# Health Tech

> How health care runs in software, from the front desk of a small practice to records, claims, payers, pharmacy and trials, under HIPAA and the Cures Act.

A dental office, a vet clinic and a hospital look like different businesses, and underneath they run on the same records: a patient, the people and places that treat them, appointments, encounters, coded procedures, the coverage that pays for some of it and the ledger that bills the rest. Every one of those records lives in several systems at once (a practice management system on a server in the back office, an EHR, a clearinghouse, a payer, a patient engagement platform texting reminders from the front desk), each speaking its own standard (HL7 v2, FHIR, X12, NCPDP, DICOM) and each answerable to HIPAA, the Cures Act's information blocking rules, state health privacy laws and the payer's contract. This book surveys how the industry does each piece, benchmarked across Epic, Oracle Health, athenahealth, Dentrix, Open Dental, ezyVet, Weave, NexHealth, Phreesia, Availity, Waystar, Surescripts, Medidata, Veeva and the others, with no single vendor as the model, and how you'd build it, extending one core data model chapter by chapter.

It reads in ten parts, plus a reference. The Business: the parties and how money flows, the landscape, how a practice runs, business models for health software and selling into health care. Records and Interoperability: EHR and PMS records, HL7 v2, FHIR, SMART apps, documents and images, exchange networks, patient matching and code sets. Rules of the Record: HIPAA in practice, information blocking and certification, state health privacy, consent and security. Revenue Cycle: eligibility, claims, clearinghouses, remittance, denials, prior authorization, patient financial experience, coding compliance and value-based care. Practice Management and Patient Engagement: integrating with practice management systems, scheduling and online booking, reminders and recall, phones, texting, intake, reviews, payments, membership plans, veterinary, dental and specialty practices, multi-location groups, and analytics and the AI front desk. Care Delivery: telehealth, e-prescribing, labs, referrals, hospitals, digital health and patient portals. Payers, Pharma and Clinical Trials, and Beyond the US. Running the Platform: architecture, AI, operations, metrics, migrations and data use. Reference: a glossary of every term, grouped by part.

