# Athena Production Integration Plan

## Status: Call Being Scheduled (2026-03-18)

### Current Situation
- Sandbox integration fully functional (Practice ID 195900)
- **CONFIRMED 2026-03-18**: Sakthi confirmed POST /clinicaldocument is non-certified, requires paid API package
- **Mike Vicini confirmed**: Certified = GET only (read-only, free). Any POST/PUT = paid package required.
- Patient lookup (GET /patients) is free under Certified. Document upload (POST /clinicaldocument) requires package.
- **Call being scheduled**: Steve told Mike to proceed with Charlie, wants it done ASAP
- Minimum scope: 2 endpoints — GET /patients (free) + POST /clinicaldocument (paid)
- Michael Vicini (AE) looped in for package pricing
- Chris Popescu (CSM) confirmed PASS has not lost platform access

### Call Prep (Upcoming — Steve Leading)

**Status**: Steve told Mike to proceed with scheduling a call with Charlie. ASAP.
**Attendees**: Charlie Rogers (primary), Steve Johnson (should join for pricing portion even briefly)

**Note**: Steve directed the call to Charlie, which is fine for technical walkthrough. But if pricing comes up, Steve should be present — Mike is an AE, he sells to business people not developers. Options: Steve joins first 10 min for pricing then drops, or asks Mike to send pricing in writing before the call.

**Steve's Talking Points:**

1. **Opening (set the frame)**:
   > "We've got a balance assessment product called Kinometric that's already being used in our practice. We've built the integration on our end — it's tested and working in sandbox. We just need to get it into production so our providers can see test results in the patient chart. Pretty straightforward — we upload a PDF, they can pull it up during the visit."

2. **When they present pricing**:
   > "What does that look like if we bring on additional practices down the road? We want to make sure the structure works as we scale."

3. **If the price feels high**:
   > "For one practice uploading maybe 20-30 PDFs a day, that feels heavy. What's the minimum package that gets us the clinicaldocument endpoint?"

4. **Marketplace seed (drop casually)**:
   > "I noticed you've got vendors like Relaymed doing something similar on the Marketplace — uploading diagnostic results to the chart. Is that something we should be looking at for Kinometric? We're thinking about this long-term, not just for one practice."

5. **Close**:
   > "What do you need from us to get production credentials? Our technical team has the sandbox fully tested and ready to go. We'd love to get this live as soon as possible."

**What NOT to say:**
- Don't mention the 2023 cancelled contract (Chris already buried it)
- Don't get into technical details (Charlie's lane if they ask)
- Don't commit to Marketplace on the call — just explore
- Don't reveal you only have one practice if avoidable — let them assume growth
- Don't negotiate price on first call — "let me take this back to the team"

**Tone**: Treat it like a favor, not a negotiation. Steve is a paying athena customer asking to use their platform more. That's good for athena. "Help me help my practice" not "sell me a package."

### Key Contacts

| Person | Role | Email | Action Needed |
|--------|------|-------|---------------|
| Chris Popescu | CSM | cpopescu@athenahealth.com | Opened the path, helpful |
| Michael Vicini | Account Executive | (on email thread, asked for Steve's phone #) | Platform Services pricing, scheduling call |
| Sakthi Avinash | Interop PM | ssakthi@athenahealth.com | Confirm endpoint tier |
| Laura Cossick | Sr Practice Mgr (PASS) | lcossick@painandspinespecialists.com | Needs plain-English updates |
| Steve Johnson | Kinometric | rdksteve@gmail.com | Decision maker on costs |
| Charlie Rogers | Technical POC | charlie.rogers@flightsystems.net | Technical validation |
| Jake Millhausen | Johnson Consulting | jake@johnsonconsultingllc.com | Business side |
| Anant Johnson | Johnson Consulting | anant@johnsonconsultingllc.com | On thread |
| DealDesk | athena Marketplace | DealDesk@athenahealth.com | Marketplace application |
| Marketplace | athena Marketplace | Marketplace@athenahealth.com | Alternative contact |

