Clinical software selection in 2026 favors FHIR-first products. Six criteria distinguish production-ready.
1. FHIR API completeness. Verify with Inferno.
**2. SMART on FHIR support.**
**3. US Core conformance.**
4. Terminology binding depth.
5. Vendor roadmap alignment.
6. Third-party ecosystem access.
Evaluation framework
| Criterion | Weight | Verification |
|---|---|---|
| FHIR completeness | High | Inferno tests |
| SMART support | High | Live demo |
| US Core | High | Inferno tests |
| Terminology | Medium | Version + updates |
| Roadmap | Medium | Reference customers |
| Ecosystem | Low | Marketplace size |
Red flags
1. Custom auth vs. SMART. 2. Unversioned US Core. 3. Sync-only bulk export. 4. Manual terminology. 5. Custom profile requirements.
Reference-check questions
1. Time to production? 2. CMS-0057 level? 3. Inferno test failures? 4. Profile update handling? 5. Support quality?
Selection timeline
1. RFP: 2-4 weeks. 2. Demo: 4-8 weeks. 3. References: 2-4 weeks. 4. Negotiation: 4-8 weeks. 5. Implementation: 6-24 months.
Clinical software selection is FHIR-centric. The six criteria above cover most decision factors.