Modular SMART on FHIR Applications
Tessera is a Canadian-built specialty digital twin platform: a per-patient virtual representation scoped to a specialty programme, built from FHIR-native capture. Six flagship modules on one FHIR R4 foundation, each working independently or together, like tiles in a mosaic, and each launching from your EMR/EHR.
Tessera does not replace your EMR/EHR
If your EMR/EHR’s care planning works for your programme, keep using it. Tessera works alongside your EMR/EHR and does what EMR/EHRs were never designed to do: cross-team data visibility, specialty registry-grade analytics, and a governed substrate for clinical AI.
Core Modules
Five core applications, plus the configurable Clinical Registries framework below, that form the foundation of the Tessera platform.
Focus
Central Hub & Navigation
The front door to the platform. One login, one patient search, full context carried into every app, Tessera or any SMART on FHIR app.
Key Features:
- Single sign-on (OAuth2 / OIDC via Keycloak)
- Multi-organisation selection
- FHIR-native patient search (PHN & demographics)
- Context-preserving SMART launch
- Role- and pathway-level access control
Engage
Patient Portal
Turns patients from passive recipients into active partners. Distinctive dual-mode design, patient self-service and provider review, PHN-native.
Key Features:
- PHN-native patient authentication
- Pending PROMs / PREMs (KCCQ, EQ-5D, PHQ-9, GAD-7)
- Care-pathway timeline & care-team directory
- Educational resources & linked conditions
- Provider mode launched from Focus with context
CarePlan
Pathway Execution & Variance
Turns guidelines on paper into care journeys that happen, with automated variance detection, a capability rarely found in mid-market tools.
Key Features:
- Evidence-based pathway templates (CHF, Diabetes, Post-Surgical, Chronic Pain)
- Real-time goal & activity tracking
- Automated variance detection (schedule, clinical, adherence, milestone)
- Closed loop: DetectedIssue → Flag → Task → resolution
- Patient-visible progress via Engage
- Care-team-wide sharing: family, teachers, home nurses, and community specialists (Children with Medical Complexity)
Service Directory
Service, Capacity & Diversion Coordination
Route patients on data, not memory. Service discovery, real-time capacity, and diversion coordination across your network.
Key Features:
- Canadian four-tier service classification
- Real-time capacity gauges & wait-time benchmarks
- Network-wide diversion dashboard with reasons
- Multi-factor routing recommendations
- Markdown report export for capacity planning
Nomics
Pathogen Genomics Intelligence
A FHIR-native LIMS for genomic surveillance, specimen to surveillance network, in one platform, with real-time outbreak detection.
Key Features:
- 7-stage specimen-to-sequence lab workflow
- Lineage (Pangolin/NextClade), variant calling & AMR detection
- Automated SNP clustering & phylogenetic outbreak detection
- One-click GISAID / PulseNet Canada export
- Multi-pathogen: viral and bacterial
The Tessera data contract
A platform-level data contract, enforced at the platform layer rather than per project, is what produces analytics-ready data at provincial scale. It collapses to three pillars.
Governed concepts
Stable definitionIds and linkIds, deprecate-don’t-delete, coded values from authoritative sources, and validation at the point of capture.
Governed lineage
Complete provenance and full audit. Source, organisation, user, form version, and capture date travel with every data point. Nothing is overwritten silently.
Governed analysis
Native time and location dimensions, so point-in-time queries are the default and the same query returns the same result as the schema evolves.
The TMS team’s BC Trauma registry shows value governance in practice: injury and procedure codes are pulled live from the TQIP API, so the registry stays current with the authoritative source rather than drifting against it.
Clinical Registries: one configurable framework
The sixth flagship is a single, FHIR-native registry framework, configured per programme, not custom-built. The registries below are pre-built starter templates: dynamic Questionnaire forms, built-in scoring and staging, and outcome and variance tracking.
Start from a template and configure it to your protocols, or scaffold a new one on the same engine.
Atrial Fibrillation
Anticoagulation management, rhythm control, CHADS-VASc
Cardiac Surgery
Pre-op optimisation, ERAS protocol, post-op recovery
Heart Failure
GDMT optimisation, fluid management, readmission prevention
Cath Lab
PCI outcomes, stent tracking, ACS pathways
Cardiogenetics
Genetic testing, family history, risk stratification
Cardiac Devices
Pacemaker/ICD tracking, device follow-up
Electrophysiology
EP studies, ablation procedures, arrhythmia mapping
Perfusion
Cardiopulmonary bypass, blood conservation, monitoring
GU Cancer
Staging, treatment protocols, surveillance (4 questionnaires)
Breast Cancer
Screening, treatment coordination, survivorship
Transplant Donor
Donor evaluation, organ matching, procurement coordination
Transplant Recipient
Waitlist management, immunosuppression, rejection monitoring
Organ Donor Decisions
Consent tracking, family discussions, allocation preferences
Pediatric Diabetes
A1c monitoring, insulin management, growth tracking
Stroke
Door-to-needle time, rehab milestones, secondary prevention
Trauma
Injury severity scoring, resuscitation, surgical interventions
Children with Medical Complexity
ICF assessments, care coordination, caregiver support
Every registry runs on the same engine, structured FHIR Questionnaires, Group enrollment, and integration with CarePlan for pathway tracking, so each one looks, behaves, and integrates the same way.
Platform Architecture
Built on healthcare interoperability standards from the ground up.
SMART on FHIR Native
Every module is a SMART on FHIR app. Launch from your EMR/EHR with patient context automatically passed.
Shared Authentication
Custom OAuth2 authorization server with PKCE. Single sign-on across all Tessera modules.
FHIR R4 Data Layer
All clinical data stored in FHIR R4. CarePlan, Goal, Task, Observation, DetectedIssue and more.
Multi-Tenant Architecture
Schema-per-tenant isolation. Each organisation sees only their data. Canadian data residency.
Modern Tech Stack
Built with modern, proven technologies. React frontends, Node.js services, and FHIR R4 data layer, all designed for healthcare environments.
- Frontend: React 18, TypeScript, Vite, TailwindCSS
- FHIR: fhirclient.js, Azure Health Services, HAPI FHIR
- Auth: OAuth2, PKCE, SMART on FHIR launch
- Backend: Node.js, Express, GraphQL, PostgreSQL
- Infrastructure: Azure Canada, Docker, Redis
FHIR Resources in Use
How It Works Together
A typical clinical workflow across Tessera modules.
Clinician logs in once, searches the patient, opens the registry worklist
Completes structured intake on a dynamic FHIR Questionnaire
Instantiates the pathway; goals and activities begin tracking
System detects a deviation and raises a flag for the care team
Patient sees their progress and submits a pending PROM
Dashboard updates; on to the next patient in the worklist
See the Platform in Action
Book a demo to see how Tessera's modular platform can support your clinical programmes.