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OHIA FOUNDING MEMBER  ·  FHIR R4  ·  PATENT PENDING

Conduit moves referrals, records,
and clearances between medical and dental providers.

Today these handoffs run on fax machines, phone calls, and X-rays burned to a CD. Conduit connects the software each office already uses, so a referral reaches the right office with its records and images, and the clearance comes back, even when no two systems match.

Physician Dentist Dentist Dentist Provider Payer
conduit · live activity
Sunridge Health Network
Connected Systems 4 / 4 live
Open Dental
14 locations
Eaglesoft
8 locations
Dentrix Ascend
3 locations
Epic / Cerner
EHR partners
Patient Activity Live
Sarah M., 67 just now
Cleared for valve replacement Cardiology
Marcus T., 54 2m ago
Pre-radiation workup Oncology
Jamie L., 8 4m ago
X-rays delivered to specialist Pediatric
Robert H., 71 7m ago
Prior auth approved Insurance
Aisha N., 34 9m ago
Records available in Apple Health Patient App
0
Providers
0
Systems
0
Patients Today
0%
Success
What Conduit Does

Referrals in. Clearances back.
Records that follow the patient.

Conduit connects the systems that run medical and dental care, so a referral reaches the right provider, the clearance comes back, and the documentation that gets care paid for travels with it. One connection, every direction.

01

Send a referral, get the clearance back.

Physicians refer patients to dentists and get documented clearance returned. Dentists refer to specialists and the records follow the patient. Bidirectional, structured, and tracked to completion instead of lost to fax.

Days Round-trip, not weeks of phone tag
02

Capture Medicare medical-dental revenue.

CMS now reimburses dental care that is integral to a covered medical procedure, but only with documented coordination. Conduit produces the FHIR documentation chain that makes those claims auditable and payable.

CMS 2027 Ready ahead of mandate
03

Connect any system, through one integration.

Medical EHRs, dental practice management systems, payers, patient apps, and AI platforms. Conduit handles the connections, the data translation, and the compliance work, so each side plugs in once and reaches the rest.

FHIR R4 One standard, every direction
Who It's For

One platform.
Every side of care.

Physicians refer to dentists and get clearances back. Dentists refer to other dentists and records follow. Payers see documented coordination. Patients see their full history. Pick your side.

Medical Groups
Oncology, cardiac, transplant, multispecialty

Refer patients to a dentist from your EHR and get documented clearance back, with the trail Medicare needs to pay before treatment starts.

Dental Groups & Practices
Independent practices to multi-location DSOs

Send a referral to another dentist or specialist on any software and have it arrive, with records and images attached. Coordinate clearances with your patients' physicians, and keep records following the patient.

PMS & AI Platforms
Software vendors and health AI

Add medical and dental FHIR data to your product through one API. We handle the connections, the translation, and the compliance work.

Payers
Medicare Advantage and commercial

Cleaner data and documented coordination today, on a path toward FHIR-native prior authorization ahead of the 2027 mandate.

The Problem

Six Ways Care Falls
Through the Cracks Between Systems

Medical and dental systems were never built to talk to each other, or to the rest of healthcare. Referrals get lost, clearances never arrive, and patients pay for it. No one connected them. Until now.

01Medical ↔ Dental
1.9M/ year
Preventable dental-related ER visits

Medical specialists can't refer in.

Cardiologists and oncologists have no electronic way to send referrals to dental PMS. Clearance travels by fax, or not at all.

02Reimbursement
2024
CMS unlocked linked dental coverage

CMS pays. Only with documentation.

Medicare now covers dental "inextricably linked" to medical care, but only with a digital coordination trail. That trail doesn't exist today.

03Dental ↔ Dental
2550%
Dental specialist referrals that never complete

Dentists can't reliably refer to other dentists.

A GP refers a patient to an oral surgeon or endodontist, often an independent practice on different software, and the referral gets faxed or printed. No tracking, no confirmation. In 25–50% of cases, nobody knows the patient never arrived.

04DSO Harmonization
7580%
DSO share of US dentistry this decade

DSOs run on incompatible platforms.

A DSO growing through acquisition inherits a patchwork of PMS, so a patient's record can't follow them between the group's own locations. X-rays get repeated.

05Patient Access
Zero
Dental PMS routing to Apple Health

Patients can't see their records.

Apple Health, Google Health Connect, MyChart all carry medical records. Not a single dental PMS publishes to any of them.

