FossibleWorks Health Central

One Healthcare IT platform - enabling future ready & scalable care delivery.

Most healthcare technology forces a trade-off. You buy a hospital management system (to manage CareOps) that runs operations but treats clinical data as an afterthought — or a clinical EHR that's standards-compliant but can't run a hospital. Then you spend years and budgets stitching them together, and your AI ambitions stall on top of data that never quite agrees with itself.

Health Central is one platform that does all three — and does them well.

Build your product. Not your plumbing.

The Foundation, at a Glance

Humans — One Identity, Three Front Doors

Practitioner → /mproviderPatient → /mportalOperations → /desk

AI Agents — Inside the Perimeter

Internal Agents3rd-Party AgentsSMART on FHIR Apps

Open Standards · FHIR R4 · APIsAI Agent Access

One login · one permission model · one deployment ↓

PractitionersClinical Provider WorkspaceCharting · orders · results · clinical workflows

PatientsPatient PortalRecords · appointments · results · messaging

OperationsOperations DeskBilling · front desk · inventory · finance

Clinical & operational data — always in sync, in real time ↓

ClinicalFHIR R4

Clinical Record

Powered by Medplum · standards-compliant

EncountersObservationsConditionsMedicationsDiagnostic ReportsCare Plans

Always
in sync

OperationsHIS · PMS

Operations & Finance

Powered by Frappe & ERPNext

Registration · ADTScheduling · LIS / RISBilling & RCMInventory · ProcurementAccounting · HR / PayrollWorkflows

One Source of Truth

Real-time syncUnified audit trailRole-based accessABDM · HIPAA · NABH ready

Extend it — every extension inherits the same identity, permissions & audit ↓

SMART on FHIR

Plug in third-party clinical apps, securely scoped to exactly the data they're allowed to see.

Business Apps

CRM, HR, helpdesk, and custom workflows — add what you need, all under one roof.

Analytics · Tuva

Purpose-built clinical data warehouse for population health, risk, outcomes, and AI.

FHIR-Native · AI-Ready · Always in Sync · Open Source · No Vendor Lock-In

FHIR-Native · AI-Ready · Always in Sync · Open Source · No Vendor Lock-In

The Problem With Healthcare IT Today

• Two systems, one patient. Operations in one product, clinical data in another — and a permanent integration project keeping them barely in sync.
• Stale data everywhere. Nightly batch jobs and reconciliation queues mean the number on screen is often hours old. Nobody fully trusts it.
• AI that can't ship. Pilots impress in a demo, then die in production because the data is inconsistent, the permissions are unclear, and no agent can see the whole patient.
• Lock-in and license sprawl. Per-seat clinical licenses, per-module operational licenses, per-integration fees — and you still don't own your data.

Health Central is built to erase all four.

How It Compares

	HIMS-only system	Clinical EHR-only	DIY integration	Health Central
Full hospital operations	✅	❌	⚠️ partial	✅
FHIR-native clinical record	❌	✅	⚠️ mapped later	✅
One login / one permission model	✅	✅	❌	✅
Real-time, no ETL between systems	n/a	n/a	❌	✅
Production-grade AI / MCP surface	❌	⚠️ clinical only	❌	✅ both planes
Open source, you own the data	⚠️ varies	⚠️ varies	⚠️ varies	✅

One Platform, Three Surfaces

1. A Maximal Hospital Management Surface (HIMS)

Everything it takes to run a hospital or clinic group, built in — not bolted on:

• Patient registration, ADT, bed and ward management
• Appointment scheduling, queues, and front-desk workflows
• Billing, revenue cycle, and insurance
• Pharmacy, inventory, and procurement
• Accounting, HR, and payroll

This is full ERPNext-grade operational depth, purpose-shaped for healthcare. You're not buying a thin clinical app and improvising the business side — the entire operational backbone of a hospital is native to the platform. → Fossible HIS

2. FHIR-Native Clinical EHR / EMR

The clinical record is built on FHIR R4 from the ground up — not exported to a standard later, but standards-compliant the moment data is created. That means:

• Specialty- and department-specific clinical workflows — built directly on FHIR resources
• Lab (LIS), radiology (RIS), therapy, and the full encounter → order → result loop
• Terminology baked in: ICD-10, SNOMED-CT, LOINC, RxNorm, CPT/HCPCS
• Interoperability that's native, not a project: HL7 v2, CDA, SMART on FHIR, CDS Hooks, device integration

Your clinical data is portable, interoperable, and ready for ABDM / HIPAA / NABH-grade compliance by design — because it was FHIR-native from day one. → Medplum Health Data Platform

3. Every Box Checked for the AI Agent & Worker Surface

AI in healthcare fails on infrastructure, not models. Prototypes die in production because data access is inconsistent, permissions are unclear, and the integrations are fragile. Health Central is built so agents are safe enough to actually deploy:

• Full programmatic access — every clinical resource and every operational record is reachable through a stable API. No UI-only operations, no internal pathways agents can't reach.
• MCP-native on both sides — a clinical MCP surface and an operational MCP surface, so agents get discoverable, scoped, auditable tools out of the box.
• Standardized data models — clinical data is FHIR, which modern AI models already understand. No brittle, org-specific schemas to teach an agent.
• Real guardrails — agents operate inside the same permissions, workflows, and audit trail as humans. The "can suggest, but a person acts" pattern is enforced by the platform, not promised in a slide.
• The whole picture, at once — because operations and clinical data live in one platform, an agent can reason over both — billing and the encounter, the order and the inventory — inside one permission and audit perimeter. Single-domain platforms structurally can't do this.