## Chapters

- [The Health Tech Business](https://www.syntaqx.com/books/health-tech/health-tech-business): How health care works in software: the parties, how the money flows, the life of a visit, and the core data model every later chapter extends.
- [The Health Tech Landscape](https://www.syntaqx.com/books/health-tech/health-tech-landscape): Who sells health software: EHR and practice management markets, patient engagement, revenue cycle, networks, telehealth, and who bought whom.
- [The Practice Business](https://www.syntaqx.com/books/health-tech/practice-business): How a small practice runs and earns: the front desk, production and collections, recall as revenue, DSOs and MSOs, corporate practice law and consolidators.
- [Business Models for Health Software](https://www.syntaqx.com/books/health-tech/health-tech-business-models): How health software charges: per location and provider, payments, per transaction, percentage of collections, API fees, pharma-funded and consumer models.
- [Selling Software into Health Care](https://www.syntaqx.com/books/health-tech/vendor-compliance-posture): What a vendor needs to sell into health care: business associate status, BAAs and their chains, HITRUST and SOC 2, reviews, state laws and the FTC breach rule.
- [EHRs, PMSs & the Clinical Record](https://www.syntaqx.com/books/health-tech/ehr-and-pms-data): What an EHR and a PMS each hold, the problem list, meds, allergies and notes, charting by specialty, the legal record, amendments and retention by state.
- [HL7 v2 & Interfaces](https://www.syntaqx.com/books/health-tech/hl7-v2): The pipe-delimited messages that still run hospitals: segments, ADT, orders, results, scheduling and charges, acknowledgments, MLLP and interface engines.
- [FHIR](https://www.syntaqx.com/books/health-tech/fhir): FHIR from the integrator's side: resources and REST, search, R4 to R6, US Core and certification, Bulk Data export, Subscriptions, CDS Hooks and terminology.
- [SMART on FHIR & App Platforms](https://www.syntaqx.com/books/health-tech/smart-on-fhir): How apps get into EHRs: SMART App Launch, v2 scopes, EHR and standalone launch, backend services, Epic and Oracle app programs, and patient access apps.
- [C-CDA, Documents & Images](https://www.syntaqx.com/books/health-tech/documents-and-ccda): Clinical documents and images: C-CDA templates, Direct secure messaging, fax and scans, DICOM, PACS and DICOMweb, and dental imaging bridges.
- [Networks & Exchange](https://www.syntaqx.com/books/health-tech/health-information-exchange): How records move between organizations: HIEs, eHealth Exchange, CommonWell, Carequality, TEFCA and QHINs in October 2026, query vs push, individual access.
- [Patient Matching & Identity](https://www.syntaqx.com/books/health-tech/patient-matching-and-identity): Finding the right patient without a national ID: MPIs, matching algorithms, the appropriations rider, duplicates and overlays, merges, and IAL2 proofing.
- [Terminologies & Code Sets](https://www.syntaqx.com/books/health-tech/terminology-and-coding): The codes inside health records: ICD-10, CPT, HCPCS, CDT, SNOMED CT, LOINC, RxNorm, NDC, CVX and taxonomy codes, licenses, release cadence, value sets and maps.
- [HIPAA in Practice](https://www.syntaqx.com/books/health-tech/hipaa-in-practice): HIPAA where health software meets it: who is covered, TPO and minimum necessary, right of access, marketing, texting and email, breaches and OCR enforcement.
- [Cures Act, Information Blocking & Certification](https://www.syntaqx.com/books/health-tech/information-blocking-and-certification): Information blocking under the Cures Act: actors, EHI, the ten exceptions, penalties, ONC certification, HTI-1 through HTI-5 and USCDI, as of October 2026.
- [State Health Privacy & Sensitive Data](https://www.syntaqx.com/books/health-tech/state-health-privacy): Health privacy beyond HIPAA: consumer health data laws, California's CMIA, Part 2 for SUD records, the vacated reproductive health rule, minors and genetics.
- [Consent, Authorization & Proxies](https://www.syntaqx.com/books/health-tech/consent-and-authorization): The consents of health care: HIPAA authorizations, consent to treat, financial and telehealth consent, Part 2, personal representatives, minors, pet owners.
- [Security for Health Data](https://www.syntaqx.com/books/health-tech/health-records-security): Security for health records: ransomware and Change Healthcare, HHS 405(d) practices and CPGs, break-the-glass, access audits, device security, downtime.
- [The Revenue Cycle](https://www.syntaqx.com/books/health-tech/revenue-cycle): How a practice gets paid: front, middle and back end, the X12 transaction family and operating rules, the KPIs, and in-house versus outsourced RCM.
- [Eligibility & Benefits](https://www.syntaqx.com/books/health-tech/eligibility-and-benefits): Checking coverage before the visit: 270/271, real-time and batch, service type codes, dental frequencies and maximums, coordination of benefits, cards, portals.
- [Claims](https://www.syntaqx.com/books/health-tech/claims): Billing the payer: 837P, 837I and 837D, the CMS-1500, UB-04 and ADA forms, scrubbing and NCCI edits, modifiers, attachments, acknowledgments, timely filing.
- [Clearinghouses](https://www.syntaqx.com/books/health-tech/clearinghouses): The switch between practices and payers: what clearinghouses do, payer IDs, EDI, ERA and EFT enrollment, pricing, APIs, dental, Change Healthcare, switching.
- [Remittance & Posting](https://www.syntaqx.com/books/health-tech/remittance-and-payment-posting): How payer money lands: the 835 ERA, CARC, RARC and group codes, EFT and TRN reassociation, payer virtual cards and their fees, auto-posting, secondary claims.
- [Denials, Appeals & Claim Status](https://www.syntaqx.com/books/health-tech/denials-and-appeals): When payers say no or nothing: 276/277 claim status, denial categories, Medicare's five appeal levels, commercial appeals, audits, recoupments, underpayments.
- [Prior Authorization](https://www.syntaqx.com/books/health-tech/prior-authorization): Asking the payer first: the 278, pharmacy ePA in NCPDP SCRIPT, CMS-0057-F's 2026 and 2027 dates, Da Vinci CRD, DTR and PAS, gold carding, and AI in review.
