How to Pass an Epic App Orchard Security Review (First Try)

Getting your app approved through Epic App Orchard can take anywhere from four to eight weeks, and even longer if your submission is sent back for missing documentation or clarification. Many development teams assume the review is mainly about whether their application functions correctly. Before that review, you still need the integration itself working, covered in how to connect your app to Epic EHR. In reality, most delays happen because reviewers cannot clearly verify how the app handles protected health information, authorization scopes, or security controls. Understanding what Epic evaluates before you submit can save weeks of back-and-forth and significantly improve your chances of passing the review on your first attempt.

What Epic App Orchard Reviews

The security review is designed to determine whether Epic can trust your application with patient data, not simply whether your software works as intended. Reviewers evaluate how your application authenticates users, the FHIR scopes it requests, how patient information is stored, how data moves through your system, and whether your security controls meet healthcare industry expectations.

Your redirect URIs are carefully verified to ensure authorization requests cannot be redirected to unauthorized destinations. Reviewers also examine encryption practices, audit logging, privacy controls, and documentation describing how protected health information is collected, processed, retained, and deleted. If your application requests access to sensitive data, you should be prepared to explain exactly why each permission is necessary and how the information will be protected throughout its lifecycle.

Many developers spend weeks refining features while overlooking documentation. In practice, a well-documented application with clear security controls often progresses through review more smoothly than an application with excellent functionality but incomplete compliance information.

Scope Justification, the Biggest Trip-Up

One of the most common reasons applications fail the review is requesting more FHIR scopes than the application genuinely requires. It is tempting to request broad permissions during development to avoid future changes, but reviewers expect every requested scope to have a clear business justification. If your app only reads medications, there should be no reason to request access to unrelated clinical resources.

A useful approach is to document every requested scope alongside the exact feature that depends on it. When reviewers understand why a permission exists, the approval process becomes much smoother. Broad requests without explanation create unnecessary questions and often result in additional review cycles.

We recently worked on an integration where the original design combined clinical records and diagnostic imaging into a single application requesting extensive permissions across multiple resource types. Rather than submitting one large application, we separated the functionality into two independently scoped applications, each requesting only the permissions required for its own workflow. The streamlined approach reduced reviewer questions considerably because every requested permission directly matched a specific feature. Keeping the requested access focused made the security review much easier to understand.

Remember that reviewers are not trying to make development difficult. Their responsibility is to ensure applications follow the principle of least privilege. The fewer permissions your application requests while still delivering its intended functionality, the easier it becomes to justify your submission.

Documentation That Prevents Back-and-Forth

Strong documentation is often the difference between a straightforward review and several weeks of additional questions. Every missing document creates another review cycle, extending the overall timeline even if your application itself requires no code changes.

A complete submission should clearly explain how data enters your application, where it is processed, where it is stored, and who can access it. Data flow diagrams are particularly valuable because they allow reviewers to understand your architecture quickly without reading large amounts of technical documentation. Your submission should also explain how protected health information is encrypted both in transit and at rest, how authentication is implemented, and how audit logs are generated for security investigations.

Privacy documentation deserves the same attention as technical architecture. Reviewers expect to understand your retention policies, incident response procedures, user access controls, and the lifecycle of patient information after it leaves the EHR. If your application temporarily caches information, explain exactly why it is necessary and when the data is deleted.

Teams sometimes treat documentation as something to finish after development is complete. In reality, preparing these materials alongside implementation produces a much stronger submission. By the time your application reaches review, every security decision should already be documented and easy to verify.

Common Rejection Reasons

Most review delays are preventable. The same issues appear repeatedly across submissions, and nearly all of them stem from incomplete documentation or unnecessary permissions rather than poor application design.

Overly broad FHIR scopes remain one of the biggest causes of rejection because reviewers cannot approve access that lacks a clear business need. Redirect URI mismatches are another common issue. Even a small difference between the registered redirect URI and the value used during authentication can trigger additional review questions. Teams should verify every URI before submitting to avoid unnecessary delays.

Vague descriptions of data handling also slow the process. If your documentation simply states that patient data is stored securely, reviewers still need to understand where it is stored, how it is encrypted, who has access to it, and how long it is retained. Missing audit logging information creates similar concerns because healthcare organizations must be able to trace access to protected health information when needed.

A good practice is to review your submission from the perspective of someone seeing your application for the first time. If any permission, workflow, or security control requires additional explanation, include it before submitting rather than waiting for follow-up questions.

Timeline and What to Expect

Most applications complete the review process within four to eight weeks, although the timeline depends heavily on the quality and completeness of the initial submission. Applications that require multiple rounds of clarification can remain in review much longer.

Start by validating your application thoroughly in the Epic sandbox before requesting production approval. Resolve authentication issues, verify redirect URIs, confirm your requested scopes, and ensure your documentation accurately reflects the implemented architecture. Submitting a smaller application with a clearly defined feature set is often more effective than presenting a large platform with unnecessary functionality. A focused initial release typically moves through review faster and provides a solid foundation for future enhancements.

FAQs

Conclusion

Passing an Epic App Orchard security review is about building trust, not just delivering working software. A successful submission demonstrates that your application requests only the permissions it needs, protects protected health information throughout its lifecycle, and provides clear documentation for every security decision. Taking the time to prepare a complete submission can significantly reduce review delays and improve your chances of first-time approval.

For organizations preparing an Epic App Orchard submission, Aishco Solutions brings deep expertise in healthcare interoperability, SMART on FHIR authentication, Epic integrations, and HIPAA-compliant application development. Our team has helped clients navigate security reviews, optimize FHIR scope requests, prepare production-ready documentation, and build secure applications that meet EHR vendor requirements. We understand the practical challenges of healthcare integrations and can help you streamline the review process from sandbox testing to production deployment.

For a deeper understanding of healthcare interoperability, explore SMART on FHIR to learn how secure authentication works, read How to Connect to Epic for guidance on integrating with Epic systems, and review Building HIPAA-Compliant APIs to strengthen your application's security architecture.