eClinicalWorks

eClinicalWorks offers solid FHIR R4 read coverage and reasonable write capabilities, but every write operation requires a separate contract. There are no webhooks or event-driven integration options.

Medium-High complexityContract-gatedFHIR R4

FHIR Version

R4 (US Core 3.1.1 / 6.1.0)

Rate Limit

250 calls/min per practice code

Sandbox

Yes — portal signup required

ONC Certified

Yes

Capability Matrix

Capability	Read	Write
Patients	Self-serve	Contract required via interop@eclinicalworks.com. Create + Update on v12.0.2/v12.0.3 only.
Appointments	Not available on eCW FHIR portal. Scheduling only via healow Developer Portal.	Only via healow Developer Portal, not the main eCW FHIR API.
Encounters	Self-serve	Contract required. Creates Telephone Encounter records only.
Clinical Notes	DocumentReference + DiagnosticReport read.
Document Upload	Self-serve	Contract required. C-CDA and PDF uploads via DocumentReference create.
Lab Results	Observation (Labs) + DiagnosticReport.
Medications	Self-serve	Contract required. MedicationRequest create; MedicationStatement reconciliation.
Allergies	Self-serve	Contract required. AllergyIntolerance create only — no update.
Conditions	Self-serve	Contract required. Condition create only — no update.
Immunizations	Self-serve	Contract required. Create only.
Vitals	Self-serve

Billing / Claims
Coverage / Insurance	Coverage read on v12.0.2+ only.
Referrals	ServiceRequest read on USCDI v3 builds only.
Bulk Data Export	Via SMART Backend Services. May require additional configuration for group definition (not confirmed in public documentation).	—
Events / Webhooks		—

DocumentedNot documentedSelf-serveGatedPartner only

Integration considerations

All write APIs require a separate contract — no self-service write access
Two separate developer portals (eCW and healow) with different registration flows
No webhooks or FHIR Subscriptions — no event-driven integration capability
Rate limit of 250 calls/min per practice is restrictive for high-volume operations
Each practice must individually activate FHIR APIs via On-Demand Activation
Practices must be on specific certified builds — older versions may not support required scopes or resources