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Healthcare integration & modernization platform

Connect What You Have. Enable What’s Next.

Simplify healthcare integration and modernize legacy systems. Connect existing clinical applications with modern APIs, digital workflows and AI-enabled solutions, without starting from scratch.

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HL7 v2 · FHIR R4 · DICOM · DICOMweb · REST APIs · WebhooksSee supported standards
Existing systems
  • HIS / EHR / HMIS
  • RIS
  • PACS and modalities
  • LIS
MiddleOffice
New capabilities
  • Modern applications
  • AI and analytics applications
  • Other PACS and reading sites
  • Patients and referrers
  • ABDM (India)
The challenge

Healthcare systems were not built to talk to each other

Most organizations run a mix of systems bought over many years. Each new connection adds cost and risk.

  • Fragmented systems

    HIS, RIS, PACS, LIS and modalities each hold part of the patient journey, and staff re-enter what one system cannot pass to the next.

  • Legacy infrastructure

    Older systems still run core workflows but expose little beyond proprietary or point-to-point interfaces.

  • Disconnected data

    Orders, studies and reports drift out of step, so cases arrive without context and results go missing.

  • Expensive custom interfaces

    Every new application can mean another bespoke interface to build, test and pay for.

  • Maintenance complexity

    A web of one-off connections is hard to monitor, and failures are often found by users rather than by IT.

How MiddleOffice works

Connect, transform, route, monitor, modernize

MiddleOffice sits between the systems you run and the applications you want to add, and handles each handoff.

  1. Connect

    Attach existing systems through standard interfaces instead of new point-to-point builds.

    • HL7 v2 over HTTP API, file drop or MLLP
    • FHIR R4 API
    • DICOM receive, DICOM Exchange and MWL Service

  2. Transform

    Map patient, order and study data between the formats each system expects.

    • HL7 v2 acknowledgements and duplicate protection
    • Patient and order data available as FHIR R4 resources

  3. Route

    Send each message or study to the system or reading team that needs it.

    • Rule-based study routing (DICOM C-STORE SCU)
    • Automatic radiologist assignment
    • Push FHIR resources to other systems
    • Patient and referrer messages over WhatsApp, email or SMS

  4. Monitor

    Track every handoff so a failed delivery is visible and recoverable.

    • Status history for studies and reports
    • Automatic retries and held failed messages
    • Message search, delivery alerts and replay
    • Reporting dashboards across connected systems

  5. Modernize

    Add new applications and services while the systems you rely on stay in place.

    • Standards-based access for new applications
    • Replace one system later without rebuilding every interface
Systems you run today
  • HIS / EHR / HMISHL7 v2 · FHIR R4
  • RISHL7 v2 orders and scheduling
  • PACS and modalitiesDICOM · DICOM Exchange · MWL Service
  • LISHL7 v2 results (ORU)
MiddleOffice
  1. Connect
  2. Transform
  3. Route
  4. Monitor
What you can connect them to
  • Modern applicationsFHIR R4 API · REST APIs · webhooks
  • AI and analytics applicationsDICOM routing · DICOMweb retrieve
  • Other PACS and reading sitesDICOM send by rule
  • Patients and referrersWhatsApp · Email · SMS
  • ABDM (India)RadpicsAI production connector
Supported interfaces are listed in Standards and connectivity. Mapping and routing are agreed for each deployment.
Why MiddleOffice

Integration made simple. Modernization made possible.

Easy healthcare integration

One integration layer instead of a new interface for every pair of systems.

  • HL7 v2, FHIR R4, DICOM and DICOMweb in one place
  • Start with a single workflow, then extend
  • Interfaces confirmed for your systems during scoping

Legacy modernization without replacement

Keep the HIS, RIS and PACS that work, and add capabilities around them.

  • No rip-and-replace programme to begin
  • Older systems reach new applications through standard APIs
  • Swap one system later without re-wiring the rest

AI-ready interoperability

Give AI and analytics applications a governed path to the data they need.

  • Route studies to an application by rule
  • Standard retrieval through DICOMweb and FHIR R4
  • Results written back as a DiagnosticReport through the FHIR API
Standards and connectivity

Supported standards and interfaces

Support differs by message type and direction. Interfaces for your systems and versions are confirmed during scoping.

