Every healthcare organization has some level of interoperability in place—usually baked into their EHR.
However, when it comes to connecting data across large health systems, bespoke apps, or legacy databases, the built-in tools can fall short.
That's where integration engines come in—flexible software that connects disparate systems so data flows exactly where it's needed, in the right format. One long-standing option in this space is Mirth® Connect by NextGen Healthcare, which helps organizations connect data sources to destinations to share clinical, operational, and other essential data.
It also supports more complex connections, like linking EHRs to immunization registries, HIEs, and national networks that facilitate care coordination. Originally released as a dual-licensed open-source and commercial solution, it attracted a global user base. Mirth recently shifted to a commercial model, bringing with it full enterprise support and advanced capabilities like a new Command Center.
"Mirth has played an important role in helping organizations define and build their interoperability strategy for their specific needs," says Mo Chebli, vice president of product management for interoperability at NextGen Healthcare. In this conversation, he shares why interoperability is more critical than ever, what's new in Mirth Connect 4.6, and how organizations are creatively using the platform to meet evolving demands—from regulatory pressure to AI enablement.
Q: Mirth Connect has been at the forefront of healthcare interoperability for over two decades. Why is it so important today, and what has the platform helped organizations achieve?
Chebli: Interop is mission-critical, and a big part of that comes down to the fact that healthcare is a team sport. There are so many different players involved in a patient's care—primary care, specialists, payers, labs—and they all need to share data, often across various platforms. Even within the same health system, there are internal systems that have to talk to each other. That's why you need something flexible like Mirth that can manage those connections and scale with you as your environment changes.
Interop should be embedded in the patient journey from the very beginning. When someone calls to schedule an appointment, integration is already happening in the background—checking eligibility, sending appointment reminders, and placing reminder calls. It continues throughout diagnosis, treatment, discharge, and follow-up.
And, of course, there's the regulatory angle: we have laws like the 21st Century Cures Act and information-blocking rules that now have real teeth. Organizations that don't allow appropriate access to data can face actual penalties. So, interop isn't optional anymore—it's a requirement. And organizations need to make sure they're doing it securely, protecting the privacy of patients as their data moves across different systems.
Mirth has been central to all of that—from helping patients access their records to reducing duplicative testing and supporting compliance. No two integrations are the same, and being able to customize your integration needs is what's made Mirth successful over time.
Q: What new features and enhancements does Mirth Connect 4.6 deliver?
Chebli: We made some big changes in version 4.6. First, we updated our license. Mirth was open source for a long time, but now it's transitioned into a commercial product. That means clients get enterprise-level support, consistent security updates, and access to the latest integration standards and deployment models.
From a feature standpoint, one of the major additions is our SSL manager, now deeply integrated into Mirth at all license levels. It helps organizations manage and monitor their security certificates and connectivity to third-party systems. We also launched a Command Center, which gives organizations a unified portal to manage all their deployments. Many health systems are running multiple instances of Mirth across environments, which has been a challenge. The Command Center solves that by providing visibility and analytics across all your connections.
Q: How can healthcare organizations assess whether their current systems are ready for optimal data exchange?
Chebli: Today, EHRs are required to deliver strong APIs that support patient access and third-party vendor integrations. So we always tell people to start there. Are you using all the capabilities your system can already support?
Then, see where your additional needs are. With AI, large language models (LLMs), ambient listening tools, and patient engagement solutions, there's now so much low-hanging fruit for organizations to add meaningful technology to improve patient and provider experiences. But often, you need integration to do that well—and embed it into the provider's workflow without adding clicks or red tape. That's usually where an integration engine like Mirth helps. It solves real-world problems. And because we're API-first, you can connect with the public APIs now being offered by every major EHR.
Q: What's a creative use case of Mirth Connect that you can share with our readers?
Chebli: We're constantly getting pinged about our product being used out in the wild in new and creative ways. One of the most interesting ones was a recent study published in the New England Journal of Medicine. Researchers used Mirth to extract structured data from Epic and feed it into an LLM to evaluate clinical quality measures for sepsis.
