System Architecture

The defining characteristic of CareVue is flexibility. Medsphere has innovated at every level of the technology stack to create a solution limited neither by environment nor the inclusion of different components. 

Medsphere’s cloud and software-as-a-service (SaaS) strategy also gives clients both local and remote implementation options. Medsphere makes our CareVue EHR for acute and inpatient behavioral health hospitals available in a hosted model via industry-standard Amazon Web Services. Cloud-based CareVue is accessible from all the most commonly used platforms, including Windows, Linux and MacOS. 


The CareVue client employs either the Microsoft .NET framework or Mono, an open source implementation of Microsoft .NET, to provide modern functionality in a cross-platform graphical user interface (GUI) that is interoperable, language independent (C#, HTML 5, CSS, Java) and simple to deploy. The CareVue architecture enables the client to run natively on Windows or Linux systems. This flexibility allows facilities to leverage current hardware investment, expand resources and reach a greater clinical user base. 


At the network level, Medsphere updates an RPC-based approach through the use of CareVue Bridge, a middleware component developed by Medsphere that manages interaction between server and client, handles raw communication with the server, and provides an interface to the client. The implementation of the CareVue Bridge gives Medsphere the ability to use on-the-wire encryption for greater levels of security and enables the system to interact with Web-based applications.


The CareVue server layer uses Java, a platform-independent programming language intended to run anywhere, to give the overall technology improved market viability and extensive commercial market benefits. Through the use of Java, Medsphere enables the advancement of CareVue and preserves the longevity of the product. The incorporation of recognized interfacing technology standards such as Health Level 7 (HL7) enables CareVue to communicate effectively with required third-party applications (e.g., administrative, financial, PACS) in creating a complete, efficient enterprise EHR solution.

Database Interoperability

Medsphere has developed a database projection technology that allows customers to view CareVue’s hierarchical file manager database management system as a modern, relational database via a MySQL storage engine. Use of a standard Java Database Connectivity (JDBC) interface enables commercial off-the-shelf (COTS) reporting tools and data warehousing using Structured Query Language (SQL). This greatly expands CareVue’s ability to provide data analysis tools, performance metrics and operational reporting.

Application Server

At the Application Server level, Medsphere uses Java technologies to provide CareVue with more flexibility via an object domain layer. Medsphere developed this Java layer as part of the CareVue technology stack to enable greater application functionality, realize wider interoperability and increase development velocity. Through the use of this domain layer, CareVue applications can seamlessly connect to legacy modules and other Java-based applications, leveraging modern development methodologies (agile) and tools. For example, this tool is used to support interoperability with pharmacy billing systems. Medsphere provides additional flexibility at the Application Server level by giving clients the choice of either InterSystems Caché or Fidelity GT.M, a commercial open source solution.

Operating System

Medsphere offers freedom of choice at the OS level by certifying the use of CareVue on multiple platforms, allowing organizations to choose Linux or Windows operating systems, and hence a wider variety of hardware.


CareVue runs on any Intel x86 hardware. Medsphere provides recommended sizing guidelines for server-based configurations to support the optimal performance of the CareVue system. This gives clients a variety of choices, including Hewlett-Packard’s Intel-based products.

Medsphere is hardware-agnostic regarding compatibility with the CareVue Bar Code Medication Administration (BCMA) application. Customers can deploy whatever brand of barcode reader they choose. Most barcode readers are literally plug and play and are formatted to read a variety of barcodes. We recommend testing any legacy barcode scanners during implementation. Otherwise, purchase one for testing during implementation to make sure it works properly before go live. Typically, scanner ergonomics are more of an issue than specific functionality or compatibility.