This is the surface that powers documentation agents, RCM and prior-auth automation, care coordination, and agentic workers — on a real, auditable system of record.

Built for Two Kinds of AI

Healthcare AI isn't one thing. Health Central is built for both.

AI agents that assist. Copilots that work alongside your clinicians and staff — drafting clinical notes, summarizing a patient's history, surfacing the right context at the right moment, recommending an order or a next step. The human stays in control of the final action.

AI workers that get work done. Autonomous workers that own end-to-end operational workflows:

• Revenue cycle — claims preparation and submission, prior authorization, denial management, payment posting, eligibility checks
• Patient operations — intake and registration, scheduling and rescheduling, reminders, follow-up
• Care coordination — routing results, flagging gaps, triggering the next step in a care plan
• Back office — inventory, procurement, reconciliation, reporting

These aren't chatbots bolted onto a dashboard. They're operators inside your system — working through the same permissions, the same workflows, and the same audit trail as your human staff. See how the AI layer works →

Why the Architecture Wins

Beyond the three surfaces, the platform's structure delivers benefits competitors can't easily copy:

• One identity, single sign-on. Clinicians, patients, and operations staff authenticate once. Three role-based front doors — provider, patient portal, operations desk — one identity, one permission model, one deployment.

• No ETL. Near real-time everywhere. There's no nightly batch job syncing a clinical mirror to an operational source of truth. Clinical and operational data are each read live from their owner. Reports, dashboards, and — critically — AI agents act on current state, not yesterday's snapshot.

• Two of the strongest open-source ecosystems, combined. Health Central stands on Frappe / ERPNext for operations and Medplum for FHIR-native clinical data. You inherit two mature, battle-tested communities — and the entire app ecosystem of each (Frappe CRM, HR, Helpdesk; SMART on FHIR clinical apps) plugs in without integration projects.

• Analytics, done right with Tuva. Clinical and financial analytics run on Tuva Project as a dedicated warehouse — keeping heavy analytical load off your live systems while giving you healthcare-grade insight across both clinical outcomes and revenue.

• No vendor lock-in. Frappe, ERPNext, and Medplum are open source. You own the code, the data, and the deployment.

Built on a Proven Open-Source Stack — With the Hard Part Already Solved

Health Central isn't a proprietary black box and it isn't a pile of parts you assemble yourself. It's three of the most proven open-source platforms in healthcare and operations, integrated into one real-time, AI-ready foundation:

• Frappe & ERPNext power the operational and revenue-cycle backbone — practice management, billing and RCM, inventory, accounting, HR, and a low-code layer to build anything specific to your model. Proven across 10,000+ organizations in 140+ countries. → Fossible HIS
• Medplum powers the FHIR-native clinical record — the standards-compliant system of record, patient and provider apps, terminology, and the SMART on FHIR app ecosystem. → Medplum Health Data Platform
• Tuva powers AI-ready analytics — standardized clinical data flows into a purpose-built clinical data warehouse for population health, risk stratification, outcomes, and operational forecasting.

What you don't have to build is the part that matters most: getting clinical, operational, and analytical data to work as one coherent, real-time, agent-addressable foundation. That's what Health Central is.

Enterprise-Grade, by Default

The foundation ships with the things that are normally a multi-year program in their own right — clinical standards, compliance posture, ERP depth, and a build layer to make it yours.

Clinical standards and terminologies, native. FHIR R4 as the system of record, plus the terminologies real clinical work runs on — ICD-10, SNOMED-CT, LOINC, RxNorm, CPT/HCPCS — and the interop standards to move data in and out: HL7 v2, CDA, SMART on FHIR, CDS Hooks, DICOM-ready imaging. Standards-compliant as data is created, not converted after the fact.

Enterprise compliance and HIPAA build-ready. The platform is built to be deployed into regulated environments — HIPAA build-ready, and architected for ABDM and NABH alignment. Role-based access control, a complete standards-based audit trail across both clinical and operational actions, encryption, consent and scoping for third-party apps, and flexible hosting — cloud, on-prem, hybrid, or air-gapped — so the data-residency and isolation requirements of your jurisdiction are a deployment choice, not a re-architecture.