06AI & Analytics
40M+
ChatGPT Health users · zero dental

AI platforms can't access dental.

Every health AI launched in 2026 has the same blind spot. Dental data is missing from all of them.

The Solution

Four Exchange Patterns.
One Bridge.

Every referral, record, and clearance problem across medical and dental reduces to one of four patterns. Conduit handles all four, through a single FHIR R4 layer. Below is the architecture. See it play out in real patient workflows in the next section.

Pattern 01 · Medical ↔ Dental Exchange

Physicians refer in. Dentists clear out.

Physicians send referrals to dentists directly from Epic or Cerner via SMART on FHIR launch. Dentists return clearances, consult notes, and treatment summaries as structured FHIR data, with a full audit trail that satisfies CMS documentation requirements for "inextricably linked" dental coverage.

OHIA Priority 1 SMART on FHIR CMS Reimbursable
epic · chart review
SMART App
Hutchinson, J.
65y · M · MRN 4471829
Pre-op clearance required · Aortic valve repair
Conduit · Dental Coordination
Referred toDr. Lee, DDS
PMSOpen Dental · Loc 14
Sent14:32 today
StatusRouting via FHIR…Acknowledged ✓Clearance returned ✓
Pattern 02 · Dental ↔ Dental Exchange

Send a referral to another dentist. The records follow.

A dentist refers a patient to another dentist. A GP to an oral surgeon, an independent practice to a specialist across town. The referral arrives with records, imaging, and treatment history attached, even when the two offices run different software. Conduit translates between systems through a FHIR R4 canonical center, so the referral, the records, and the result all come back. The cross-PMS translation is the engine. The dentist just sends a referral.

OHIA Priority 2 Cross-PMS
conduit · cross-pms transfer
Bundle in flight
Source
Open Dental
Patient · Hutchinson, J. Records · 14 documents Images · 8 series
via FHIR R4
Destination
Eaglesoft
Practice · Pearl Dental SE Location · #003 Provider · Dr. Okafor
FHIR Bundle · 14 resources Patient Composition Observation ImagingStudy
Pattern 03 · Authorizations & Claims Exchange

X12 today. FHIR-native tomorrow.

Prior auth requests, claim submissions, and payer responses flow between dental systems and insurance carriers. Today: BridgeLink translates PMS → FHIR → X12 278/837D through existing clearinghouse infrastructure. Tomorrow: FHIR-native prior auth under CMS 2027 mandates.

OHIA Priority 5 X12 Bridge FHIR-Native 2027
bridgelink · prior auth translation
X12 ↔ FHIR
request.fhir.json
x12_278.edi
// FHIR Claim · 837D-equivalent
{
  "resourceType": "Claim",
  "use": "preauthorization",
  "patient": { "reference": "Patient/4471829" },
  "provider": { "reference": "Practitioner/dds-lee" },
  "item": [{
    "productOrService": { "code": "D7240" // CDT }
  }]
}
translated · routed · acknowledged
// X12 278 · payer-bound
ST*278*0001~BHT*0007*13*REF12345*20260514~
HL*1**20*1~NM1*X3*2*DELTA DENTAL*****PI*1234~
UM*HS*I*35***Y~DTP*472*D8*20260514~
SV3*AD:D7240*RC~
Pattern 04 · Patient & Developer Access

Dental records, in the apps patients already use.

Patient dental records published to FHIR patient-scoped APIs with CARIN Blue Button alignment and TEFCA/QHIN participation. Patients see their dental records in Apple Health and ChatGPT Health. Developers and AI companies call the Conduit API to access the entire connected dental network through a single integration.

OHIA Priority 3 CARIN Blue Button TEFCA Aligned
Health · Dental
CleaningApr 8, 2026
ProviderDr. Lee, DDS
FindingsNo caries
Bitewing series4 images
PanoramicMar 2026
ViaConduit · FHIR
Provider PMSOpen Dental
In Practice

Workflows That Used to Take Days.
Now Take Seconds.

Five clinical workflows that show how the four exchange patterns above play out for actual patients. Step-by-step, from referral to outcome.

The Scenario

A 65-year-old patient scheduled for cardiac valve replacement. Cardiologist must rule out oral infection to prevent endocarditis. Surgery cannot proceed without documented dental clearance, and CMS now requires digital coordination for reimbursement.

