Runbeam vs Mirth Connect: Choosing the Right Healthcare Integration Platform

Healthcare organisations face a critical decision when selecting an integration platform: how do you connect diverse systems while maintaining security, compliance, and operational efficiency? Two prominent solutions serve this space—Mirth Connect, an established healthcare integration engine, and Runbeam, a modern secure data integration platform built on the open-source Harmony proxy.

This guide examines both platforms through practical use cases to help you determine which solution best fits your organisation's needs.

Understanding the Landscape

Before diving into specific scenarios, it's important to understand what each platform brings to healthcare interoperability:

Mirth Connect is a widely-adopted integration engine that specialises in healthcare message transformation. Built primarily for HL7 v2 and v3 message processing, it has been a cornerstone of healthcare IT infrastructure for many organisations managing traditional EMR-to-EMR communication.

Runbeam represents a different architectural approach—a secure data integration platform that orchestrates modern data mesh architectures. Built on the open-source Harmony proxy, it provides centralised management for distributed data connectivity across protocols including FHIR, HL7, DICOM, and modern REST APIs.

The choice between these platforms often comes down to your organisation's architecture vision and integration requirements rather than raw capability comparison.

Use Case 1: Modern Cloud-Native Healthcare Deployments

The Scenario

Your organisation is building a new digital health platform using microservices architecture, containerised deployments, and cloud-native infrastructure. You need to integrate with legacy EMR systems while also exposing FHIR resources to modern applications and third-party developers.

When Runbeam Excels

Runbeam was designed specifically for this scenario. The platform's container-based API proxy architecture means each integration component can be deployed, scaled, and managed independently using your existing Kubernetes or container orchestration tools.

The Harmony proxy foundation provides lightweight, efficient connectivity that fits naturally into microservices patterns. You can deploy Harmony instances alongside your applications, enabling behind-the-firewall integration without complex VPN infrastructure or centralised bottlenecks.

For organisations building modern healthcare platforms, Runbeam's orchestration layer provides visibility and governance across your entire data mesh while maintaining the architectural flexibility that cloud-native development demands.

When Mirth Connect Fits

Mirth Connect can operate in containerised environments, though it was originally designed for traditional server-based deployments. If your organisation has existing Mirth expertise and workflows, adapting these to cloud infrastructure may be more practical than adopting a new platform.

Use Case 2: Legacy System Integration and Message Transformation

The Scenario

Your hospital network operates legacy EMR systems that communicate via HL7 v2 messages. You need reliable message routing, transformation, and validation with minimal disruption to existing workflows. The integration team is experienced with JavaScript-based message mapping.

When Mirth Connect Excels

This is Mirth Connect's traditional strength. The platform provides mature tools for HL7 v2 message processing, including visual channel builders, JavaScript-based transformation logic, and extensive filtering capabilities.

For organisations deeply invested in HL7 v2 message-based integration patterns, Mirth Connect offers a familiar, battle-tested solution. The large community and extensive documentation around common HL7 scenarios can accelerate implementation.

When Runbeam Fits

Runbeam handles HL7 message processing through its FHIR HL7 gateway capabilities, but its architectural approach differs. Rather than centralising all transformation logic in a single integration engine, Runbeam enables distributed processing where transformation logic lives closer to the systems that need it.

Runbeam/Harmony uses JSON transforms that can convert any kind of data—from HL7 v2 messages to FHIR resources to custom proprietary formats. These transforms are declarative and version-controlled, making them easier to test, audit, and maintain than script-based transformations. The JSON-based approach means data transformations are portable across different deployment environments and can be managed as configuration rather than code.

This approach excels when you're transitioning from legacy messaging to modern API-based integration. Runbeam can bridge both worlds, allowing you to gradually modernise integration patterns without disrupting existing message flows.

Use Case 3: Distributed Data Mesh and Multi-Site Networks

The Scenario

Your healthcare network spans multiple hospitals, clinics, and research facilities. Each site needs to maintain data sovereignty while enabling secure data exchange for patient care coordination and research collaboration. You need governance and compliance across this distributed architecture.

When Runbeam Excels

This scenario showcases Runbeam's core design philosophy. The platform's secure data mesh architecture enables each site to deploy local Harmony proxy instances that handle connectivity within their environment while connecting to the broader network through secure WireGuard VPN tunnels.

The centralised Runbeam dashboard provides orchestration and monitoring across all distributed instances, giving your IT team visibility into data flows without creating a centralised data bottleneck. Each site maintains control over its data while participating in the broader healthcare interoperability network.

