Hospital chain deployment

The hospital chain deployment is where JamBridge's cross-facility architecture shows its value most clearly. A single patient attends multiple branches. Their medication is prescribed at Branch 01, their lab results are at Branch 03, their imaging is at Branch 02. Without a unified golden record and cross-facility FHIR store, clinicians at each branch see only a fragment of the patient's history — and safety events like drug-drug interactions across branches are invisible.

Network topology

In a typical 3–10 branch chain, every branch runs its own HIS. JamBridge is deployed as a central service (or HA cluster) that all branches connect to over dedicated MLLP TCP sockets.

Branch 01                Branch 02                Branch 03
MEDITECH                 Cerner                   Epic
 │                        │                        │
 └── MLLP :2575 ──────────┘                        │
 └── MLLP :2576 ─────────────────────────────────► │
                                                    │
                    ┌───────────────────────────────┘
                    │
                    ▼
              JamBridge :8443
              MLLP :2575–:2582
              │
              ├── JamMPI :8081 (golden records)
              ├── HAPI FHIR :8080 (central FHIR store)
              ├── JamGuard :8094 (cross-branch DDI)
              ├── JamSHR :8084 (cross-branch IPS)
              └── AJ Consent :8082 (consent enforcement)

The golden record is what makes this work

Every benefit of the central FHIR store depends on JamMPI correctly resolving each message to the same golden patient ID. Before connecting additional branches, validate that your national ID coverage is sufficient for CERTAIN-grade matching. See Cross-branch patient identity →.

What the central FHIR store enables

Because all branches write to the same HAPI FHIR instance (linked by golden patient ID), any component that reads from HAPI sees the complete cross-branch record:

• JamGuard sees all active MedicationRequests across all branches → detects cross-branch DDI
• JamSHR assembles IPS from all branches → clinician sees complete medication, allergy, and lab history
• JamDHIW aggregates all branches for population health → district-level disease surveillance
• JamPHR shows patient their complete record → one portal regardless of which branch they attend

Full ADT flow walkthrough

Here is what happens when Branch 01's MEDITECH admits a patient previously seen at Branch 03:

1. MEDITECH sends ADT^A01 to JamBridge on MLLP :2575
2. JamFR resolves BRANCH-01 to Organization/org-br01-001
3. JamMPI finds CERTAIN match: GOLDEN-00441 (same patient seen at Branch 03 as a different MRN)
4. JamTS translates local codes to LOINC
5. AJ Consent: org-br01-001 + Patient + write + TREAT → "permitted": true
6. HAPI FHIR: PUT /fhir/Patient?identifier=MRN12345 → Patient v3 written
7. JamConnect POST_WRITE: IPS cache invalidated for GOLDEN-00441
8. Dr. Smith opens JamPHR: GET /fhir/Patient/GOLDEN-00441/$summary → IPS from Branch 01, Branch 03, central lab
9. Dr. Smith orders Warfarin 5mg → JamGuard finds Aspirin 100mg at Branch 03 → MAJOR DDI — blocked

Deployment models

Model	When to use
Central JamBridge	2–20 branches, single region
Active/Active cluster	20+ branches, HA required
Regional hubs	50+ branches, multi-region
National HIE	Country-wide, government deployment