6 AI agents. 7 FHIR write-back types. Every click from note to immunization — automated. That is what happens when you connect DeepCura to eClinicalWorks.
Most AI scribes listen to your encounter and hand you a note to copy-paste. That is one step. DeepCura deploys 6 specialized AI agents that handle the entire encounter workflow — and write everything directly back into eClinicalWorks via FHIR R4:
- ✓AI Scribe — generates a 14-section HL7 clinical note, delivered as a full ORU^R01 message
- ✓Diagnoses — extracts problems, maps to ICD-10 + SNOMED severity, pushes to the chart
- ✓Allergies — captures allergens with criticality levels, validates SNOMED CT codes
- ✓Medications — new prescriptions via MedicationRequest + reconciliation via MedicationStatement
- ✓Lab Orders — LOINC-coded ServiceRequests with clinical justification
- ✓Immunizations — CVX codes with site, route, dose, and lot tracking
At 20 patients a day, that is ~1,500 clicks eliminated — roughly 4-5 hours of data entry, gone. eCW's Prism AI handles about 1 of these 6 workflow steps. DeepCura handles all of them.
This guide covers exactly how each agent works with eClinicalWorks, what Prism AI does and does not do, and how to evaluate whether a dedicated AI scribe for eCW is worth the investment for your practice.
This guide was last updated in February 2026. All technical claims are based on DeepCura's production eClinicalWorks FHIR R4 integration (2,000+ lines of dedicated integration code). Pricing reflects current publicly available information.
Watch: Full eClinicalWorks Integration Demo
See all 6 AI agents working inside an eClinicalWorks encounter — from note generation through immunization recording — in under 10 minutes.
Why Most AI Scribes Fall Short with eClinicalWorks
The typical AI medical scribe workflow with eClinicalWorks looks like this: the scribe listens to the encounter, generates a SOAP note, and the clinician copies it into eCW. That is essentially a voice-to-text tool with a clipboard. It saves time on the note itself, but it does nothing for the 80% of the encounter workflow that happens after the note is written — diagnoses, allergies, medications, lab orders, and immunizations.
eCW Prism AI, eClinicalWorks' own built-in AI assistant, improves on this by offering basic ambient dictation capabilities. But it stops there. There is no structured diagnosis management, no allergy write-back, no medication order entry, no lab ordering, and no immunization recording. For a platform that supports FHIR R4, Prism AI leaves most of the automation opportunity on the table.
The eClinicalWorks challenge goes deeper than most EHR integrations. Delivering notes into eCW requires constructing a full HL7 v2 ORU^R01 message — a complex clinical messaging format with 14 mandatory sections including MSH, PID, OBR, and OBX segments. The note content must be Base64-encoded and wrapped in a FHIR DocumentReference resource. Most AI scribes cannot construct this message format, which is why they fall back to copy-paste workflows.
DeepCura is the only AI scribe platform with full bidirectional eClinicalWorks FHIR R4 write-back across all six workflow stages. It does not just generate a note and hand it off — it processes the encounter through 6 specialized AI agents, validates every output against medical coding standards, and pushes structured data directly into the correct eCW chart fields. No copy-paste. No manual data entry. No switching between screens. For a detailed comparison of how other AI scribes handle EHR integration, see our Best AI Medical Scribes in 2026 ranking, our Freed AI review, and our Heidi Health review.
The 6 AI Agents
DeepCura's eClinicalWorks integration uses a multi-agent architecture — 6 specialized AI agents that each handle one stage of the clinical workflow. Each agent runs on GPT-4.1 with streaming server-sent events (SSE) for real-time output, and every agent includes a 3-stage validation pipeline: AI extraction, coding standard cross-reference, and clinician confirmation before any data is written to the chart.
Here is what each agent does and why it matters for eClinicalWorks users.
1. AI Scribe — 14-Section HL7 Clinical Note
The AI Scribe agent captures the ambient encounter audio and generates a comprehensive clinical note with 14 structured sections: Chief Complaints, Allergies, History of Present Illness, Medical History, Surgical History, Hospitalization History, Family History, Social History, Review of Systems, Physical Exam, Treatment Plan, Assessment, Procedures, and Patient Education.