1
Cardiologist orders clearance in Epic
Opens SMART on FHIR Conduit app inside Epic. Patient context pre-populates. Selects patient's dentist from provider directory. Submits. Never left the EHR.
2
Conduit routes the ServiceRequest
Translates FHIR ServiceRequest to PMS format via Axiomera. Routes to dentist's Open Dental instance through HeyDonto Synchronizer. Alert fires in PMS.
3
Dentist performs exam and clears patient
Exam, X-rays, and infection treatment documented in PMS. Dentist signs clearance form. Conduit extracts as FHIR Composition.
4
Clearance appears in Epic chart
Structured clearance data arrives in cardiologist's EHR. Surgery green-lit. Full audit trail preserved for CMS reimbursement documentation.
Surgery scheduled on time. No faxing. No lost records. Full CMS compliance.
epic · cardiology · chart
SMART on FHIR
Hutchinson, J.
65y · M · MRN 4471829
Pre-op dental clearance required · Aortic valve repair
Conduit · Dental Coordination
Referred toDr. Lee, DDS
PMSOpen Dental · Loc 14
ResourceFHIR ServiceRequest
CMS auditCaptured ✓
StatusClearance returned
0
Faxes
3d
Round-trip
0%
Auditable
The Scenario

Dentist identifies a suspicious lesion during a routine hygiene visit. Without Conduit, this finding travels by fax, if it travels at all. With Conduit, it triggers an immediate, structured referral to oncology with the intraoral image attached.

1
Detection at the chair
Dentist captures suspicious lesion during exam. Intraoral image saved directly in PMS. Clinical notes documented with lesion characteristics.
2
Conduit sends structured referral
Conduit transmits FHIR ServiceRequest + Media (intraoral image) to ENT or Oncologist's EHR. Patient context, clinical notes, and imaging included.
3
Specialist confirms diagnosis
Biopsy performed. Pathology report generated. Staging recorded in medical EHR. The referral loop closes automatically.
4
Care loop closes back to dentist
Treatment plan returned to dentist. Pre-radiation dental clearance scheduled immediately, preventing osteoradionecrosis through coordinated care timing.
Early detection preserved. Patient not lost between chair and oncology. Pre-radiation clearance coordinated immediately.
oncology · pre-treatment workup
Inbound
Lewis, R.
58y · F
case onc-26-1184
Inbound finding
Lesion · left lateral tongue
From Open Dental · Dr. Park
Attachment
Intraoral image
ServiceRequest + Media
Triage
Biopsy · 48h
Scheduled with Dr. Hayashi
Loop back
Pre-XRT clearance
FHIR Composition returned
FHIR ServiceRequest + Media Observation ImagingStudy Condition
The Problem

Every day a dentist refers a patient to another dentist, a GP to an oral surgeon, an endodontist, a periodontist. Between 25–50% of those referrals never complete. The patient doesn't arrive, results never come back, and nobody knows the loop broke.

!
Today: GP refers to endodontist, different PMS
The GP uses Open Dental. The endodontist uses Eaglesoft. No shared standard. The referral is printed, faxed, or emailed. No tracking, no confirmation, no accountability. In 25–50% of cases, nobody knows it failed.
1
GP initiates digital referral in their PMS
The referral is documented in Open Dental. Axiomera classifies the clinical data (CDT codes, SNODENT diagnoses, imaging metadata) and maps everything to FHIR R4. No special workflow. No extra steps.
2
FHIR record routes to specialist, any PMS
Conduit translates the canonical FHIR record into Eaglesoft's format. A structured referral arrives in the specialist's PMS complete with clinical notes, imaging metadata, patient context. No fax. No CD. No phone call.
3
Treatment report flows back automatically
When the specialist completes treatment, the outcome (clinical notes, procedure documentation, follow-up recommendations) flows back to the GP's chart. Filed. Confirmed. The loop closes every time.
Referral arrives. Records transfer. Results return. Revenue on both ends protected.
conduit · cross-pms transfer
Bundle in flight
Source
Open Dental
Practice · Sunridge GP Provider · Dr. Patel Records · 14 documents Images · 8 series
via FHIR R4
Destination
Eaglesoft
Practice · Apex Endo Provider · Dr. Okafor Status · Accepted Loop · Awaiting result
Translation chain · CDT → SNODENT → FHIR → Eaglesoft Patient Composition ServiceRequest ImagingStudy
The Scenario

A 50-location DSO runs Open Dental at 30 sites and Eaglesoft at 20, following acquisitions. A patient who moved across town visits their nearest location, which runs the other PMS. Their full history is invisible. X-rays are repeated. The patient's trust in the brand erodes.

