Mirth is the commercial offering many people use - it is nice because it handles the MLLP protocol, gives you a mapping system, lets you transform and call your own endpoints. That’s also why it sucks: it’s a big heavy system.
Well there is the FOSS Mirth option and the NextGen Mirth Option which is the "premium" corporate-backed version. Mirth is like the glue for healthcare in the US. Most of the companies I've worked with use it. Whats another options? Redox? HAPI? Qvera?
It might not be great but I think its better then most offerings.
Redox has already priced themselves so high, it's unclear what value they are providing. A big reason to go with Redox is that you don't have to setup a VPN with the target hospital, have staff monitoring the VPN to ensure it's up and you don't have to parse your own HL7v2 messages.
IMHO Redox is now so expensive that you have to wonder if you might be better off doing all of this work yourself. As others have mentioned, there is a free Mirth offering and parsing HL7v2 is not that bad.
I think it really depends on your scale. If I'm a small healthtech startup and I can interchange with people hooked up to the candidate QHINs like eHealth and CommonWell I just saved thousands of independent VPN setups and HL7 mappings.
But I already have thousands of independent VPN setups and API integrations, so the cost is harder to justify at scale.
That is exactly how my previous employer (HIE) operated. Mirth was fairly low-cost and if we wanted. We could bootstrap our own Mirth Servers. But managing that many VPNs was a giant pain.
