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The Headless EHR

Adaptable. Streamlined. Certified.

Oystehr provides the server, APIs, and certification you need so you can build the custom EHR for your use-cases.

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Compliance and Standards

Get FHIR, USCDI, ONC, X12 and HIPAA from the start. Health-tech software is highly regulated. Multiple organizations govern complicated, overlapping standards. Legislative and statutory mandates change regularly. Payers, states, and exchanges have their own requirements. Oystehr does the heavy lifting to ensure your application maintains compliance in a shifting landscape.

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Oystehr is an API-first solution. You can invoke Oystehr APIs entirely a la carte. There is no data silo, no obligation to use any particular front-end. You can use our open-source EHR or not. You can maintain your own database or not. You can build an application entirely on Oystehr’s hosted infrastructure or interact strictly with the APIs you need statelessly. You can create inbound Zambdas (serverless hosted functions) that accept invocations from external systems, and you can create outbound Zambas that listen for Oystehr events and push data to external systems. You will not experience the restrictions on external integrations that monolithic EHRs impose.


Oystehr offers a comprehensive read/write FHIR API and hosted storage for both R4 and R5. It’s almost table-stakes, but because so few EHR vendors actually offer full, unrestricted FHIR access, it’s important. FHIR is the native data model of Oystehr, not a bolt-on afterthought. We support multiple versions of FHIR and an upgrade path as new versions are released. However, we view Oystehr as “more than just a FHIR store.” Offering direct FHIR access is critical for interoperability and implementing many workflows, but the real power of Oystehr’s FHIR API is that it is directly integrated with all our other service offerings. So, if you want to do an insurance validation, claims submission, order a diagnostic test, initiate a video telemed call, or support SMS or text chat, you can do so directly from Oystehr APIs and appropriate FHIR records are created.

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Custom Endpoints

Zambdas offers a powerful tool for tailoring your application without needing your own server. With Zambdas, you create custom API endpoints using your own custom code. Zambdas are hosted within your own segregated, provisioned environment within the Oystehr. This environment has direct access to Oystehr events and data, allowing you to create robust integrations and applications with server-side logic.

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Configure HIPAA-compliant, customizable video workflows using Oystehr's telehealth service. Oystehr seamlessly provisions multi-party video access for you, no external account setup required, and associates it with appropriate FHIR resources.

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Patient Messaging & Engagement

Like Oystehr’s video service, the messaging and engagement service offers comprehensive provisioned support for one way messaging and multi-party threaded two-way communications without requiring external account setup, configuration, or integration. Sending an SMS to patients is a single line API call, and complex, multi-party threaded communications with routing and promotion are also directly supported within the API.

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Identity and Access Management

Our security services empower users with robust protection through customizable access policies and multi-factor authentication (MFA), including Passwordless SMS, ensuring stringent safeguards for sensitive data and system access. Our OAuth system is out-of-the-box and easy to configure.

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File Management

In addition to our FHIR store, the Z3 File storage service provides binary storage that directly integrates with Oystehr role based security, access policies, and FHIR associated events and triggers. This can be used to easily handle file management workflows like uploading insurance cards, DICOM images or other arbitrary unstructured data to trigger workflow activity.

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While all Oystehr endpoints are directly accessible as RESTful services, we provide a comprehensive SDK to help make invocation and common workflow patterns easier to implement.

Developer Console

Direct API access is great, and always available, but sometimes it’s nice to manipulate services and data via a user interface. The Oystehr Developer Console allows you to provision new users, applications, and environments, create and assign access policies and roles, monitor logs, create FHIR resources, and deploy Zambda functions.

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E-Prescriptions (beta)

Oystehr provides both an API and embeddable UIs for eRx. Our eRx service is unique in that we handle prescription issues without requiring intervention from a clinician in most cases. If a medication is out of stock, the pharmacy is closed, or there is a long wait time, we automate the process of communicating with the patient to re-route the prescription. This is a huge time-saver for many clinical use-cases.