1
Patient visits cross-PMS location
Patient visits a location running Eaglesoft. Their full history is stored in Open Dental at their previous location. Without Conduit: invisible.
2
Conduit resolves patient identity across PMS
Axiomera's DHM identifies the patient across both PMS systems. Full record (imaging, treatment history, perio charts) translated to FHIR canonical form and available in real time.
3
Clinician sees complete history
No repeated X-rays. Verified medical history. Previous treatment plan visible. The patient experience is seamless, exactly what the DSO brand promised.
Patient records follow the patient, across any PMS, any location, without forcing migration.
conduit · dso operations
Sunridge Dental Partners
0
Locations
0
PMS Platforms
0
Records Today
Cross-location records routedlast 7 days
MTWTFSS
Location groupPMSRecords/day
Loc 01–14Open Dental847
Loc 15–22Eaglesoft312
Loc 23–25Dentrix Ascend103
Loc 26–27Curve Dental22
The Opportunity

OpenAI, Google, Apple, and hundreds of AI health companies are building comprehensive patient health assistants. Every one of them has the same problem: when they query health data, dental records are missing. Conduit is the only API that solves it.

1
Developer integrates the Conduit API
Any authorized application integrates the Conduit FHIR R4 API once. Conduit handles the heavy lifting: PMS translation, patient consent, security, and network routing. The developer just calls the endpoint.
2
Reach every customer-authorized source
Each customer independently authorizes configured data delivery pathways, across Open Dental, Eaglesoft, Dentrix, Curve, CareStack, and cloud PMS platforms.
3
Standards coverage expands
As more PMS platforms are supported and more FHIR profiles are implemented, Conduit's transformation library grows, giving each customer broader reach with the same single integration. This is how Conduit becomes the standard dental FHIR service.
One integration with Conduit → transformation and delivery to every destination your customers direct.
conduit · developer api
FHIR R4
request.sh
Patient.json
Bundle.json
# Patient-scoped FHIR query · OAuth bearer · illustrative
$ curl https://<your-conduit-host>/v1/Patient/4471829 \
    -H "Authorization: Bearer eyJh..." \
    -H "Accept: application/fhir+json"
200 · application/fhir+json
{
  "resourceType": "Patient",
  "id": "4471829",
  "name": [{ "family": "Hutchinson", "given": ["J"] }],
  "meta": {
    "source": "OpenDental://practice-014",
    "profile": ["http://example.org/fhir/StructureDefinition/dental-patient"]
  },
  "extension": [
    { "url": "...dental-chart", "valueReference": "Composition/dc-9921" }
  ]
}
New Revenue

Medicare Is Now Paying for Dental.
When It's Linked to Medical Care.

"Inextricably Linked" Dental Coverage, Expanded

CMS now covers dental services that are integral to the clinical success of a Medicare-covered procedure: exams, diagnostics, infection elimination, and treatment. The catch: Medicare won't pay without documented care coordination between the medical provider and the dentist. A referral qualifies, and that's exactly what Conduit provides. Less than 50% of cancer patients currently receive dental clearance before cancer therapy. That's the gap.

Cardiac

Dental exam and infection elimination prior to valve replacement or valvuloplasty. Cardiologists need documented clearance. Conduit provides the audit trail.

Oncology

Oral care before chemo, CAR-T therapy, radiation, or high-dose bone-modifying agents. CMS requires documented coordination. Conduit makes it happen in real time.

Transplant

Dental workup prior to organ transplant to eliminate oral infection risk before immunosuppression. Digitally documented for CMS reimbursement.

Renal

Oral exam and treatment for ESRD dialysis patients to clear infection. Digital referral and clearance documentation satisfies CMS requirements.

The unlock is documentation + coordination. Dentists must be Medicare-enrolled. The referral chain must be documented. Conduit provides the FHIR-based transformation service that makes it all auditable, and reimbursable.

The Alliance

OHIA: The Oral Health
Interoperability Alliance

OHIA is a cross-industry coalition bringing together the dental industry, standards organizations, government observers, EHR vendors, and technology partners to solve dental data isolation. HeyDonto is a founding contributor, building the infrastructure that turns OHIA's vision into production reality.