What makes this different from every other AI scribe on the market: DeepCura constructs a full HL7 v2 ORU^R01 message for note delivery into eClinicalWorks. This is not a simple text dump into a free-text field. The ORU^R01 message includes properly formatted MSH (message header), PID (patient identification), OBR (observation request), and OBX (observation result) segments. The clinical note content is Base64-encoded and delivered as a FHIR DocumentReference resource, which eCW processes and routes each section into the correct chart area.
This per-section delivery means the Chief Complaint appears in the Chief Complaint field, the Assessment appears in the Assessment field, and so on — preserving eCW's native chart structure rather than dumping everything into a single progress note box.
2. Problem and Diagnosis Management
The Problem and Diagnosis agent extracts every clinical problem and diagnosis mentioned during the encounter and maps each one to both ICD-10-CM codes and SNOMED CT severity levels (Mild, Moderate, or Severe). Each condition is categorized as either an encounter-diagnosis (relevant to this visit only) or a problem-list-item (ongoing chronic condition).
The agent also suggests additional diagnoses based on the patient's current medication list, lab results, and clinical context. For example, if a patient is on metformin and their most recent HbA1c is 7.8%, the agent will suggest Type 2 Diabetes (E11.9) if it is not already on the problem list. Each suggestion includes a confidence score so the provider can make an informed decision.
This two-tier approach — explicit problems plus AI-suggested conditions — catches diagnoses that might otherwise be missed during a busy clinic day.
3. Allergy Management
The Allergy agent extracts every allergen mentioned during the encounter — medications, foods, and environmental factors — along with SNOMED CT substance codes, criticality levels (low, high, or unable-to-assess), and reaction types.
This is critical for patient safety. Manual allergy entry in eClinicalWorks is error-prone — clinicians often enter free-text descriptions that do not trigger drug interaction alerts. By mapping allergens to standardized SNOMED CT codes and assigning proper criticality levels, the agent ensures that every allergy entry works with eCW's built-in clinical decision support and drug interaction checking.
Each allergy is categorized by type — food, medication, or environment — and pushed to eCW as a structured FHIR AllergyIntolerance resource with all required fields populated.
4. Medications — Prescriptions and Reconciliation
The Medications agent handles two distinct FHIR resource types: MedicationRequest for new prescriptions and MedicationStatement for medication reconciliation. This dual approach ensures that new orders and existing medication updates are handled through the correct eCW workflows.
Every medication is coded using RxNorm codes exclusively. This is a deliberate technical decision — eClinicalWorks returns error code 2027 when NDC (National Drug Code) identifiers are used for medication write-back. RxNorm codes are the only reliable coding system for eCW's FHIR medication endpoints.
Each prescription includes the medication name, RxNorm code, dosage instructions, route of administration, and frequency. Medication reconciliation entries include the current status (active, completed, stopped) and any dosage changes detected during the encounter.
5. Lab and Imaging Orders
The Lab Orders agent extracts every lab test and imaging study mentioned during the encounter and creates FHIR ServiceRequest resources with LOINC codes. Each order includes clinical justification text, which eCW uses for insurance pre-authorization workflows.
The agent includes confidence scoring to prevent false positives. A clearly stated "let's get a CBC and lipid panel" gets a high confidence score and is ready for one-click confirmation. A tentative "we might want to consider an MRI" gets a lower score and is flagged for provider review. This prevents accidental order placement from casual mentions during the encounter.
