One chain of custody, from the rack to the result.
We are systems architects for eClinicalWorks, CGM AP EASY, Epic Beaker and the systems around them. Our chain-of-custody programs bring three disciplines under one umbrella: PazNetworks hardware deployments, CarolinaEMR provisioning, and Carolinas.ai edge AI and security. Every device, interface and result can be traced to a source, an owner and a date.
Fig. 0 · The umbrella, as three layersAxonometric · not to scale
The umbrella
Three disciplines, one record of what is true on site.
Most healthcare IT projects split the network, the clinical systems and security across different vendors, and each keeps its own version of the truth. We run them as one program with one reconciled record, so a lab result, the interface that carried it and the switch port it crossed belong to the same story.
Every fact we hand over carries its state and its date.
Our drawings, films and dashboards use the same five states. Missing data is drawn as missing, never as empty space, and a snapshot from last month is labeled with last month's date. That is how a chain of custody stays honest.
VerifiedConfirmed in the field or by a live source, with the date it was seen.
InferredDerived from documents; hatched so it never passes for verified.
UnknownNot established. Drawn dashed, with the source that is missing.
ContestedSources disagree. Shown as unknown and named until resolved.
Not surveyedOutside what has been captured so far: the scope of the next visit.
The storyline · six phases
From reconciliation to proof, one phase at a time.
Each phase ends at an exit gate: a condition that has to be true before the next phase starts. The audit is Phase 00, implementation runs through Phase 04, and the retainer is Phase 05.
00All three disciplines
Reconcile
Before anything is built, every source is read, compared and dated.
Rack sheets, inventory articles, network drawings, vendor exports and live monitoring rarely agree. We read them in a fixed order of authority, list every contradiction, and decide how each one is shown. A drawing of the wrong room is worse than no drawing.
What we do
Field statements from your team, captured first
Rack sheets, elevations and device schedules
Inventory and asset records
Network drawings, ports and ownership
Live monitoring snapshots, each with its date
What you receive
Defect list: every contradiction between sources
Decision log: how each contested fact is shown
Source register with owners and dates
Exit gateNo fact enters the program without a source and a date.
Fig. 1 · ReconcileAxonometric · not to scale
01PazNetworks · hardware deployments
Infrastructure
The physical layer, drawn rack unit by rack unit.
Racks, power, structured cabling, switching, wireless and the edge collectors that watch them. Clinical, lab, guest and device traffic are segmented and documented, and every port has an owner.
What we do
Rack and power build, cable management, labeling
Switching, VLAN segmentation, wireless coverage
Edge collectors for monitoring and analytics
As-built photographs tied to each drawing
What you receive
RU-accurate rack elevations and device schedules
Network design drawing: links, ports, ownership
Axonometric rack film of each room
As-built record set
Exit gateEvery rack unit is accounted for, and every port has an owner.
Fig. 2 · InfrastructureAxonometric · not to scale
02CarolinaEMR · clinical systems
Provisioning
The clinical systems, configured and connected end to end.
We architect and provision the clinical and lab systems in the chain: eClinicalWorks in the practice, CGM AP EASY in anatomic pathology and dermatopathology labs, and Epic Beaker in health-system laboratories, plus the instruments, label printers, barcode scanners and interface engines around them. Every order, specimen and report is traced from the system that sends it to the system that files it.
What we do
EHR and practice management build
Lab orders, specimen labeling and results flow
HL7 v2 interfaces: demographics, orders, results
Users, roles, templates and permissions
Test scripts, sign-off and go-live support
What you receive
Interface map: system, message, direction, owner
Provisioning runbook and role matrix
Test evidence for every interface
Go-live plan and post-live punch list
Exit gateEvery interface is traced end to end, with test evidence, before go-live.
AI that runs where the data lives, inside a boundary we can draw.
Edge AI keeps inference close to the systems that produce the data, so patient information does not need to leave the site to be useful. Each data path is drawn, assigned an owner and logged, and access is reviewed.
What we do
Edge AI nodes on site, next to the data
Trust boundaries and data-flow mapping
Access control, logging and review
Security baselines for collectors and nodes
What you receive
Data-flow and trust-boundary drawing
Edge node build sheets
Access review and logging baseline
Monitoring and alert baselines
Exit gateEvery path that carries patient data is drawn, owned and logged.
Fig. 4 · Intelligence & securityAxonometric · not to scale
04The umbrella
One chain of custody
Hardware, provisioning and AI analytics fused into one timeline.
Signals from the network, the clinical interfaces and the edge are joined per site into one custody timeline. Each source keeps its own authority: the network controller owns port state, monitoring owns alerts, device configuration owns routing. When a source goes quiet, its last known good value stays on screen with its age.
What we do
Collectors, normalization and one site record
Interface health beside network and device health
Clear source-of-truth boundaries per signal
Last Known Good states, labeled and dated
What you receive
Site evidence dashboard
Custody timeline: who changed what, when, from which source
Monthly evidence report
Exit gateStale data never masquerades as current.
Fig. 5 · One chain of custodyNetwork · interfaces · edge
05Monthly retainer
Operate & prove
Each month, fewer unknowns than the month before.
The drawings, films and dashboards are re-rendered from the same reconciled record whenever something changes. The share of the site that is unknown or not yet surveyed is the number we report and the number we shrink.
What we do
Change control against the reconciled record
Scheduled re-surveys of contested areas
Re-rendered drawings and films after each revision
Quarterly architecture review
What you receive
Monthly evidence bar per site
Change log with sources
Current drawing set, always dated
Exit gateThe unknown segment shrinks, and you can see it shrink.
Fig. 6 · Operate & proveIllustrative data
The systems in the chain
Every EMR has its own story, because we integrate with each one differently.