HL7 v2

  • Receive ADT, SIU, ORM, OMG, OMI and ORU messages
  • Acknowledgements (AA/AE/AR) and duplicate-message protection
  • Send ADT, SIU and ORM messages
  • Send signed reports as ORU^R01 results

HL7 transports

  • HL7 over the HTTP API or file drop
  • HL7 over MLLP
  • Encrypted transport (TLS) for MLLP links

FHIR R4

  • API: Patient, Encounter, Appointment, ServiceRequest, Observation, Organization, Location
  • API: ImagingStudy and Practitioner (read), DiagnosticReport (read and create)
  • Send FHIR resources to other systems

DICOM

  • Receive studies from modalities and PACS (C-STORE SCP)
  • MWL Service: Modality Worklist for your modalities (MWL C-FIND SCP)
  • Send studies to other PACS or applications by rule (C-STORE SCU)
  • DICOM Exchange: move studies between PACS, sites and RadpicsAI cloud
  • Encrypted transport (TLS) for DICOM links

DICOMweb, REST APIs and webhooks

  • DICOMweb search and retrieve (QIDO-RS, WADO-RS)
  • REST APIs with token-based access through RadpicsAI single sign-on
  • Webhooks: signed (HMAC) event notifications to other applications
Storing studies over DICOMweb (STOW-RS) is not supported.

India: ABDM

  • Connection to ABDM through RadpicsAI’s production connector
Details by standard: HL7 and FHIR, DICOM and DICOMweb, healthcare APIs and ABDM.
Communication and reporting

Reach patients and referrers, and see every handoff

Beyond connecting systems, MiddleOffice delivers messages to the people waiting on them and reports on what is moving through.

Communication layer

Design message templates once and deliver them to patients, referrers and staff on the channel each one uses.

  • Template designer for messages and notifications
  • Customer communication and delivery over WhatsApp, email and SMS
  • Short URLs for appointment and report links
  • WhatsApp
  • Email
  • SMS
  • Short URLs

Reporting and dashboards

See the activity moving through your connected systems in one place.

  • Dashboards for activity across connected systems
  • Reports on message volumes and delivery
  • One view for IT and operations teams
Integration use cases

Where teams start

Each use case lists the capabilities it relies on.

Legacy HIS/EHR to modern applications

Hospitals · Healthcare SaaS companies
The gap
A new application needs patient and order data held in an older HIS that only speaks HL7 v2.
How MiddleOffice helps
MiddleOffice receives the HL7 v2 messages and exposes the data through a FHIR R4 API the new application can use.
Relies on
  • HL7 v2 receive
  • FHIR R4 API
  • Push FHIR resources to other systems

RIS/PACS and imaging workflow connectivity

Hospitals · Imaging centres
The gap
Orders are re-typed at the modality, and studies reach PACS without the right patient or order.
How MiddleOffice helps
Modality Worklist gives modalities the scheduled order from MedCARE™ or your current RIS, and studies arrive in MedPACS™ or your PACS with that order attached.
Relies on
  • MWL Service
  • DICOM receive
  • DICOM send by rule

Healthcare data routing and transformation

Hospital networks · Systems integrators
The gap
Each system expects data in its own form, and failed handoffs go unnoticed.
How MiddleOffice helps
Messages are acknowledged, mapped and delivered with retries, and failures are held with their error for follow-up.
Relies on
  • HL7 v2 receive and send
  • Retries and held failed messages
  • Message search and replay

AI applications in clinical workflows

Hospitals · AI and analytics vendors
The gap
Each AI pilot needs its own route to images and a way back into the reporting workflow.
How MiddleOffice helps
Studies are routed to the application by rule or retrieved through DICOMweb, and its output can be written back as a DiagnosticReport through the FHIR API. MiddleOffice moves the data; it does not analyse images.
Relies on
  • DICOM send by rule
  • DICOMweb search and retrieve
  • FHIR DiagnosticReport create

Multi-facility interoperability

Hospital networks · Teleradiology providers
The gap
Studies and orders must move between sites that run different systems.
How MiddleOffice helps
An on-site gateway at each facility connects to RadpicsAI cloud, and routing rules send studies to the right site or reading team.
Relies on
  • On-site DICOM gateway
  • DICOM Exchange between facilities
  • Rule-based study routing
  • Automatic radiologist assignment

Patient and referrer communication

Hospitals · Diagnostic centres
The gap
Staff phone or email patients and referrers one at a time about appointments and reports.
How MiddleOffice helps
Messages built from templates are delivered over WhatsApp, email or SMS, with short URLs for appointment and report links.
Relies on
  • Template designer
  • WhatsApp, email and SMS delivery
  • Short URLs
Getting started

From first workflow to go-live

Integration projects start small. Each step is agreed with your IT and clinical teams.

  1. Scope one workflow

    Pick a single handoff, such as HIS order to signed report, and list the systems, versions and messages involved.

  2. Connect in a test environment

    Attach your systems to a non-production environment and exchange sample messages and studies.

  3. Map and route

    Agree field mappings, routing rules and acknowledgements for each system.