6. Immunization Records
The Immunization agent captures every vaccination administered during the encounter and creates FHIR Immunization resources with CDC-maintained CVX (vaccine administered) codes. Each record includes:
- ✓Site codes — Left Arm (LA), Right Arm (RA), Left Thigh (LT), Right Thigh (RT)
- ✓Route codes — Intramuscular (IM), Subcutaneous (SQ), Nasal Inhalation (NASINHLC)
- ✓Dose quantity and unit of measure
- ✓Lot number for tracking and recall purposes
This level of detail is particularly valuable for pediatric practices, where immunization tracking and reporting to state registries is a significant administrative burden.
eCW Prism AI vs DeepCura: Head-to-Head
The following comparison shows the workflow coverage difference between eClinicalWorks' built-in Prism AI and DeepCura's full FHIR R4 integration.
| Capability | eCW Prism AI (Built-in) | DeepCura ($99/mo) |
|---|---|---|
| Ambient AI Scribing | Yes | Yes |
| Note Generation | Yes (unstructured) | Yes (14-section HL7 v2) |
| Push Notes to eCW | Basic (single field) | Yes (per-section HL7 ORU^R01) |
| Problem/Diagnosis Push | No | Yes (ICD-10 + SNOMED) |
| Allergy Management | No | Yes (SNOMED + criticality) |
| Medication Orders | No | Yes (RxNorm) |
| Medication Reconciliation | No | Yes (MedicationStatement) |
| Lab/Imaging Orders | No | Yes (LOINC) |
| Immunization Records | No | Yes (CVX + site/route) |
| AI-Suggested Diagnoses | No | Yes |
| FHIR R4 Write-back | No | Yes (7 resource types) |
| Workflow Automation Score | 1/6 | 6/6 |
Prism AI is a reasonable starting point for practices that only need basic ambient scribing and are satisfied with eClinicalWorks' native documentation workflow. But for practices that want to automate the full encounter — from clinical notes through immunization recording — it covers roughly 15% of the opportunity.
How Many Clicks Does This Actually Save?
We measured the manual click count for a typical primary care encounter in eClinicalWorks across every workflow stage:
- ✓Note documentation: 20-25 clicks (section navigation, field entry, template selection)
- ✓Problem/diagnosis entry: 8-10 clicks per diagnosis (search, select, confirm, set severity)
- ✓Allergy updates: 5-8 clicks per allergen (search, select, set criticality, confirm)
- ✓Medication orders: 10-12 clicks per medication (search, select, dosage, route, frequency, sign)
- ✓Lab/imaging orders: 8-10 clicks per order (search, select, justification, sign)
- ✓Immunization recording: 6-8 clicks per vaccine (search, select, site, route, lot, confirm)
Total: approximately 70-90 clicks per patient encounter.
At 20 patients per day, that is roughly 1,500 clicks — the equivalent of 4-5 hours spent on data entry rather than patient care. Over a year, that adds up to approximately 1,000 hours of administrative work.
At an average physician compensation rate of $300/hour, those 1,000 hours represent $300,000 in annual opportunity cost. Even recovering 50% of that time through automation delivers $150,000 in value — for a tool that costs $1,188/year.
Pricing
DeepCura is priced at $99 per month for 1,000 credits, which supports approximately 15-20 patient encounters per day for a typical primary care provider. High-volume practices or those using more credit-intensive features (multi-agent processing across all 6 agents) may see usage closer to $165/month.
For context, here is how that compares:
- ✓eCW Prism AI: Included with eClinicalWorks subscription, but limited to basic ambient scribing — no structured diagnosis management, no medication orders, no lab ordering, no immunization recording
- ✓Freed AI: $39-$119/month tiered pricing — no native eClinicalWorks FHIR integration, no structured write-back
- ✓Nuance DAX Copilot: Custom pricing (typically $200-400/month), strong ambient scribing but limited workflow automation beyond notes
- ✓DeepCura: $99/month for 6 AI agents with full eClinicalWorks FHIR R4 bidirectional integration
The value proposition is straightforward: for the same price as a scribe-only tool, DeepCura automates 6x more of the workflow.
Start with a free trial to see all 6 agents in action with your own eClinicalWorks environment. No credit card required. Sign up at app.deepcura.com/register.
Getting Started: Connect eCW in 3 Steps
Getting DeepCura connected to your eClinicalWorks instance takes under 5 minutes:
- ✓Sign up at app.deepcura.com/register — free trial, no credit card required.
- ✓Navigate to Settings > EHR in the DeepCura dashboard and select "eClinicalWorks" as your EHR system.
- ✓Authorize via OAuth 2.0 — DeepCura uses the PKCE authorization code flow to securely connect to your eCW instance. Tokens auto-refresh, so you never need to re-authenticate.
