The managed layer between every Personal Health Application and every Health Information Exchange.
Already routing production traffic across a growing footprint of connected HIEs. One governed on-ramp for PHAs. One calm, compensated connection for exchanges. Full compliance built in.
One integration. Both sides of the wire.
Under the 21st Century Cures Act, every HIE must fulfil patient-directed access requests — with no volume ceiling and no default compensation. Consumer platforms are now shipping health-record access to hundreds of millions of users, and their traffic lands on HIE endpoints.
Cures Gateway sits in the middle: vetting each PHA, proving each patient's identity, honouring 50-state consent, buffering traffic, scoring every document, and keeping a compliant audit trail on every request.
HIEs receive one calm, governed connection and revenue on each request. PHAs receive one contract and one endpoint that unlocks a national footprint of exchanges.
How a patient-directed request flows through the Gateway
Four moves, every request, in seconds.
Vet the PHA
Legal, security and technical vetting before any Personal Health Application can call the network.
Prove the patient
Identity assurance to NIST IAL2 — the person requesting is who they claim.
Honour consent
Capture and enforce the applicable state consent regime, coast to coast, on every request.
Deliver & score
Route via FHIR R4 / IHE XCPD / XCA. Score the response on 47 IQHD quality dimensions.
Two sides of the same problem. One shared infrastructure.
Whether you steward a Health Information Exchange or build a Personal Health Application, Cures Gateway removes the integration, compliance and scale work that stands between patients and their records.
Absorb the wave. Keep the value.
An unbounded regulatory obligation becomes governed, compensated participation — with zero infrastructure investment and full control over your rate limits.
- One integration; every current and future PHA reaches you through it.
- Hourly XCPD / XCA-DQ / XCA-DR limits you set from your dashboard.
- ONC-defensible audit trails and 50-state consent orchestration.
- 47-dimension IQHD quality scoring on every CCD your network returns.
- Per-request revenue share — negligible at pilot scale, transformational at wave scale.
One MSA. One endpoint. National reach.
Building a Personal Health Application that needs authorised access to patient records? Cures Gateway is the single, standards-based on-ramp to a growing footprint of connected exchanges — with the trust framework already in place.
- Standards-based endpoints: FHIR R4, USCDI, IHE XCPD / XCA-DQ / XCA-DR.
- Patient identity proofed to NIST IAL2 before any record moves.
- Consent captured and honoured under the applicable state regime.
- TEFCA IAS alignment — Cures Gateway as your request-only IAS Provider.
- Trust framework, contracting and compliance done once, network-wide.
Live and connected exchanges
Cures Gateway routes real production traffic through the HIEs below, with more joining every quarter.
Live footprint of the 9 connected HIEs. Medallies operates as a national provider directory across the connected network.
Built on the standards regulators expect.
No custom sidecars. No proprietary lock-in. Cures Gateway speaks the same standards HIEs already run.
FHIR R4 · USCDI
Standards-first API surface. Patient, Encounter, Condition, Medication, Observation, DocumentReference and the rest of the USCDI classes.
IHE XCPD · XCA-DQ · XCA-DR
Native support for the IHE profiles HIEs already use for cross-community patient discovery, document query and retrieval.
TEFCA IAS aligned
Request-only IAS Provider posture. Patient-directed traffic, not treatment or payment routing.
NIST IAL2
Identity assurance on every requesting patient before any record moves.
HIPAA · 45 CFR Part 171
ONC information-blocking regime honoured end-to-end. 50-state consent orchestration.
SOC 2 (in progress)
Formal controls program, audit trails on every request, 24/7 operations centre.
IQHD — 47-dimension quality scoring
Every CCD returned through the network is scored on 47 quality dimensions across completeness, coding, medications and allergies — with joint continuous-improvement reports for each HIE.
Four long reads for the people who need the whole picture.
Each of the pages below expands one facet of Cures Gateway — the law that makes it necessary, the wave it exists to absorb, the stewards whose work makes this next era possible, and the five visions for what HIEs can become next.
The 21st Century Cures Act
4 min readWhat the Act establishes, the eight exceptions, up-to-$1M-per-violation enforcement, and how Cures Gateway is built to fulfil it.
Read the legislative foundation → § 2 · The waveThe PHA wave, quantified
8 min readLive ledger, projected volumes, per-request economics, working IQHD and EHR analysis demos, and the roadmap HIEs steer.
Explore the platform → § 3 · The stewardsTo the builders of the bridges
6 min readA letter to the HIEs that connected American healthcare, and where the network goes next.
Read the letter → § 4 · The visionsFive visions for the next era
10 min readFederated privacy · intelligent quality · equity engine · living record · quality mesh. What HIEs can become.
Read the five visions →