There are arguments that LLMs might be able to solve this kind of knowledge problem on their own without needing codified data through interoperability. However, the study showed that structured interop can actually improve the output of these models.
Another creative use case involves provider inboxes. One of the biggest contributors to provider burnout is managing message overload. Mirth is being used in combination with an LLM to read the inbox and identify and respond proactively to messages. That's a multifaceted exchange—back and forth between AI and an interop engine—to make it all work. The industry has been developing these interop tools for a long time, and it's exciting to finally see them powering the next wave of innovation.
Mirth® Connect by NextGen Healthcare delivers highly flexible integration tooling for any organization tasked with data integration, whether you need to connect many internal systems or are building a product of your own. Mirth Connect allows you to optimize your interoperability needs regardless of the system, message type, and transfer protocol. This proven integration engine, with nearly 20 years of expertise, has a template-driven architecture, providing for quick, easy, and flexible development. Learn more at nextgen.com.
Analytics hold immense potential to reshape healthcare, but when misapplied, they often overwhelm providers with too much irrelevant information, complicating workflows and patient care.
“Healthcare practices need analytics that are simple, actionable, and intuitive,” says Dr. Dany Dominguez Perez, vice president of clinical analytics and population health at NextGen Healthcare.
In this conversation, Dr. Dominguez Perez dives into exciting advances in analytics and their impact on healthcare delivery. He reveals how the NextGen® Enterprise Data Warehouse and NextGen® Insights Solutions are transforming healthcare operations—unlocking deeper clinical insights, identifying care gaps, and ensuring practices focus on what matters most, all without adding to the burden of already overstretched teams.
Q: How does better access to analytics empower healthcare teams to make more informed decisions in their daily practice?
Dominguez Perez: When healthcare teams have better access to analytics, they can address more complexities while prioritizing their most critical tasks. This empowerment starts with simplicity. A centralized system with single sign-on capabilities ensures that all relevant data is in one place and can be tailored to the specific roles of team members. For example, instead of everyone in the practice consuming the same generic reports, analytics should be segmented by job role, ensuring actionable information reaches the appropriate team member. Providers need clinical insights and risk-assessment analysis at the point of care, while operational and financial analytics benefit practice managers and executives.
NextGen’s Enterprise Data Warehouse has multiple engines that analyze complex medication combinations and patients with multiple comorbidities, providing advanced clinical decision support. There is no time to go through this mentally during a 20-minute visit, so having something at the point of care that does that for you is crucial. Intentional planning with leadership backing is vital, or even the most sophisticated intuitive platform will fall short.
Q:How can healthcare teams use data-driven insights to address inefficiencies without adding to their workloads?
Dominguez Perez: Healthcare teams are grappling with increasing complexity from payer requirements to care coordination. That’s why having a dedicated leader focused on data strategy is critical. By sharing only targeted, relevant information with the appropriate teams, inefficiencies can be significantly reduced. For example, analytics can help COOs direct the right information to call centers, front-desk staff, and care teams, ensuring that each group addresses its specific responsibilities without being overwhelmed. Analytics can also streamline patient communication by aggregating outreach efforts. Too often, patients receive overlapping calls from various team members, which leads to confusion and wasted resources. Centralizing communications eliminates redundancy.
Automation is also crucial for reducing inefficiencies without adding more work. Practices can leverage historical data to optimize staffing, reduce patient wait times, and predict patient volumes. Additionally, ambient listening technology can document provider-patient conversations directly into the chart, using large language models (LLMs) to suggest precise CPT and ICD codes that accurately reflect the patient’s condition, saving providers hours of administrative time.
Q:How do you balance the need for actionable data with the risk of overwhelming healthcare teams with too much information?