- [Patient Statements, Estimates & Collections](https://www.syntaqx.com/books/health-tech/patient-financial-experience): The patient's bill: responsibility after insurance, good faith estimates, price transparency, statements, payment plans, medical debt, collections.
- [Coding, Documentation & Compliance](https://www.syntaqx.com/books/health-tech/coding-and-documentation): What a claim may say: E/M guidelines, documentation integrity, coverage policy, compliance programs, the False Claims Act, Anti-Kickback and Stark.
- [Value-Based Care & Quality](https://www.syntaqx.com/books/health-tech/value-based-care): Paying for outcomes: MIPS, APMs, the Shared Savings Program, ACO REACH and LEAD, Medicare Advantage, risk adjustment, HEDIS and eCQMs, and what to capture.
- [Integrating with Practice Management Systems](https://www.syntaqx.com/books/health-tech/pms-integration): Reading and writing a practice's PMS: sync agents on the office server, vendor APIs and partner programs, write-back, fees, gatekeeping, drift and conflicts.
- [Scheduling & Online Booking](https://www.syntaqx.com/books/health-tech/scheduling-and-online-booking): How a practice schedule works: providers, operatories, appointment types and patterns, blocks, slot search, online booking, insurance at booking, ASAP lists.
- [Reminders, Confirmations & Recall](https://www.syntaqx.com/books/health-tech/reminders-and-recall): Confirmations and reminder cadences, the evidence, no-show measurement, hygiene recall, vaccine and optical reminders, reactivation and unscheduled treatment.
- [Phones for Practices](https://www.syntaqx.com/books/health-tech/practice-phones): The practice phone system: VoIP for small offices, call pop from the PMS, routing and hours, missed-call text-back, 911 duties, recording consent, analytics.
- [Two-Way Texting & Messaging](https://www.syntaqx.com/books/health-tech/patient-texting): Practices texting patients: the practice number, registration, the TCPA health care exemption, STOP, HIPAA and texting, portals versus SMS, email, the inbox.
- [Digital Intake, Forms & Consent](https://www.syntaqx.com/books/health-tech/digital-intake-and-forms): Intake packets, medical history, insurance cards and ID, e-signature and consent, writing forms back to the PMS, tablets and kiosks, accessibility, language.
- [Reviews & Reputation](https://www.syntaqx.com/books/health-tech/reviews-and-reputation): Practice reviews: asking every patient, gating and private feedback, the FTC review rule, replies without PHI, gag clauses, listings and directories.
- [Telehealth](https://www.syntaqx.com/books/health-tech/telehealth): Video, audio-only and asynchronous visits, remote monitoring codes, Medicare telehealth status as of October 2026, licensure compacts and DTC enforcement.
- [E-Prescribing & Pharmacy](https://www.syntaqx.com/books/health-tech/e-prescribing): NCPDP SCRIPT and Surescripts, EPCS under DEA and CMS rules, PDMPs, DEA telemedicine prescribing status, pharmacy claims, embedded eRx and compounding.
- [Labs, Imaging & Diagnostics](https://www.syntaqx.com/books/health-tech/labs-and-diagnostics): Lab and imaging orders and results, CLIA and its report rules, Labcorp and Quest connectivity, at-home testing, critical values and results release under Cures.
- [Referrals & Care Coordination](https://www.syntaqx.com/books/health-tech/referrals-and-care-coordination): Referral management and closed loops, the fax that still carries them, Direct messaging, discharge and ADT notifications, care management codes and post-acute.
- [Hospitals & Health Systems](https://www.syntaqx.com/books/health-tech/hospitals-and-health-systems): Inpatient versus ambulatory, ADT and bed management, the Epic-centered enterprise, Conditions of Participation, EMTALA, 340B, price transparency, selling in.
- [Digital Health Apps & Devices](https://www.syntaqx.com/books/health-tech/digital-health-and-devices): Wellness or device, FDA software rules and the 2026 CDS and wellness guidance, wearable and phone health data, the FTC breach rule and digital therapeutics.
- [Patient Portals & Patient Access Apps](https://www.syntaqx.com/books/health-tech/patient-portals-and-access): Portals and proxy access, payer Patient Access APIs, certified APIs and phone records, open notes, results release and portal messages billed as e-visits.
- [Health Tech Architecture: Building It Yourself](https://www.syntaqx.com/books/health-tech/health-tech-architecture): Tenancy by practice and group, PHI segmentation, the sync and integration layer, events, a FHIR facade over your model, audit everywhere and a reference build.
- [AI in Health Tech](https://www.syntaqx.com/books/health-tech/ai-in-health-tech): Ambient scribes, coding and prior auth AI, patient-facing chat, decision support transparency, FDA device rules, state AI laws and LLMs with PHI under a BAA.
- [Operations, Support & Downtime](https://www.syntaqx.com/books/health-tech/health-tech-operations): Support access to PHI, downtime and incident notices to practices, uptime and dependencies, on-call, breach clocks, and correcting data in clinical records.
- [Health Tech Metrics](https://www.syntaqx.com/books/health-tech/health-tech-metrics): Practice, revenue cycle, engagement and vendor metrics defined: locations, NRR and GRR, revenue per client, days in A/R, no-shows, and how each gets miscounted.
- [Data Migration & Conversions](https://www.syntaqx.com/books/health-tech/data-migration-and-conversions): PMS and EHR conversions: what moves (ledgers, insurance, images, notes), EHI export, legal retention after switching, archives, and the cutover weekend.
- [De-identification, Research & Data Use](https://www.syntaqx.com/books/health-tech/de-identification-and-data-use): Safe Harbor and Expert Determination in practice, limited data sets and DUAs, tokenized linkage, research and IRBs, sale of PHI, and FTC and state law.
- [Health Tech Glossary](https://www.syntaqx.com/books/health-tech/glossary): Every health tech term by part: business, records and interoperability, privacy, revenue cycle, practices, care delivery, payers, pharma and platform.