietary quality metrics dashboard aggregating data from multiple sources
  • Legacy HL7 v2 interfaces to ancillary systems
  • Real-time provider productivity monitoring for operational management

Standard EHR integration wasn’t sufficient because the workflow management system controlled specialty-specific documentation requirements, template routing, and quality checkpoints that needed to interact with voice documentation workflows.

Technical Implementation

The development team built a custom integration layer using OrbDoc’s API platform:

API-Based Workflow Orchestration: When providers initiated encounters in the workflow management system, APIs triggered corresponding OrbDoc encounter creation with specialty-specific templates and custom fields populated from workflow context.

Bidirectional FHIR Synchronization: Patient demographics, encounter details, and problem lists synchronized from Epic through FHIR R4 resources. Completed documentation flowed back to Epic as DocumentReference resources with embedded CDA documents.

Webhook-Driven Process Automation: Real-time webhooks triggered workflow state transitions. When transcription completed, the workflow system automatically advanced to quality review state, assigned reviewers based on specialty rules, and updated provider dashboards.

HL7 v2 Integration for Ancillary Systems: MDM messages containing clinical notes routed to laboratory systems, radiology PACS, and billing platforms through existing HL7 v2 infrastructure.

Custom Analytics Pipeline: API endpoints for usage metrics and quality scores fed the health system’s analytics warehouse, enabling enterprise-wide reporting that combined OrbDoc data with operational metrics from other systems.

Technical Architecture

The integration layer deployed as containerized microservices in the health system’s Azure cloud environment:

  • Authentication service managing OAuth tokens and API key rotation
  • Event processor consuming OrbDoc webhooks and routing to internal message queue
  • FHIR adapter translating between Epic and OrbDoc FHIR implementations
  • HL7 v2 gateway transforming FHIR resources to HL7 messages for legacy systems
  • Data synchronization service handling bidirectional updates and conflict resolution

All components logged to centralized SIEM for security monitoring and maintained separate audit trails for HIPAA compliance.

Implementation Metrics

Development Timeline: 12 weeks from requirements to production deployment

  • Weeks 1-3: API integration development and sandbox testing
  • Weeks 4-6: FHIR resource mapping and Epic integration
  • Weeks 7-9: Webhook implementation and workflow automation
  • Weeks 10-12: User acceptance testing and production deployment

Technical Performance:

  • Average API response time: 145ms for read operations, 380ms for transcription creation
  • Webhook delivery latency: 95% delivered within 2 seconds of event occurrence
  • FHIR synchronization: 99.7% successful sync rate with automatic conflict resolution
  • System availability: 99.95% uptime for integration layer components

Operational Results:

  • 1,200+ providers using integrated workflows across specialties
  • 8,500+ encounters processed daily through custom integration
  • 40% reduction in documentation time compared to previous transcription system
  • 99.2% provider adoption rate within 6 months of deployment
  • Zero security incidents or HIPAA violations during integration operation

Lessons Learned

Schema Flexibility Critical: Healthcare data varies significantly across specialties. The API’s support for custom fields and flexible template structures enabled specialty-specific workflows without platform modifications.

Webhook Reliability Matters: Initial implementation used simple HTTP endpoints for webhooks. Production deployment required message queue buffering and dead letter queues to handle network issues and service maintenance windows.

FHIR Implementation Variations: Despite FHIR standardization, Epic’s FHIR implementation required custom mapping logic for several resources. Extensive testing in Epic sandbox environment essential before production deployment.

Security Review Complexity: Enterprise security review process added 4 weeks to timeline. Early engagement with security teams and comprehensive documentation of data flows accelerated approval process.

Developer Resources

OrbDoc provides comprehensive resources supporting developers throughout the integration lifecycle from initial prototyping to production deployment and ongoing maintenance.

API Documentation

Complete API reference documentation available at https://developers.orbdoc.com includes:

  • Detailed endpoint descriptions with request/response examples
  • Interactive API explorer for testing calls directly from documentation
  • Schema definitions for all request and response objects
  • Authentication guides with code examples in multiple languages
  • Webhook payload schemas and event catalog
  • FHIR implementation guide detailing supported resources and search parameters
  • HL7 v2 message specifications and field mappings

Documentation includes runnable code examples in Python, JavaScript, Java, C#, and Ruby with authentication handling, error processing, and best practices.

Software Development Kits (SDKs)

Official SDKs available for popular programming languages:

Python SDK: pip install orbdoc-sdk

  • Complete API coverage with type hints
  • Automatic OAuth token refresh
  • Built-in retry logic with exponential backoff
  • Webhook signature verification utilities

JavaScript/TypeScript SDK: npm install @orbdoc/sdk

  • Node.js and browser support
  • Promise-based async API
  • TypeScript definitions for IDE autocomplete
  • React hooks for common workflows

Java SDK: Available via Maven Central

  • Fluent API design
  • Jackson-based JSON serialization
  • Configurable HTTP client
  • Comprehensive logging integration

C# SDK: Available via NuGet

  • Async/await support throughout
  • LINQ-friendly result handling
  • Dependency injection integration
  • Azure Functions compatible

All SDKs include comprehensive unit tests, integration examples, and detailed inline documentation.

Sandbox Environment

Full-featured sandbox environment available at https://sandbox.orbdoc.com provides:

  • Isolated testing environment with synthetic data
  • API endpoints mirroring production
  • Test accounts and sample encounters
  • Webhook testing with request inspection
  • No PHI or production data exposure

Sandbox environment supports complete integration development and testing without touching production systems or handling real patient data.