Dominguez Perez: According to HRSA, nearly half of providers experience burnout. This is often due to the high number of complex decisions they face daily. The key to managing this, again, lies in delivering data that is role-specific, intuitive, and prioritized. For example, care teams in charge of rooming patients need two pieces of information: a list of patients who frequently miss their appointments and times when they are most likely to show up, while management-level staff require trends and patterns to guide interventions. At the C-suite level, leaders need only key performance indicators (KPIs) that signal overall progress.
Overloading teams with complex graphs and datasets leads to confusion and inefficiency. It takes the average person between 60 seconds and two minutes to understand a chart, a graph, or other detailed data visualizations. Dashboards must be intuitive and designed to accommodate different preferences. We allow users to choose formats that are easiest for them to interpret for quick decision-making. Finally, prioritization is critical. Practices should focus on a few high-impact KPIs rather than attempting to address all areas simultaneously. Establishing workflows and training staff for these priorities ensures successful implementation and prepares teams for future changes.
Q: Looking ahead, what excites you most about how data and analytics are transforming patient care and healthcare delivery?
Dominguez Perez: The potential of analytics to drive personalized medicine is particularly exciting. By combining genomics with vast datasets, we can tailor treatments to individual patients in ways previously unimaginable. As a Cuban-born medical doctor, I find this especially important. Many medications today were tested on limited demographics. Machine learning is helping close these gaps by analyzing broader datasets.
Wearables powered by LLMs are also advancing rapidly, offering greater precision and relevance. These devices are more capable of detecting when an older person falls or when their oxygen level drops, helping providers act quickly. Preventive medicine is also set to benefit greatly. Sophisticated algorithms can detect early signs of chronic conditions, enabling interventions before they escalate. Meanwhile, enterprise data tools like ours prioritize the 20% of data that answers the most pressing questions, focusing on what truly matters. This allows organizations to address personalization, prevention, and efficiency, creating a smarter and more effective healthcare system.
As patient expectations continue to evolve, the demand for more intuitive and supportive healthcare experiences is higher than ever.
Today’s patients expect more than just functional care—they want care that is accessible, responsive, and tailored to their needs. Healthcare is embracing a more connected approach, with technology playing a central role in empowering patients to take an active part in their care.
Jenna Hagan, Director, Application Specialists at NextGen Healthcare, understands the potential of this transformation. Drawing on her experience as a practice administrator and patient, she knows the importance of creating a complete care experience that benefits both patients and providers. “We have to stop thinking in pieces and start thinking in full journeys,” she says. Below, Hagan explores how the NextGen® Closed Loop™ Patient and Practice Experience is reshaping care by closing the gaps between patients, providers, and technology.
Q: NextGen Healthcare is helping practices and providers reimagine the patient journey by empowering patients to take a more active role in their care. Why is this so important?
Hagan: Historically, the patient journey has been fragmented, and healthcare technology hasn’t always served us well. It often places the burden solely on the patient or the practice to manage everything from paperwork and scheduling to payments. Rarely does it support both equally. For example, some systems might automate messages asking patients to fill out forms electronically, but staff still have to enter the information into the system manually. Reimagining the patient journey means adopting a balanced, transformative approach that considers the needs of both the patient and the practice.
The right approach and technology create a more meaningful and streamlined experience, reducing the workload for staff and allowing patients to feel more engaged and supported throughout their care. This also encourages patients to take an active role in their health because they feel heard and can access care more easily.
Q:Why is it so crucial that practices keep up with evolving patient expectations around access to care?
Hagan: Healthcare has evolved tremendously over the past few decades, from paper charts to EHRs and Meaningful Use criteria, along with MIPS reporting and quality measures. Now, the patient and provider experience is evolving rapidly as science and technology advance, and we must meet the rising expectations around this transformation to ensure access to care improves.
For example, I recently moved to another state and signed up with four new healthcare providers. It was a challenging experience—one that required multiple phone calls to confirm appointments, stacks of paperwork, and even receiving 13 emails within an hour to set up a password. These frustrations are common, and if practices don’t keep up, they risk losing patients and providers. Patients may cancel appointments or not return due to the complicated process, and providers, in turn, will see their schedules suffer. It’s no longer negotiable: We must make access to care easier for patients while ensuring that providers have the support they need.
