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Mirth and eClincial Works

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  • Mirth and eClincial Works

    Hi. I’m new to Mirth group and currently getting my certification in Healthcare IT at a local university. The final project for class is to create a not for profit organization to implement EMR/EHR in small physician practices in the local area. Some of us would really like to run with this once class is over. We are using a model similar to the CHCF and will be using eClinical Works (eCW) as the solution to begin.

    eCW will be a Software as a Service hosted by eCW. From what I understand from eCW is that there is a small piece of software on the client that communicates with eCW databases and there is no cache (for security). One of the deliverables for the class is to use Mirth as the interface engine. I downloaded Mirth onto my Mac and began playing around with it. For someone who is not all that technologically savvy, I was able to transfer and rename some files around on my laptop using it.

    How would this work using eCW? My impression is that each physician’s office would have one computer with Mirth Connect on it and using a customized channel/interface, communicate with the eCW databases, correct? (I understand we would have to build that channel/interface to eCW databases and we would have to have permission from eCW to access that data.) What am I missing? Is it really that simple? Any suggestions? Has someone already used eCW with Mirth?

    I know this is probably a lot of questions. I’m trying to really understand how this works so we can make it a viable solution for our organization.

    We need to keep this as low cost as possible to start, but if it takes off we would want to start using Mirth Appliances in the future.

    Thanks in advance for any help.

  • #2
    Wow, Mirth Connect as a deliverable? that's cool. Could you simplify the problem a bit and try and explain what you are going to need an interface for. If each physician's office is running eCW would you need Mirth to send data to a central node?


    • #3
      Hey Brad. We are going to need to interface with an HIE and eventually with NHIN. I don't believe we would need Mirth Connect to talk with labs or pharmacies because that is part of the eCW package. eCW would be hosting all the data, but as of this time they don't report it to an HIE.

      We are also looking at creating a patient portal. I believe (and please do correct me if I am wrong) we would be able to use Mirth Connect to pull the necessary patient information and provide to patient through a secure website.


      • #4
        you could definitely use mirth to pass data from a database to an HIE . Do you have an HIE in mind?


        • #5
          Thanks for all your help so far.

          At this point we do not have an HIE in mind. I'm not really sure there is one in the area at the moment, but San Diego did just get a Beacon grant to begin putting one together.

          If an HIE were available, would Mirth have to be on a computer in every physician practice we support to pass that data?


          • #6
            I will be very interested to see what you can do with Mirth and eCW. For the past 2 years I've been pulling encounter, demographics, lab, and med data out of an eCW back-end running on MySQL server. I pull the data out of eCW at a safety net clinic, encrypt it and FTP it to my facility were I then push it in to a county wide diabetes registry on SQL Server.

            This worked great until eCW changed their policy this year about giving access to the data on MySQL Server. I've been going back and forth with them for 2 months and have an agreement that they will give me access only to a back up of the database. This will work for my needs because I don't need a real-time data exchange, but I'm not sure this would work for a HIE.

            It seems you would need Mirth at every practice office but you also may need something more. How do you plan to do patient matching? Will the provider make a request for data on a specific patient? If so, will there be an interface of some sort. It would be awkward for the practice office to interact with Mirth. Mirth would just be for receiving and sending data. It is not something I would expect an MA or provider would interact with.


            • #7
              I'll also add that we have been talking with eCW about hosting the product as an ASP for smaller practices in the area. The main reason we are leaning away from them is because of the cost of developing interfaces. eCW sells its own interface engine with the EMR but from talking with them they charge $10k-$15k for each interface you want to open up. It does not seem like it is like Mirth or other 3rd party interface engines where you can set up a new interface yourself. On the other hand, I'm just starting to work with a practice using AllScripts and another using NextGen and in both cases someone in the practice has access to the interface engine and can do the mapping and set up with no additional cost for the new interface. I will be using Mirth at my end to send them HL7 messages.


              • #8
                Originally posted by Paul P View Post
                If an HIE were available, would Mirth have to be on a computer in every physician practice we support to pass that data?
                I think that would depend on how you could access the data. eCW is hosted, so for a given physician you could access their data from anywhere if eCW allows it. If eCW requires that Physician A must access it using A's VPN connection to eCW and only from the office, then you're stuck and have to have a Mirth instance at each office.

                Another constraint may be the cost of interfaces as GregD mentions. If you can piggyback Mirth on top of an existing interface, it's far cheaper to install Mirth at the physicians office than it is to pay eCW for a new interface.

                I guess the simplest way to explain it is that Mirth needs to be able to get the data the HIE needs. If you can get that data centrally, then you can install Mirth centrally. If you can only get that data at the physician offices, then you're stuck installing Mirth at the physician offices.
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                • #9
                  Interesting. So has anyone been able to connect yet to an eclinical works DB without eclinical works help (piggybacking Mirth on top on an existing interface)? Those that work with eclinical works is an interface as expensive as quoted?


                  • #10
                    Is the Mirth applicable in all offices who have company Physician?

                    You know I'm working one of the top company in our place, that has it's own company physician and nurses too. But I'm one of the workers who assign in our clinic, as data encoder and assistant to our nurses.

                    What we had now is more on patients card, every time our patients who come to visit the clinic and been diagnosed by our physician. So the findings will be put on the paper cards. Of course we have the office interface, so it is advisable in a office to use eCW.

                    Please give some sort of reason why we need it for our daily transaction with our patients. So that I can recommend this our physician and be brought out to our heads.


                    • #11
                      Not sure what you're asking for. I just wanted to know if anyone is piggybacking Mirth on top on an existing eclinical works interface to get data from a database.


                      • #12
                        I did/am connecting to an eCW running on MySQL 5.1. I say 'did/am' because originally it was hosted on a server locally and I could access the database directly. Last year the practice moved the db to an ASP. The interesting thing is, when it was local I could access all of the tables, no problem. When it was moved off site I was told that eCW no longer allowed this because of potential HIPAA violations. However, they were willing to give me regular backups of the database. Very odd. So now I get weekly back-ups which I restore locally and report off of.

                        I'm not using Mirth to do this, but the point is, even if Mirth can do it, eCW might not give you the ability to get in unless it is an older installation. As a side note, the eCW database is crazy. There are over a 1000 tables in the db. It took me a while to figure out where everything is so I could get out what I needed.



                        • #13
                          I work with a practice that runs eClinicalWorks (not ASP hosted model). I have a couple questions for you but believe that you can still connect to the database even if you are hosted at eClinicalWorks.

                          Please contact me at my e-mail address: kgaston at or kgaston at



                          • #14
                            eCW and Mirth - Interface Costs

                            Originally posted by snaven View Post
                            Interesting. So has anyone been able to connect yet to an eclinical works DB without eclinical works help (piggybacking Mirth on top on an existing interface)? Those that work with eclinical works is an interface as expensive as quoted?
                            We have done a lot of ECW interfaces and they don't cost that much per interface.

                            What they are probably quoting is a one-time fee for development costs, plus installing and testing the interface.