When Mirth Connect Fits

Mirth Connect typically operates as centralised integration hubs at each site. While you can deploy multiple Mirth instances across locations, managing and monitoring these separate installations requires additional tooling and operational overhead. For organisations comfortable with site-by-site management and less concerned with unified orchestration, this model can work effectively.

Use Case 4: Medical Imaging and DICOM Integration

The Scenario

Your organisation needs to integrate PACS systems with AI analysis platforms, clinical decision support tools, and research databases. You require seamless EMR PACS integration that enables image data to flow to modern applications while maintaining compatibility with legacy radiology systems.

When Runbeam Excels

Runbeam's protocol-agnostic architecture treats DICOM as a first-class citizen alongside FHIR, HL7, and REST APIs. The Harmony proxy can handle DICOMweb connectivity, enabling modern applications to access imaging data through RESTful interfaces while maintaining compatibility with traditional DICOM networking.

This flexibility is particularly valuable when building medical imaging workflows that span both legacy PACS infrastructure and modern AI/ML pipelines. Runbeam can orchestrate the entire data flow, ensuring images reach analysis platforms in appropriate formats while maintaining audit trails for compliance.

When Mirth Connect Fits

Mirth Connect includes DICOM support through additional modules, making it capable of handling medical imaging integration. For organisations already using Mirth for HL7 message processing, extending the same platform to handle DICOM can simplify operational management.

Use Case 5: Developer Experience and Integration Velocity

The Scenario

Your development teams are building new applications that need to integrate with healthcare systems. You want to empower developers to create integrations quickly without becoming experts in healthcare protocols or compromising security and compliance requirements.

When Runbeam Excels

Runbeam's open source foundation provides developers with transparent, well-documented interfaces and the ability to examine and extend the underlying Harmony proxy code. The secure API gateway approach means developers can work with modern REST APIs while Runbeam handles protocol translation and healthcare-specific requirements behind the scenes.

Container-based deployment means developers can run local instances of the entire integration stack, enabling proper testing before production deployment.

When Mirth Connect Fits

Mirth Connect provides a graphical interface for building integration channels, which can lower the barrier to entry for teams comfortable with visual development tools. The large community and extensive examples of common integration patterns provide valuable resources for learning and troubleshooting.

Compliance, Governance, and Auditability

Both platforms take healthcare compliance seriously, but their approaches differ:

Runbeam provides an audit-ready data pipeline with comprehensive logging and traceability built into the platform architecture. The distributed nature of the Harmony proxy means audit events are captured at the network edge, providing detailed visibility into data access and transformation.

Mirth Connect offers audit logging and can be configured to meet compliance requirements, though organisations typically need to build additional governance frameworks around the platform. The centralised architecture means audit data flows through the integration engine, which can simplify some compliance scenarios.

Making Your Decision

Choosing between Runbeam and Mirth Connect ultimately depends on your organisation's specific context:

Choose Runbeam When:

• Building modern, cloud-native healthcare platforms
• Implementing distributed data mesh architectures
• Requiring orchestration across multiple sites and systems
• Prioritising developer experience and API-first integration
• Planning for long-term architectural flexibility
• Valuing open source transparency and community development

Choose Mirth Connect When:

• Primarily processing HL7 v2 messages in traditional patterns
• Team has extensive existing Mirth expertise and workflows
• Operating primarily in centralised, server-based infrastructure
• Need immediate access to large library of HL7-specific resources

Consider Hybrid Approaches:

Many organisations don't need to choose exclusively. Runbeam can complement existing Mirth Connect deployments, handling modern API integration and distributed connectivity while Mirth continues processing traditional message flows. This allows gradual migration toward modern architectures without disrupting operational systems.

The Path Forward

Healthcare interoperability is evolving beyond point-to-point message transformation toward distributed, API-driven data exchange. While traditional integration engines served the industry well, modern healthcare organisations increasingly need platforms that support cloud-native architectures, distributed deployment, and developer-friendly interfaces.

Runbeam's foundation on the open-source Harmony proxy represents this evolution—providing healthcare-specific capabilities without locking organisations into proprietary ecosystems or centralised bottlenecks.

Whether you choose Runbeam, Mirth Connect, or a hybrid approach, the most important decision is selecting a platform that aligns with your organisation's architectural vision and supports your long-term integration strategy.

Explore Runbeam

Ready to see how Runbeam's secure data integration platform can transform your healthcare interoperability? Explore the open-source Harmony proxy or contact us to discuss your specific integration requirements.

The future of healthcare integration is distributed, secure, and surprisingly developer-friendly. Welcome to modern interoperability.