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Diagnostics (beta)

A simple diagnostic ordering API that allows your application’s users to directly place orders for laboratory and radiology with Quest, Labcorp, and thousands of smaller independent facilities.

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Payments (beta)

Like all Oystehr services, you are welcome to use your own payment processor, but Oystehr provides a payment processing solution powered by Stripe that allows you, without any additional account creation or integration effort, to immediately process payments from patients. We aggregate all payment activity through our service to leverage better processing rates with volume, which we directly pass on to Oystehr users. Like all Oystehr services, the payment processing API integrates automatically with our FHIR datastore to facilitate tracking and association of co-pays, claims submission, billing services, and other RCM activities.

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Claims Submission (beta)

Oystehr’s claims submission service allows you to directly submit claims to any payer. You don’t need to contract for or configure a clearinghouse or otherwise arrange for external accounts and access to process submissions, Oystehr handles all of that under the hood.

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Insurance Validation

Oystehr’s insurance validation service allows you to directly submit patient insurance information for real-time validation from payers.

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Open-Source EHR

Here’s the real long-term goal of Oystehr: reduce the time and cost to deploy best-of-breed healthcare software, including full scope EHRs by 95%. We want custom EHR deployments to take weeks or months rather than years. We think a comprehensive set of headless services are necessary but not sufficient. They’ll reduce scope by about 45%. The other 50% requires a front-end implementation. We offer Ottehr, a production-ready, open-source front-end EHR that you can fork and use to create the perfect product for your organization.

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Patient Engagement

Existing EHRs offer notoriously poor patient engagement solutions. They don’t easily integrate with third party products like Salesforce or other CRMs, and they offer minimal patient engagement from within the EHR itself. Oystehr has both. With Oystehr’s messaging service, you can directly build complex two-way patient engagement workflows, track funnels or other metrics, all seamlessly within the EHR and patient record. You can set up endpoints to securely sync data with external patient CRMs to conduct campaigns or other marketing activities. But, the service can be used for clinical use cases, like complex care coordination, chat-based interactions, or triggered communications based on real-time health data.

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Revenue Cycle Management

Do you operate under a value-based care model that requires gathering and submitting complex metrics to payers? Are you strictly telehealth focused and find EHR RCM modules to be productivity killers? Do you need to better automate claim resubmission or are you ambitious enough to integrate an AI LLMs into your claim scrubbing process? Perhaps you simply need to eliminate tedious manual processing by your RCM staff to reduce costs. You can leverage Oystehr’s Claims Submission Service to handle workflows that don’t fit neatly or easily into traditional EHR RCM interfaces.

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Appointment Scheduling

Scheduling can be incredibly complicated because scheduling systems often must consider very specific factors like specific patient input, payer requirements that vary contract to contract, state licensure, type of appointment, provider preferences, time of day, overall capacity, and other organization specific details. This complexity lends itself very cleanly to custom solutions.

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Healthcare delivery is changing rapidly. Entire clinical organizations exist that deliver only virtual care. Other organizations are experimenting with hybrid in-home, virtual, and in-clinic care. Telehealth workflows are not a one-size-fits-all prospect. Oystehr offers the building blocks for delivering complex, custom solutions that integrate a first-class telehealth experience directly into your EHR.

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Your providers love how efficiently they can document within your current EHR, right? Imagine an EHR where you could easily build custom clinical encounter solutions tailored to your own needs. Eliminate all the unnecessary distractions and clicking with a documentation solution that exactly fits your org.

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* ONC Compliance, Payments Service, Diagnostics Service coming Q2 2024.

Learn why healthcare orgs trust Oystehr as their health tech dev platform

Meet with our engineers
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Our new behavioral health intake application, built on Oystehr, allowed us to build a solution that is customized for our use including scheduling, insurance validation, and direct integration with our eClinicalWorks EHR.

Mordechai Raskas
Mordechai Raskas

Chief Medical Information Officer at PM Pediatric Care

Meet with our engineers to learn more about building with Oystehr.