What eCW’s FHIR API covers, what it doesn’t, and how teams get full read and write access.
The certified FHIR endpoint exists to satisfy ONC’s rule, which scopes it to USCDI: a government-defined list of clinical data. It is read-focused, and it reads that clinical data well.
The eCW FHIR API has no concept of scheduling, eligibility, claims, or documents. Writes are partial and need a separate commercial agreement, and there is often no way to confirm a write landed.
FHIR exports problems, meds, allergies, and labs. The moment you need to write back, or touch anything operational, you are off the map.
eCW’s FHIR Create APIs cover a few clinical resources and require a separate commercial contract before you can even start. Most workflows have no write path at all.
eCW often does not expose the read endpoints needed to verify a write even landed (there is no “list documents for patient”). So failures are ambiguous and writes can’t be safely retried.
The same eCW instance, two integration paths. The right column is what FHIR gives you. The left is what Cobalt gives you.
| Capability | Cobalt | eCW FHIR |
|---|---|---|
| Scheduling | ||
| Create, reschedule, and cancel appointments | ✓ | ✕ |
| Read live provider availability | ✓ | ✕ |
| Patients & intake | ||
| Create and update patients (demographics, guarantor) | ✓ | Limited* |
| Add and update insurance on a patient | ✓ | ✕ |
| Upload documents into the patient chart | ✓ | ✕ |
| Clinical & workflow | ||
| Read clinical data (problems, meds, allergies, labs) | ✓ | ✓ |
| Send inbox messages to providers and staff | ✓ | ✕ |
| Create telephone encounters and log call outcomes | ✓ | ✕ |
| Billing & revenue cycle | ||
| Create claims from encounters | ✓ | ✕ |
| Read claims to the line item (CPT, billed, allowed) | ✓ | ✕ |
| Read remittance / ERA (payments, adjustments, denial codes) | ✓ | ✕ |
| Read fee schedules (per-code fee and allowed amount) | ✓ | ✕ |
| Real-time eligibility and benefits (deductible, copay, coinsurance) | ✓ | ✕ |
| Trust & delivery | ||
| Confirmation receipt with the new record’s eCW ID on every write | ✓ | ✕ |
| Live the same day, no certification or contracting gate | ✓ | ✕ |
*Limited: eCW exposes a narrow set of FHIR Create operations for certain clinical resources, available only under a separate commercial contract. Reads of standardized clinical data (problems, meds, allergies, labs) work well over FHIR; Cobalt reads those too, so a single integration covers both.
If you only need read-only clinical data (problems, meds, allergies, labs, immunizations), the eCW FHIR API may be all you need. Start there.
If your product books appointments, creates patients, adds insurance, checks eligibility, submits or reads claims, or uploads documents, FHIR does not get you there. Cobalt gives you real-time read and write into live eCW, with a receipt on every write.
Yes. eCW has a certified FHIR API built for ONC compliance. It covers USCDI clinical data such as problems, medications, allergies, labs and immunizations, and it is mostly read-only.
Only in part. eCW exposes a narrow set of FHIR Create operations for certain clinical resources, and they require a separate commercial agreement. There is often no read endpoint to confirm the write landed.
No. Scheduling is not in the eCW FHIR API. Cobalt creates, reschedules and cancels appointments on live eCW.
For FHIR, you register your app through eCW. For scheduling, insurance, eligibility, claims and documents, book a 30-minute call with Cobalt or use Request API access. The practice creates one eCW staff user for Cobalt, with no eCW partner contract.