That is it. No IT department needed, no multi-week implementation, no eClinicalWorks support tickets. The integration uses eClinicalWorks' standard FHIR R4 APIs, and DeepCura handles all of the authentication and connection management behind the scenes.
Who Is This For?
DeepCura's eClinicalWorks integration is the strongest fit for these practice profiles:
- ✓Primary care providers on eClinicalWorks who spend 2+ hours per day on documentation and data entry beyond the clinical encounter itself.
- ✓Multi-provider practices where consistency in documentation, coding, and order entry across providers is a priority. The AI agents enforce consistent workflows regardless of individual provider habits.
- ✓Pediatric practices where immunization volume is high and the manual vaccine recording workflow in eCW consumes significant staff time. The Immunization agent with CVX codes, site tracking, and lot numbers automates the entire process.
- ✓Clinicians frustrated with Prism AI's scope who have tried eCW's built-in AI assistant and found that it handles basic dictation but leaves everything else — diagnoses, medications, labs, allergies — completely manual.
- ✓Chronic disease management practices where patients have complex medication lists, multiple active diagnoses, and frequent lab orders. The multi-agent approach handles all of these workflows simultaneously rather than requiring manual entry for each.
For providers using other EHR systems, DeepCura also integrates with athenahealth, Epic, AdvancedMD, OptiMantra, and Veradigm. For athenahealth users specifically, see our athenahealth AI Scribe guide which covers the 8 AI agents available for that platform. For AdvancedMD users, see our AdvancedMD AI Scribe guide covering 5 AI agents with direct write-back. For international and multilingual practices evaluating alternatives, see our Heidi Health review. For a broader look at AI tools for clinical practice, see our guides to the Best ChatGPT for Doctors and the Best AI Medical Receptionist.
See DeepCura in Action
Watch the full platform demo to see how DeepCura handles ambient scribing, AI chat, patient management, and EHR integration across all supported systems.
Frequently Asked Questions
Does DeepCura integrate with eClinicalWorks?
Yes. DeepCura has a full bidirectional integration with eClinicalWorks — over 2,000 lines of dedicated FHIR R4 integration code covering clinical notes, diagnoses, allergies, medications, lab orders, and immunizations. Data flows both directions: DeepCura reads patient context from eCW and writes structured clinical data back into the appropriate eCW chart fields. This is not a copy-paste integration — it is direct FHIR R4 write-back into eClinicalWorks' native data structures.
What is the best AI scribe for eClinicalWorks?
For practices that want automation beyond basic ambient scribing, DeepCura is the most comprehensive AI scribe for eClinicalWorks. It is the only platform with 6 specialized AI agents that cover the full encounter workflow — from HL7 v2 clinical notes through immunization recording — with direct FHIR R4 write-back. Prism AI is a reasonable free option for basic dictation, but it covers approximately 15% of the total workflow automation opportunity. For a full comparison of AI scribes, see our Best AI Medical Scribes in 2026 ranking.
Is eCW Prism AI a good AI scribe?
Prism AI is a competent basic ambient dictation tool for practices that only need note generation. Its main advantage is that it is included with the eClinicalWorks subscription, so there is no separate app or additional cost. However, Prism AI is limited to basic dictation — it does not automate diagnosis entry, allergy management, medication orders, lab ordering, or immunization recording. For practices that want broader workflow automation, Prism AI covers roughly 1 out of 6 workflow steps.
How much does DeepCura cost for eClinicalWorks users?
DeepCura costs $99 per month for 1,000 credits, which supports approximately 15-20 patients per day for a typical primary care provider. There is no separate charge for the eClinicalWorks integration — all 6 AI agents and full FHIR R4 write-back are included in the standard subscription. High-volume practices may see usage closer to $165/month. A free trial is available with no credit card required.
Can DeepCura push notes directly into eClinicalWorks?