A practice EHR, an anatomic pathology lab system and a health-system laboratory meet the chain of custody at different points, with different vendors, interfaces and ways to fail. So each one gets its own integration story: the steps we take, the points we connect, what typically breaks, and the gate it has to pass.
The practice EHR
eClinicalWorks
We integrate from the practice outward.
eClinicalWorks is the practice's system of record: a cloud EHR for ambulatory care (used by more than 180,000 physicians, according to eClinicalWorks) that we have worked with since 2008. Every order starts in it and every result has to come back to it. It also ships AI across the visit (Sunoh.ai ambient notes, eCW AI Assistants and AI Playlists, the healow Genie AI contact center), and many practices already pay for tools they never switched on. So the eCW story is two integrations at once: outward to the labs and networks the practice depends on, and inward to the AI it already owns.
How we integrate
01Readiness checkeCW version, what the contract includes, and how each AI add-on is licensed and billed.
02Interfaces outLab and pathology orders leave the chart through tested interfaces.
03Results back, routedResults and signed reports return to the right patient, provider, nurse and staff inbox.
04Pilot one workflowOne provider or one workflow, with a baseline measured first.
05Configure and train by roleProviders, clinical staff, front desk and billing.
06Govern, measure, expandPatient consent for ambient recording, HIPAA, clinician review of AI output; then note time, call volume, denials and days in A/R.
We integrate between two vendors, and keep it working after every update.
CGM AP EASY is a cloud-based laboratory information system for anatomic pathology, serving AP labs since 1994 and part of CompuGroup Medical since 2022: dermatopathology, GI, surgical, urology and cytology, from accessioning and barcoding to macros, sign-out and reporting. For a practice with its own pathology lab the hard part is not the LIS. It is the interface to the EHR, which runs between two vendors, and the fact that either vendor's next update can quietly change how a report looks. We have coordinated AP EASY and eClinicalWorks interface projects from kickoff to support hand-off.
How we integrate
01Kickoff with both vendorsWe act as the practice's single point of contact with CGM and the EHR vendor.
02BuildPathology orders out of the EHR; signed reports back to the patient's chart and the provider's inbox.
03Validate with our test casesIncluding report routing for nurses and staff added as referring or copy physicians.
04Monitor real casesA monitoring period on live cases before anyone calls it done.
05Hand off to supportSign-off only when real cases come through correctly.
06Test after every updateA short script of real report types, run after every AP EASY or EHR update.
CGM AP EASYOrders out, reports back: both tested
Where we connect
HL7 and API interfaces to the EHR, practice management and billing
Physician library: referring and copy physicians, staff inboxes
Report layout: specimen parts, diagnoses, macros
Label printers, barcode scanners and workstations on the practice network
What typically breaks
After an update, specimen parts A, B, C display in a different order: a patient-safety issue, not a cosmetic one
A report reaches the ordering provider but not the covering nurse
Each vendor points at the other while the issue stays open
Exit gateSign-off only when real cases come through correctly, and again after every update.
Next stepInterface health check: run the report test script against your latest AP EASY and EHR versions.
We integrate everything around it, with Epic as the system of record.
Epic Beaker is the laboratory information system built into Epic, for clinical pathology (orders, collection, instrument results, verification) and anatomic pathology (accessioning, grossing, blocks and slides, sign-out), in the same record clinicians use. Going live on Beaker is the start. The value comes from what connects to it: instruments, label printers and scanners, digital pathology, the network and storage under all of it, and now Epic's AI (Art, Emmie, Penny, Agent Factory). The weak points are the hand-offs between rooms, so that is where we work, alongside your Epic analysts.
We are designing this kind of chain-of-custody solution for the anatomic pathology department of an academic medical center.
How we integrate
01AssessmentCurrent Beaker workflows, devices, interfaces, network and storage, and where specimens and slides lose track.
02Design with your Epic teamBeaker stays the system of record; we connect what surrounds it.
03Map every hand-offOperating room to pathology, grossing to histology, histology to the scanner, slides to the pathologist and the archive: a scan point and a device at each one.
04Pilot one hand-off or one scannerWith a baseline measured first.
05Connect digital pathologyBeaker sends case and slide information to image management over HL7; DICOM for slide images; network and storage sized for whole slide imaging.
06Govern AI, measure, expandValidation, pathologist review and documentation for accreditation; turnaround time, specimens unaccounted for, rescans and slide retrieval time.
Epic BeakerA scan point per hand-off · dashed: not tracked yet
Where we connect
Instruments, label printers and barcode scanners
HL7 to image management systems; DICOM slide images
Network and storage tiers for whole slide imaging
Epic AI for the lab: case summaries, result follow-up, coding
What typically breaks
A specimen goes missing between two rooms and is found days later
Slide scanners arrive before the network and storage can carry their files
AI switched on without validation or pathologist review
Exit gateEvery specimen and slide has a known location, with an alert when it stops moving.
Next stepHand-off map: one specimen path from the procedure room to the archive, with where it can lose track today.
eClinicalWorks, eCW, healow, Sunoh.ai and PRISMANet are trademarks of their respective owners; Epic, Beaker, MyChart and Cosmos are trademarks of Epic Systems Corporation; CGM, CGM AP EASY and CompuGroup Medical are trademarks of CompuGroup Medical SE & Co. KGaA. CarolinaEMR is an independent consulting firm and is not affiliated with or endorsed by these vendors. Product features and availability are set by each vendor and can change; we confirm what your version and contract include before any project. Drawings on this page are illustrative and do not depict a specific client site.
Begin at Phase 00
Start with a reconciliation audit of one site.
We read every source you have, draw what is verified, inferred and unknown, and hand you the defect list and the plan. The unknowns become the scope of the work.
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