  4. Validate with your team

    Run the workflow end to end with your users before anything reaches production.

  5. Go live and track

    Switch the workflow over, track deliveries, and add the next workflow when ready.

Security and deployment

Security controls and deployment options

Security controls

  • Token-based API access through RadpicsAI single sign-on
  • Audit trail of user and system actions
  • Encrypted transport (TLS) for HL7 MLLP and DICOM links

Deployment options

  • Cloud-hosted integration services
  • Hybrid: on-site gateway with RadpicsAI cloud
  • Fully on-premises deployment
We do not claim a compliance certification for MiddleOffice. Your security, hosting and regulatory requirements are reviewed during scoping, and we will tell you which controls apply to your deployment.
Our approach

Practical modernization for imaging-led organizations

  • Focused on imaging workflows

    Built around the handoffs between HIS, RIS, PACS, modalities and reporting, not a general-purpose integration engine.

  • Protects what you have invested

    Your current systems stay in service; MiddleOffice connects them rather than replacing them.

  • Practical, one workflow at a time

    Start with the handoff that costs your team the most, prove it, then extend.

  • Standards-based by design

    New applications connect through HL7 v2, FHIR R4, DICOM and DICOMweb rather than proprietary interfaces.

Illustrative workflow

From an HIS order to a signed report

How one common workflow runs through MiddleOffice, step by step.

MiddleOffice works with these products and without them. Storage tiers are covered in the MedPACS storage lifecycle.

  1. The HIS sends an imaging order as an HL7 v2 message, and MiddleOffice acknowledges it

  2. The order reaches the RIS, MedCARE™ or your own, and appears on the modality through the MWL Service

  3. The study is received with its order attached, stored in MedPACS™ or your PACS, and routed to the reading team

  4. Each handoff is recorded in the study’s status history, with failed deliveries retried

  5. The signed report returns to the HIS as an HL7 ORU^R01 result

FAQ

Questions integration teams ask

Do we need to replace our HIS, RIS or PACS?

No. MiddleOffice connects to the systems you already run through standard interfaces. You can keep them, replace one later, or add RadpicsAI products alongside them.

Which standards does MiddleOffice support?

HL7 v2, FHIR R4, DICOM and DICOMweb search and retrieve, plus REST APIs and webhooks. Support differs by message type and direction, so each interface is listed in Standards and connectivity. Interfaces for your systems and versions are confirmed during scoping.

Which vendors and systems have you integrated with?

We do not publish vendor names without permission. Tell us your systems and versions, and we will confirm the interfaces available for each during scoping.

Can MiddleOffice run on premises?

Yes. Cloud-hosted, hybrid (an on-site gateway connected to RadpicsAI cloud) and fully on-premises deployments are available. We agree which components run where during scoping.

How are failed messages handled?

Deliveries are retried automatically with increasing delays, and messages that still fail are held with their error. Teams can search for a message, review its delivery status and re-send it after a fix, with delivery and turnaround alerts to support follow-up.

Can we connect AI applications?

Yes. Studies can be routed to an application by rule or retrieved through DICOMweb, and results can be written back as a DiagnosticReport through the FHIR API. MiddleOffice moves data between systems; it does not analyse images.

Can MiddleOffice message patients and referrers?

Yes. The communication layer lets you design message templates and deliver them over WhatsApp, email or SMS, with short URLs for appointment and report links.

Does MiddleOffice include reporting and dashboards?

Yes. Reporting and dashboards show the activity moving through your connected systems, including message volumes and delivery.

Is MiddleOffice HIPAA or GDPR compliant?

We do not claim a certification for MiddleOffice. We review your regulatory and security requirements during scoping, and the security controls are listed on this page.

Does MiddleOffice support ABDM?

Yes. RadpicsAI’s ABDM connector is live in production. Each facility still needs its own onboarding, which is separate from the connector.

Is MiddleOffice a RIS or a PACS?

Neither. MedCARE™ is the RadpicsAI RIS, MedPACS™ stores imaging and MedVIEWER™ provides viewing. MiddleOffice is the integration layer between them and your other systems, and works without them.

How long does a first integration take?

It depends on the systems, interfaces and approvals involved. Scoping one workflow gives you a plan with the steps and owners for your project.

Integration assessment

Modernize Your Healthcare Systems Without Starting Over.

Tell us about the systems you run and the workflow you want to connect. We will review it with you and outline an approach.
  1. We review your systems and integration challenge.
  2. We arrange a conversation with your IT team.
  3. You receive a scoped approach for one workflow.
Book an Integration Demo

Request an integration assessment

For example, your HIS, RIS and PACS. Please do not include patient information.
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