Full ERP depth, not a thin billing module. Because operations run on Frappe and ERPNext, you get a real enterprise backbone: billing and revenue cycle, inventory and procurement, accounting and finance, HR and payroll, CRM, helpdesk, and asset management — the same engine running thousands of organizations at scale, shaped for healthcare.

Low-code and no-code, built in. Frappe's low-code/no-code layer lets your team extend the platform without forking it — custom doctypes, fields, forms, workflows, dashboards, reports, permissions, and automations. Every new object you create is automatically API- and MCP-addressable, so it's agent-ready the moment it exists. Build what's specific to your model; inherit the rest.

Hydra for rapid implementation. Hydra AI doesn't just power runtime agents — it accelerates the build itself. Standards-native, open, agent-addressable data means AI tools already understand the platform, so configuration, specialization, and go-live happen in a fraction of the usual time. Tailor a specialty workflow, stand up a department, wire an integration — fast, because the foundation was designed for it. See how the AI layer works →

Who It's For

• Multi-site hospitals and clinic groups that want clinical and operational workflows in one platform — not five integrated products held together with pipelines.

• Diagnostic and imaging chains running high-volume LIS/RIS with device integration and FHIR-standard reporting.

• Specialty and multi-specialty providers needing configurable, FHIR-native clinical workflows tailored per department. We tailor the Medplum EMR/EHR for one or two specializations to start with, then expand as you grow.

• AI-native healthcare companies building agents for documentation, RCM, prior auth, or care coordination — who need a real, auditable system of record across both clinical and operational domains underneath their models.

• Organizations pursuing ABDM, HIPAA, or NABH compliance that want FHIR-native architecture and an audit trail spanning the whole action — not compliance retrofitted after the fact.

What You Get

• One source of truth, not two systems to reconcile. Operations and clinical care share an identity, a permission model, and a deployment.
• Faster time-to-value. Standard hospital and clinical workflows ship configured, not custom-built. Stand up departments and specialties without a multi-year integration program.
• Lower total cost of ownership. Open-source core means no per-seat clinical license tax and no per-integration fees. You pay for managed deployment and support — not for the right to access your own data.
• Real-time decisions. Live data across operations and clinical care means dashboards, billing, and agents act on what's true now.
• A platform that grows with you. Add Frappe apps (CRM, HR, Helpdesk) or SMART on FHIR clinical apps without re-architecting. New capability is more of the same store, under the same rules.

Security, Privacy & Compliance — By Design

• FHIR-native architecture maps directly to ABDM, HIPAA, and NABH expectations — compliance is structural, not retrofitted.
• One audit perimeter. Every action — human or agent, clinical or operational — flows through the same role-based access control and audit trail. Reconstruct any action end-to-end from a single trail.
• Scoped, consented access for third-party apps. External clinical apps get FHIR-only, scope-limited tokens — no path to your operational or financial data.
• Agents inside the perimeter, not behind a backdoor. AI operates under the same permissions and audit as a clinician or clerk. No parallel, unaudited automation path.

Why Now

The healthcare AI moment is real — but it rewards organizations with clean, complete, real-time data and a system of record agents can safely act on. Most can't deliver that because their data is split across stale, integrated silos. Health Central is built specifically for this moment: the operational and clinical foundation that makes agentic healthcare deployable, not just demo-able. Build the foundation now and the AI roadmap compounds on top of it.

Frequently Asked

Is this a single product or two stitched together? One platform — one identity, one UI shell, one deployment. The clinical and operational planes are distinct services by design, but unified everywhere it matters to a user, operator, or auditor.

Do we get locked in? No. Frappe, ERPNext, and Medplum are open source. You own the code, the data, and the deployment.

Where does our data live? Wherever you deploy. Managed via Espresso Cloud, or run it yourself — cloud, on-prem, hybrid, or air-gapped. Your choice, your infrastructure.

Can our existing AI / SMART on FHIR apps plug in? Yes. The clinical plane is a standards-compliant FHIR server; the operational plane is fully REST- and MCP-addressable. Both ecosystems plug in without bespoke integration.

How do we handle analytics? Tuva Project runs as a dedicated clinical + financial data warehouse — healthcare-grade analytics without loading your live systems.

Explore the Platform

• Fossible HIS → — the hospital and practice-management backbone, on Frappe & ERPNext
• Medplum Health Data Platform → — the FHIR-native clinical record and app ecosystem
• Hydra AI → — the AI agent and worker layer that operates across both
• Medplum's guide to healthcare AI ↗ — the infrastructure-first thinking this is built on

Build on the Foundation

Book a Demo → · Explore the Platform → · View on GitHub →

Health Central is deployed and managed through Espresso Cloud, our enterprise managed-infrastructure platform — so your team focuses on building, and we handle the DevOps, scaling, and SLAs.

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FossibleWorks Health Central is built and maintained by Fossible Works Inc. (NY, USA) and Tacten Services LLP (Bangalore, India).