Developer Support

Community Forum: Developer community forum at https://community.orbdoc.com enables knowledge sharing, integration examples, and peer support.

GitHub Examples Repository: Open-source example implementations available at https://github.com/orbdoc/examples including:

  • Complete integration reference implementations
  • Webhook handlers for common frameworks
  • FHIR resource transformation examples
  • HL7 v2 message generators

Technical Support: Integration support available through dedicated developer support channel with SLA-based response times:

  • Standard tier: 2 business day response
  • Professional tier: 8 business hour response
  • Enterprise tier: 2 hour response with dedicated support engineer

Integration Consulting: Professional services team available for complex integrations requiring architecture review, custom development, or implementation assistance.

Developer Portal Features

API Key Management: Self-service API key generation, rotation, and revocation with granular permission scoping.

Usage Monitoring: Real-time dashboard showing API usage, rate limit status, error rates, and performance metrics.

Webhook Testing: Tools for testing webhook endpoints, viewing delivery logs, and debugging webhook integration issues.

Integration Health Monitoring: Status dashboard showing integration health, sync status, and error notifications for production integrations.

Security and Compliance

API integrations handling protected health information require robust security controls and compliance with healthcare regulations. OrbDoc’s security architecture ensures integrations maintain the same security standards as the core platform.

Authentication Mechanisms

OAuth 2.0 with PKCE: User-facing applications implement OAuth 2.0 authorization code flow with Proof Key for Code Exchange (PKCE) extension preventing authorization code interception attacks.

Access tokens expire after 1 hour requiring refresh token usage for long-running sessions. Refresh tokens use rotation mechanism where each refresh returns new refresh token and invalidates previous token, limiting exposure from token theft.

API Keys: System-to-system integrations use API keys with configurable scope restrictions. Keys support IP whitelisting, allowing only requests from approved network addresses. Automatic key rotation policies available for enterprise deployments.

Service Accounts: Dedicated service accounts for automated workflows provide audit trail separation and enable granular permission assignment independent of user accounts.

Authorization and Access Control

Role-based access control (RBAC) governs API permissions with predefined roles and custom role creation for enterprise accounts:

  • Read-Only: Access encounter data and transcriptions without modification
  • Documentation: Create and update encounters, upload audio, access notes
  • Integration Admin: Configure webhooks, manage API keys, access integration logs
  • Analytics: Access usage metrics and reporting endpoints
  • Full Admin: Complete platform access including user management and configuration

Scope-based permissions enable fine-grained access control at the endpoint level. Applications request specific scopes during OAuth authorization, following principle of least privilege.

Data Encryption

Encryption in Transit: All API traffic requires TLS 1.3 encryption. Older TLS versions rejected to prevent downgrade attacks. Certificate pinning supported for mobile applications requiring additional transport security.

Encryption at Rest: All PHI stored encrypted using AES-256 encryption. Encryption keys managed through hardware security modules (HSM) with automatic key rotation.

End-to-End Encryption: Audio uploads support client-side encryption where applications encrypt content before transmission. OrbDoc processes encrypted audio within secure enclaves maintaining encryption throughout processing pipeline.

Audit Logging

Comprehensive audit logging captures all API activity:

  • Authentication and authorization events
  • Resource access and modifications
  • Integration configuration changes
  • Webhook deliveries and failures
  • Error conditions and security events

Audit logs include timestamp, user/service account identifier, IP address, action performed, resource affected, and outcome. Logs retained for minimum 7 years meeting HIPAA requirements.

Audit log APIs enable integration with security information and event management (SIEM) systems for centralized security monitoring.

HIPAA Compliance

OrbDoc maintains HIPAA compliance for all API operations:

Business Associate Agreement (BAA): All API users handling PHI execute BAA with OrbDoc establishing HIPAA obligations and responsibilities.

Minimum Necessary: API design enforces minimum necessary principle through scope-based permissions and field-level access controls.

Breach Notification: Automated monitoring detects potential PHI exposure events triggering security incident response procedures and breach notification workflows.

Access Controls: Technical and administrative controls prevent unauthorized PHI access through authentication, authorization, encryption, and audit logging.

Security Monitoring

Real-time security monitoring detects suspicious activity patterns:

  • Unusual API usage patterns indicating potential data exfiltration
  • Failed authentication attempts suggesting credential compromise
  • Geographic anomalies in API access patterns
  • Rate limit violations potentially indicating automated attacks

Security operations center monitors these signals with automated alerting and incident response procedures.

Penetration Testing and Vulnerability Management

Regular third-party penetration testing validates API security controls. Vulnerability disclosure program enables security researchers to report potential vulnerabilities through responsible disclosure process.

Automated vulnerability scanning runs continuously with immediate patching of critical vulnerabilities. Security patches deployed without API version changes maintaining integration stability while addressing security issues.

Compliance Certifications

OrbDoc maintains compliance certifications relevant to API integrations:

  • SOC 2 Type II: Annual audit of security, availability, and confidentiality controls
  • HITRUST: Healthcare-specific security framework certification
  • HIPAA: Technical and administrative safeguards for PHI protection

Compliance reports available to enterprise customers for regulatory audit and vendor risk management processes.

Get Started with OrbDoc API

Ready to integrate voice-first clinical documentation into your healthcare applications? Access comprehensive API documentation, SDKs, and sandbox environment at the OrbDoc developer portal.

Developer Portal: https://developers.orbdoc.com

API Status: https://status.orbdoc.com

Support: [email protected]

Enterprise integration consulting available for complex implementations requiring architecture review or custom development support.