Connect to the Smart Health Network
Keep the systems and CMS-0057 APIs you are already building. Add one standard network connection that makes them reachable across the market.
Connect once. Reach every enabled, authorized counterparty.
One network connection replaces separate technical connectivity to each counterparty. Legal, authorization, product, and readiness requirements still apply. Production participants connect through the same open-source gateway build — a gateway you host or SHN hosts. The shared network routes encrypted transactions among authorized participants and cannot decrypt the clinical or administrative payload — payload keys remain at the gateways; the hub processes only the metadata required to authorize, route, and prove the exchange. Prior authorization is the first production use case; eligibility, attachments, and additional transactions follow on the same connection as they are enabled.
Cost. Providers: no SHN connection, onboarding, or conformance-testing fees, and no SHN provider network fees through 2028; later transaction fees follow the published schedule. Payers: published flat PMPM membership pricing for network participation — SHN does not separately meter or add transaction fees for onboarding, conformance testing, eligibility, or the CMS-0057 API categories. Full pricing →
If a provider system speaks supported Da Vinci transactions and supplies a resolvable payer identifier, the gateway can route them; most deployments require outbound connectivity only. Reachability is subject to participant authorization, supported transactions, and production enablement.
Decision 1 — Who hosts the gateway?
Run the gateway in your own environment — your infrastructure, your keys. Your IT vendor or systems integrator running it on your behalf is still you-hosting.
SHN operates your gateway as a managed service under your authority — the typical answer for organizations without an integration team.
Partner-hosted arrangements may become available over time.
Decision 2 — How does your clinical system reach the gateway?
The richest data path — and it reduces dependence on the EHR vendor’s native timeline.
The workflow stays entirely in the EHR, where your clinicians already work.
From the EHR marketplace — the broadest interim path for certified-EHR providers, subject to supported SMART capabilities and marketplace policies.
All three paths terminate at the same standard gateway interface — using a gateway you host or SHN hosts.
To the gateway, paths 1 and 2 are indistinguishable — if it speaks Da Vinci, it routes; the only requirement is a Coverage.payor identifier the network’s resolvers can map.
What payers do
Keep your CMS-0057 implementation. The network adds the shared distribution route into it. Connect the gateway, map your Coverage.payor identifiers, and complete network conformance. SHN handles network certification for additional counterparties — minimizing, rather than recreating, payer-specific technical onboarding. Every routed transaction creates standardized status evidence — the foundation for prior authorization patients can eventually track through participating applications.
- Register a payer client. Standard test-environment registration; the SHN CLI generates your keys locally — SHN never holds them.
- Connect your payer test endpoints to the gateway (a gateway you host or SHN hosts) and map your Coverage.payor identifiers to your routes.
- Run the Readiness Check and conformance engine against the reference FHIR test cases for your transaction types — self-serve, synthetic data.
- Complete provider-payer end-to-end testing. Validate CRD → DTR → PAS flows against the live hub with provider counterparty gateways — the gate into a named production cohort.
Start testing today — most teams begin with the cloud sandbox
Validate Da Vinci CRD, DTR, and PAS using synthetic data without deploying local infrastructure. When you’re ready to prove the complete EHR-to-gateway-to-network deployment, move to the locally hosted gateway. No negotiated participation agreement is required for sandbox testing; standard test-environment registration and terms apply.
No local infrastructure; self-service client registration; synthetic data only. Validate CRD/DTR/PAS construction against the available test routes.
- Register an API client (self-service)
- Read the SMART metadata
- Obtain a token
- Send CRD/DTR/PAS requests
- Verify the result
Prove deployment: run the gateway in your environment — keys generated and retained locally — connect the EHR or payer sandbox, and validate full EHR/payer → gateway → hub routing and conformance.
- Request developer access
- Register a provider client
- Run the evaluation bundle
- Connect the EHR sandbox
- Execute and verify
Many teams do both: cloud first to prove the requests, local second to prove the deployment.
Not the technical lead? Forward this page to your EHR, interoperability, or API team — and contact Kyle Cobb, Chief Network Officer (kyle@smarthealthnetwork.org) to schedule an onboarding working session.
Start testing: smarthealthnetwork.org/start-testing · Developer portal: developers.shn-preview.org · Gateway docs & SDK: github.com/SmartHealthNetwork/shn-gateway
Descriptive, not contractual. Get Connected v2 · July 2026.