---

## Path to Production

### Option A: Platform Services + Marketplace (Recommended)

**Timeline: 3-6 months**

1. **Email DealDesk@athenahealth.com** — Marketplace Partner inquiry
2. **Negotiate Platform Services contract** with Michael Vicini (AE)
   - Cost: not publicly disclosed, negotiated directly
   - This is what gets you production OAuth credentials
3. **athena validates integration** — security review, technical check (2-4 weeks)
4. **Receive production credentials** — change base URL, go live
5. **HITRUST e1 self-assessment** — mandatory within 90 days of GA
   - 44 controls, ~$6,250 minimum
   - Kinometric has many controls already (HIPAA compliance work)
6. **Marketplace listing goes live** — visible to all athena practices

**Advantages:**
- Production API write access (clinicaldocument upload)
- Marketing/distribution to all athena practices
- Credibility (Relaymed is a comparable partner — diagnostic results to chart)
- TM Flow is NOT on Marketplace, so competitive advantage

### Option B: Platform Services Only (Faster)

**Timeline: 6-12 weeks**

- Same contract negotiation, skip Marketplace listing
- No HITRUST requirement (only needed for Marketplace)
- Gets you production API access
- Can add Marketplace later

### Option C: Programmatic Fax Fallback (Cheapest)

**Timeline: 1 week to prototype**

- Cloud fax API (eFax/Twilio) → athena fax routing → patient chart
- ~$0.05-0.10 per page
- Zero athena API dependency
- **Downsides:** not real-time, staff review required, fax quality, patient matching may fail
- Good interim solution while Marketplace application processes

---

## Endpoint Analysis

### Endpoints Used (13 total)

**Likely Certified (free, read-only):**
- `POST /oauth2/v1/token` — authentication
- `GET /v1/{pid}/patients/{id}` — patient lookup
- `GET /v1/{pid}/patients?lastname=...` — patient search
- `GET /v1/{pid}/departments` — department list
- `GET /v1/{pid}/ping` — health check
- `GET /v1/{pid}/practiceinfo` — practice info

**Likely AthenaOne (paid, write access):**
- `POST /v1/{pid}/patients/{id}/documents/clinicaldocument` — **PDF upload (primary use case)**
- `GET /v1/{pid}/patients/{id}/documents/clinicaldocument` — document list
- `GET /v1/{pid}/patients/{id}/documents/clinicaldocument/{docId}` — document details
- `GET /v1/{pid}/chart/{patientId}/{resource}` — chart data
- `GET /v1/{pid}/chart/{patientId}/labresults` — lab results

### Workarounds Investigated (if paid access unavailable)

| Option | Viable? | Cost | Notes |
|--------|---------|------|-------|
| Certified FHIR APIs | No | Free | Read-only, no writes |
| FHIR DocumentReference POST | No | - | Only on athenaPractice, not athenaOne |
| Programmatic fax | Yes | ~$0.05/page | Not real-time, staff review needed |
| HL7 v2 ORU messages | Possible | Setup fees | Heavy infrastructure, VPN/SSH required |
| Third-party (Redox etc) | No | Adds cost | Still needs athena write access |
| Direct messaging / CCDA | No | - | Manual routing, wrong format for PDFs |

---

## Comparable Marketplace Partner: Relaymed

- Accelerate-tier partner, 4.9 stars
- Uploads point-of-care diagnostic results directly to athenaOne patient charts
- Same integration pattern as Kinometric
- Validates that athena accepts this use case

## Steve's Intent: "Like TM Flow"

Steve's "like TM Flow for billing" means: PDF test results in patient chart so providers have documentation for billing codes and clinical tracking. Current integration already does exactly this. No direct billing integration needed — just the documentation trail.

---

## Email Thread Reference
- Case: CASE-18887298
- Subject: Pain and Spine Specialists of Maryland/Kinometric
- Original request: February 27, 2026
- Charlie's tech spec response: March 13, 2026
- Chris Popescu clarification: March 16, 2026