Q:What are the components of the NextGen® Closed Loop™ Patient and Practice Experience?
Hagan: The closed loop is comprised of five key areas: access, intake, visit, care coordination, and health management. This journey, supported by a single, integrated platform, encompasses both the patient and provider experiences. It starts from the moment a patient schedules an appointment and extends all the way through to billing and collections. The platform includes AI-powered documentation for providers, automated payment collections for back-office staff, and claims processing through a clearinghouse. All elements of this technology are integrated and work seamlessly together. Whether it’s the patient interacting with the system, the provider using it, or the practice tracking data, everything is connected, removing the need for staff to switch between systems or manually enter data.
Q: How does an effective closed loop experience contribute to better outcomes for patients and providers alike?
Hagan: A well-executed closed loop experience reduces inefficiencies, cuts administrative burdens, and allows providers to focus more on patient care while offering patients convenient access. The result? Greater engagement, higher satisfaction rates, and improved operational efficiency. Patient access is one of the most important buckets of the closed loop because it sets the stage for an integrated experience all the way through. For example, when a patient completes an electronic form, it should automatically flow into the system, allowing for uninterrupted, meaningful face-to-face interactions with their provider. Ambient listening technology further enhances this experience by automating documentation, freeing providers from hours of charting so they can focus on patient care.
We’ve seen significant results with this approach and technology. One client saw a 54% reduction in no-shows after implementing our integrated platform, which uses text messaging to simplify scheduling—34% of patients are more likely to reschedule through text. The technology is intuitive, recognizing responses like “yes,” a thumbs-down emoji, or “reschedule,” which automatically triggers a text with the next available appointments.
As healthcare leaders, it’s important to consider our own experiences as patients. This perspective helps us identify opportunities and prioritize solutions. Vendor consolidation is also crucial. The more fragmented your systems are, the more difficult it becomes to maintain them. A truly effective closed loop system is about integrating technology that works seamlessly to support both patients and providers.
In the exam room, the challenge of multi-tasking often leaves physicians struggling to engage fully with patients as they simultaneously input data into a computer.
This divided attention can disrupt meaningful connections. Ambient listening technology offers a solution by seamlessly capturing provider-patient interactions and converting them into detailed documentation. This allows healthcare providers to stay fully present, free from the distraction of manual note-taking, and even regain valuable time in their day. A study in the Annals of Internal Medicine found that clinicians may need up to two additional hours of electronic data entry for every hour of direct patient contact. Ambient listening technology aims to change that.
“Having ambient technology listening in the exam room improves the provider-patient experience by capturing the entire conversation, including nuances that might be missed during a busy day,” says Jeremy Dixon, vice president of product development for NextGen Healthcare. In this conversation, Dixon discusses the power of ambient listening technology to transform exam room interactions, improve clinical workflows, and help providers reclaim joy by being more efficient and empathetic.
Q: How do you see AI reshaping the healthcare landscape, particularly in terms of improving patient care and operational efficiency?
Dixon: I like to compare the current state of AI in healthcare to the introduction of the first iPhone. When the iPhone was first released, it was limited—no app store, no 4G or 5G—but everyone could see its potential to revolutionize the digital world. Similarly, AI in healthcare is at an early stage, but it’s already starting to transform how we approach patient care and operational efficiency. Take imaging, for example. AI is now helping providers and radiologists by pinpointing details in scans that might have been missed before. Ambient technology is also advancing to overhaul clinical documentation processes, leading to greater accuracy, more quality time with patients, faster billing processes, and less burnout.
Q:Can you share the vision behind NextGen Ambient Assist and what specific challenges it aims to address in healthcare?
