Fig. 1.

Schematic for the Cosmos architecture. Backload and triggered data move onto the Cosmos queue, where it is processed by the Cosmos daemon. Data are transmitted to the Cosmos host as encrypted HL7 C-CDA documents over the Care Everywhere Network. Patient deduplication is performed by using a hashed copy of a Care Everywhere ID, after which data are filed in a Massachusetts General Hospital Utility Multi-Programming System nonrelational database, and then a search query language relational database. All participating healthcare systems communicate with the same Cosmos host. Users can access the data via a web portal.