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Healthcare IT


Our expertise in system integration has been successfully applied to many different healthcare projects. We specialize in building open source based Health Integration Engines.

Case Study


fusionSpan implemented the Transition of Care (TOC) Notification Service for the State of Michigan’s initiative to continuously improve health care quality, efficiency, and patient safety by promoting secure, electronic exchange of health information through their Health Information Exchange, and various other cloud hosted solutions to help statewide healthcare providers from exchanging data efficiently and securely.

Transition of Care

Patients transition from one provider or healthcare setting to another as the patients’ health care needs require. These transitions trigger Electronic Health Records to generate Admit-Discharge-Transfer (ADT) notifications that identify the patient along with important details that provide insight to an extremely complex set of care decisions being made by care teams, families and the patient.

Transitions of Care (TOC) Notification Service uses HIE message traffic to notify other providers that a care event has happened. The service receives HL7 Admission-Discharge-Transfer (ADT) and other similar messages from hospitals, urgent care, and other senders and uses the patient’s information to try and find a match to providers that are also treating that patient.


TOC service is made up of several reusable technologies, components, and services that leverage open-source software and do not require any proprietary software or external software licenses to run. TOC notification service connects with several external services including the Provider Directory, Master Patient Index (MPI) registry etc. It also implements Reliable delivery, message encryption and a flexible rules based routing engine.

TOC uses the Enterprise Service Bus architecture model and a component-based service-oriented architecture. TOC has been developed using Java programming language.

TOC Notification Service leverages and deploys on the Mule Enterprise Service Bus (ESB) platform. Mule ESB is an open source and light weight Enterprise Service Bus.


fusionSpan led the development of the TOC notification service platform. We not only leveraged our Mule ESB expertise for this project, but we also contributed several patches, bug fixes and enhancements back to MuleSoft. Notably we implemented custom transport connectors in Mule for HL7 v2 using the HL7 Lower Layer Protocol (LLP).

Why fusionSpan?

Our expertise is using Open Source tools to develop production grade application that can scale to handle large volumes of data, use state of the art encryption to keep patient data safe and comply with HIPAA.