Dixon: Documentation burdens are a significant pain point for providers and clinicians, exacerbated by government regulations and demand for more detailed records. Many providers find themselves working nights and weekends to stay on top of documentation, which can detract from their personal lives and contribute to burnout. NextGen Ambient Assist aims to alleviate this burden through discreet listening technology that captures conversations during patient exams. The technology then generates a structured note so that when the provider finishes the chart, they're getting a good foundation of what happened in that room. The result is a more interactive discussion between the provider and patient with fewer distractions and a more efficient clinical workflow overall, with some of our providers indicating a 60% reduction in after-hours charting. Additionally, clients have reported up to a 50% reduction in billing process time.
Q:NextGen’s ambient listening technology offers EHR integration—why is that so important?
Dixon: There's much hype around ambient technology with the explosion of vendors in the healthcare space. However, many of them are not integrated with the EHR, which forces providers to move data between different systems. They end up manually copying data from their laptop into specific fields in an EHR browser, losing that efficiency that ambient listening technology promised initially. Producing a note that is relevant to the conversation that happened in the room is just table stakes.
At NextGen Healthcare, we are focused on reducing the number of screens, clicks, and the amount of editing through robust EHR integration. What’s critical today is enabling providers to add data with a single click. We're doing that on the narrative fields and going a step further by integrating into other key clinical workflows that are very click-heavy. For example, our technology can correctly identify and add medications and diagnosis codes directly into the EHR without the provider having to do anything other than accept the AI-generated suggestion.
Q: What has been the feedback from healthcare providers who are using this technology?
Dixon: Providers are excited to have a tool that helps accurately document the encounter in less time and with more accuracy. When they finish their charting, they have a note that is about 95% accurate. This consistently helps reduce cognitive fatigue because they don’t have to go back and relive all these encounters hours after the fact.
They are also excited about having a better work-life balance. For example, one provider who is an early adopter of ambient listening technology has a lake house she goes to with her family in the summer. Before using this technology, she always took her computer with her to catch up on notes while everyone else was sleeping in. But now, for the first time in years, she’s been able to enjoy that family time. Another provider who uses Ambient Assist said they are seeing as many as five more patients a day while still getting home earlier to be with their family.
Overall, providers report that they are saving five to ten minutes per encounter on EHR documentation time. This tool allows them to spend more time with patients because they can trust the system to document the encounters accurately.
Chebli: Interop is mission-critical, and a big part of that comes down to the fact that healthcare is a team sport. There are so many different players involved in a patient's care—primary care, specialists, payers, labs—and they all need to share data, often across various platforms. Even within the same health system, there are internal systems that have to talk to each other. That's why you need something flexible like Mirth that can manage those connections and scale with you as your environment changes.
Dominguez Perez: When healthcare teams have better access to analytics, they can address more complexities while prioritizing their most critical tasks. This empowerment starts with simplicity. A centralized system with single sign-on capabilities ensures that all relevant data is in one place and can be tailored to the specific roles of team members. For example, instead of everyone in the practice consuming the same generic reports, analytics should be segmented by job role, ensuring actionable information reaches the appropriate team member. Providers need clinical insights and risk-assessment analysis at the point of care, while operational and financial analytics benefit practice managers and executives.
Hagan: Historically, the patient journey has been fragmented, and healthcare technology hasn’t always served us well. It often places the burden solely on the patient or the practice to manage everything from paperwork and scheduling to payments. Rarely does it support both equally. For example, some systems might automate messages asking patients to fill out forms electronically, but staff still have to enter the information into the system manually. Reimagining the patient journey means adopting a balanced, transformative approach that considers the needs of both the patient and the practice.
Dixon: I like to compare the current state of AI in healthcare to the introduction of the first iPhone. When the iPhone was first released, it was limited—no app store, no 4G or 5G—but everyone could see its potential to revolutionize the digital world. Similarly, AI in healthcare is at an early stage, but it’s already starting to transform how we approach patient care and operational efficiency. Take imaging, for example. AI is now helping providers and radiologists by pinpointing details in scans that might have been missed before. Ambient technology is also advancing to overhaul clinical documentation processes, leading to greater accuracy, more quality time with patients, faster billing processes, and less burnout.