How Shriners Children’s bridged two EMRs without disrupting clinical care

Industry: Healthcare
Location: Tampa, Florida
Organization size: 7,000+ employees
Hyland solutions: OnBase

During Shriners Children’s multiyear Epic program, teams needed to keep clinical documentation complete and available while Cerner and Epic ran in parallel. Hyland OnBase served as a real-time automation and integration layer between the two EMRs, helping reduce downtime risks, delays and documentation gaps during go-live periods. In production, the workflow processed more than 11,600 clinical documents and orchestrated over 30,000 HL7 messages end to end, supporting more than 2,300 clinicians. With OnBase coordinating matching, enrichment and delivery, information reached the right chart at the right time — without duplicate work, manual reconciliation or added burden on clinical teams.

As Epic adoption expanded, Shriners Children’s needed real-time visibility to documentation across Cerner and Epic — two EMRs with no shared identifiers, different encounter logic and misaligned FIN/CSN values. Results finalized in Cerner also had to appear in Epic before Epic encounter and order numbers existed. That gap created the potential for missing results, mismatched records and manual rebuilds in both systems.

At the same time, Cerner Dynamic Documentation was generated in HTML — a format Epic couldn’t reliably display — so important clinical notes might not be visible when clinicians needed them. Without automation, teams would have faced dual documentation, delayed access to key information and incomplete charts — adding operational strain and increasing patient-safety risk during go-live and beyond.

Shriners Children’s deployed Hyland OnBase as a governed intermediary to ingest, match, enrich and deliver clinical documentation between Cerner and Epic. Using accession numbers as the cross-system anchor, OnBase matched Cerner results to Epic encounters once Epic generated the required identifiers, populated the encounter and order values, and delivered the enriched documents into Epic using HL7 messaging.

The organization also addressed documentation visibility by converting HTML-based Dynamic Documentation into standardized PDFs through OnBase configuration and scripting. OnBase then routed the converted documents to Epic with the correct metadata so they displayed consistently. Across both workflows, processing ran in real time with no manual intervention, helping eliminate duplicate documentation and keep records aligned.

The solution enabled straight-through processing with no manual indexing or reconciliation steps, supporting a stable go-live period with no post–go-live defects reported. More than 11,600 documents were processed, and over 30,000 HL7 messages were orchestrated to help ensure results and converted notes were attached to the correct Epic charts without delay.

More than 2,300 clinicians were supported, with documentation available at the point of care. This helped protect patient safety, maintain workflow continuity and strengthen clinician confidence as Epic adoption progressed.

The accession-based integration architecture will be reused for the Shriners Children’s Canadian Epic implementation and for the migration of three years of historical Cerner data. For converted results, the same matching and metadata enrichment approach will help align documents to the appropriate Epic encounter — supporting continuity, data integrity and clinical reliability throughout the conversion.

Shriners Children’s will continue using OnBase as a governed solution for automation and integration to support interoperability and additional content-driven clinical and operational use cases.

_{*Shriners Children’s participation in the Hyland Innovation Awards and related materials does not constitute an endorsement of Hyland or its products or services.}