How this softwareactually gets built.

Matching a person to their record is the hardest problem in health integration and is almost always estimated as a checkbox. Duplicates, merges, near-matches, and why the auto-match threshold is a clinical decision rather than a technical one.

Nobody replaces everything at once. A field guide to the message types, mapping traps and versioning realities of wiring a new platform into the EMR, LIS and PACS a hospital already runs without a rip-and-replace.

Interfaces get funded as one-off builds and then run for a decade with no owner. What changes when the integration layer is treated as something with a roadmap, a support model and a person whose name is on it.