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Healthcare FHIR Lakehouse: 18 EMRs Unified on Medallion Architecture

About the Client

The client is a regional hospital network managing clinical data across 18 legacy EMR systems. Data fragmentation and lack of interoperability limited care coordination, analytics, and population health initiatives. To overcome these challenges and build a unified, scalable data platform, the organization partnered with Zymr.

Key Outcomes

68% Reduction in ADT Message Errors
Unified Patient Record Across 2.4 Million Annual Encounters

Business Challenges

The hospital network operated multiple legacy EMR systems, resulting in siloed clinical data and inconsistent formats. This fragmentation made it difficult to establish a single source of truth for patient records and limited real-time data access across care teams.

Interoperability challenges further complicated data exchange, with HL7 v2 messages often containing errors or inconsistencies. This increased dependency on manual data validation and IT intervention, slowing down clinical and operational workflows.

The absence of a standardized data model also restricted advanced analytics and population health initiatives. Clinical teams faced delays in generating insights, as data preparation required significant time and effort.

Additionally, ensuring compliance with HIPAA regulations while managing large volumes of PHI across systems added complexity to governance, security, and audit requirements.

Business Impacts / Key Results Achieved

Zymr enabled the hospital network to unify fragmented clinical data into a scalable FHIR-based lakehouse architecture, improving data quality, accessibility, and analytics capabilities.

  • 68% Reduction in ADT Message Errors
  • Unified Patient Record Covering 2.4 Million Annual Encounters
  • Accelerated Population Health Analytics with Minimal Data Preparation Effort
  • Improved Data Governance with HIPAA-Compliant Security Controls

Strategy and Solutions

Zymr designed and implemented a modern healthcare data platform using a medallion lakehouse architecture to standardize, secure, and operationalize clinical data.

  • Medallion Lakehouse Architecture
    Built a three-layer architecture with Bronze tables storing raw HL7 v2 messages, Silver tables containing validated FHIR R4 resources, and Gold tables supporting analytics and reporting.
  • FHIR-Based Data Standardization
    Transformed and normalized clinical data into FHIR R4 format to enable interoperability and consistent data access across systems.
  • Data Quality and Validation Pipelines
    Implemented automated validation processes to reduce message errors and improve overall data reliability.
  • Population Health Analytics Enablement
    Enabled advanced analytics use cases including quality measure calculations, cohort analysis, and readmission risk scoring.
  • PHI Governance and Security
    Applied column-level security, audit logging, and HIPAA-compliant infrastructure with BAA agreements to ensure data protection and compliance.
  • Unified Patient Record Creation
    Consolidated patient data across multiple EMRs into a single longitudinal view to support better care coordination and clinical decision-making.
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