1
Medical–Dental Coordination
Exchange Pattern 1: SMART on FHIR launch, bidirectional referrals and clearances
2
Dental–Dental Interoperability
Exchange Pattern 2: Cross-PMS record exchange through FHIR canonical center
3
Patient Access
Exchange Pattern 4: FHIR patient APIs, CARIN Blue Button, TEFCA/QHIN participation
4
Provider Directory
Lets DSOs pick where referrals go, with CMS alignment built in
5
Insurance Simplification
Exchange Pattern 3: X12 bridge today, FHIR-native prior auth and claims tomorrow

Conduit addresses all five OHIA priorities through a single production platform.

Standards Foundation
HL7 FHIR R4
SMART on FHIR
OHIA Implementation Guides
CARIN Blue Button
CMS-9115-F / CMS-0057-F
CMS 2027 Prior Auth Rule
TEFCA / QHINs
ADA CDT / SNODENT
SNOMED CT / LOINC / ICD-10
OHIA Founding Contributor
Active across all three implementation tracks: Medical-to-Dental, Dental-to-Dental, Patient Access.
How It Works

FHIR Is the
Canonical Center

Conduit never translates directly between two proprietary formats. Every exchange passes through FHIR R4 first. Your PMS needs one connector, not one for every other system in the network.

1
Source Connectivity
SMART on FHIR (Epic/Cerner) · HeyDonto Synchronizer (Open Dental, Eaglesoft, Dentrix) · Cloud APIs (CareStack, Curve, tab32) · BridgeLink (X12 EDI)
2
Semantic Translation (Axiomera)
SCE classifies clinical concepts, binds to CDT/SNODENT/SNOMED/LOINC/ICD-10 · DMM translates to/from FHIR · DHM resolves duplicates and conflicts across sources
3
Routing & Delivery
Multi-hop referral chain tracking · Provider directory resolution (OHIA Priority 4) · AuditEvent traceability for CMS compliance · Configurable retry and error handling
Canonical Architecture
Epic / Cerner
Open Dental
Eaglesoft
Dentrix
X12 EDI
FHIR R4
Canonical Model
Consumer Apps
AI Platforms
Analytics
Payers
TEFCA/QHINs
We don't build point-to-point interfaces. Everything translates to FHIR R4 first, then delivers wherever you direct it.
PMS Connectivity

Built for Every Major Dental PMS.

Source integration is the variable. Everything downstream follows OHIA's implementation guides uniformly, regardless of which PMS a practice runs.

PMS Platform Vendor Architecture Connectivity Method
Open Dental
Open Dental SoftwareOn-Prem · MySQLHeyDonto Synchronizer
Eaglesoft
Patterson DentalOn-Prem · SQL AnywhereHeyDonto Synchronizer
Dentrix
Henry Schein OneOn-Prem · ProprietaryHeyDonto Synchronizer
Dentrix Ascend
Henry Schein OneCloud-NativeCustomer API
CareStack
CareStackCloud-NativeCustomer API
Curve Dental
Curve DentalCloud-NativeCustomer API
tab32
tab32Cloud-NativeCustomer API
Epic / Cerner
Epic Systems / Oracle HealthEHR · FHIR-NativeSMART on FHIR App

Conduit integrates with your system in the way that works for you. Additional PMS integrations delivered on request.

Why It Matters Now

The Cost of Waiting
Is Growing Every Year

~$8.75
Saved Per Transaction
With electronic eligibility checks vs. manual processing
$200–500M
Annual Health System Losses
From referral leakage alone, per major health system
2027
CMS Prior Auth Mandate
FHIR-based prior authorization APIs required by law. Conduit is already compliant.
2024
OHIA Formed
Industry & government unite on dental interoperability standards
2025
HL7 Connectathon
Medical-dental FHIR referrals validated in live production environment
NOW
2026
CMS Coverage Expands
Medicare pays for linked dental care, only with documented digital coordination
2027
Prior Auth Rule
CMS mandates FHIR-based prior auth APIs for all payers. Conduit ready today.
Get Started

Stop losing referrals
between offices.

Tell us about a referral you lose today, medical to dental, dentist to dentist, or provider to payer, and we'll show you it run end to end on the software your offices already use.

Medical Group / Health System
Oncology / Specialty Group
Dental Group or Practice
PMS Vendor
Payer / Insurance
AI / Developer