Yes. DeepCura constructs a full HL7 v2 ORU^R01 message with 14 structured sections and delivers it to eClinicalWorks as a Base64-encoded FHIR DocumentReference. Each section — Chief Complaint, HPI, Assessment, Plan, Physical Exam, and more — routes to the corresponding field in the eCW chart. This preserves eCW's native chart structure and is fundamentally different from pasting text into a single progress note field.
Does DeepCura handle medication reconciliation for eCW?
Yes. The Medications agent handles two distinct FHIR resource types: MedicationRequest for new prescriptions and MedicationStatement for medication reconciliation. This means both new medication orders and updates to existing medications (dose changes, discontinuations, continuations) are processed through the correct eCW workflows. All medications use RxNorm codes exclusively — eCW returns error code 2027 when NDC codes are used.
How does DeepCura compare to Freed AI for eClinicalWorks?
Freed AI is an ambient-only AI scribe that does not integrate with eClinicalWorks beyond copy-paste workflows. It generates notes from encounter audio, but the clinician must manually copy the note into eCW and handle all downstream tasks (diagnoses, medications, labs, allergies, immunizations) manually. DeepCura automates all of these steps with direct FHIR R4 write-back into eClinicalWorks. For a detailed comparison, see our Freed AI review and our DeepCura vs Freed AI breakdown.
Is DeepCura HIPAA compliant?
Yes. DeepCura is fully HIPAA compliant and provides a Business Associate Agreement (BAA) to all covered entities. All data — including encounter audio, generated notes, and eClinicalWorks FHIR API communications — is encrypted in transit (TLS 1.2+) and at rest (AES-256). The platform maintains SOC 2-aligned security practices and undergoes regular security assessments. Audio recordings are processed in real-time and are not stored after note generation is complete.
Final Verdict
Prism AI is a fine starting point — it is included with eClinicalWorks and handles basic ambient dictation. But for practices that want to automate the full encounter workflow, Prism AI covers roughly 15% of the opportunity.
DeepCura covers 100%. Six specialized AI agents handle every stage from HL7 v2 clinical notes through immunization recording, with direct FHIR R4 write-back across 7 resource types that eliminates manual data entry. At $99/month — the same price as most ambient-only AI scribes — it automates 6x more of the workflow and saves approximately 70-90 clicks per patient encounter.
If you are running your practice on eClinicalWorks and spending hours per day on documentation and data entry, the math is straightforward. Start a free trial and see all 6 agents in action with your own eCW environment.
For more on AI-powered clinical documentation, explore our AI Medical Scribe platform overview and our Best AI Medical Scribes in 2026 comprehensive comparison.
References
[1] eClinicalWorks, "Cloud-Based EHR, Practice Management, and Patient Engagement," eclinicalworks.com. eclinicalworks.com
[2] eClinicalWorks, "Prism AI — AI-Powered Clinical Documentation," eclinicalworks.com. eclinicalworks.com/prism
[3] HL7 International, "FHIR R4 — Fast Healthcare Interoperability Resources," hl7.org. hl7.org/fhir
[4] HL7 International, "HL7 v2 ORU^R01 — Observation Result/Unsolicited," hl7.org. hl7.org/implement/standards
[5] SNOMED International, "SNOMED CT — Systematized Nomenclature of Medicine," SNOMED.org. snomed.org
[6] World Health Organization, "International Classification of Diseases, Tenth Revision (ICD-10)," WHO. who.int/classifications/icd
[7] U.S. National Library of Medicine, "RxNorm — Normalized Names for Clinical Drugs," NLM. nlm.nih.gov/research/umls/rxnorm
[8] Regenstrief Institute, "LOINC — Logical Observation Identifiers Names and Codes," loinc.org. loinc.org
[9] Centers for Disease Control and Prevention, "CVX — Vaccines Administered Code Set," CDC. cdc.gov/vaccines/programs/iis
[10] U.S. Department of Health and Human Services, "HIPAA for Professionals," HHS.gov. hhs.gov/hipaa/for-professionals
[11] DeepCura, "AI Medical Scribe Platform — Ambient Scribing, AI Receptionist, EHR Integration," DeepCura.com. deepcura.com
[12] Freed AI, "AI Medical Scribe — Ambient Clinical Documentation," Freed.ai. getfreed.ai