InterSystems IRIS vs Caché, Health Connect and HealthShare: 2026 Guide

InterSystems sells three products that healthcare teams often mix up. InterSystems IRIS for Health is a data platform with a built-in FHIR repository. Health Connect is the integration engine. HealthShare is a family of products, such as the Unified Care Record, built on top of IRIS for Health. Caché and Ensemble are the older products that IRIS replaced, and InterSystems plans no maintenance releases for them after 31 March 2027.

This guide explains which product does what, how to choose between them, and how to plan a move from Caché or Ensemble to IRIS before that date. Published product and lifecycle facts are linked in the text. Nirmitee is a healthcare integration services company; we do not resell InterSystems licenses.

The short answer: which InterSystems product do you need?

Pick the product by the job you need done. The table below matches common jobs to products.

The InterSystems product family explained

For the products compared here, InterSystems IRIS provides the underlying data platform. IRIS for Health adds healthcare features, Health Connect provides the integration engine, and HealthShare Unified Care Record is a packaged shared-record product.

InterSystems IRIS

InterSystems IRIS is a multi-model database and application platform. It stores data as tables, objects and key-value globals in one engine, and you can query the same data with SQL or work with it in ObjectScript or Python. It is the successor to Caché, first released in 2018.

InterSystems IRIS for Health

IRIS for Health is IRIS plus healthcare features. InterSystems describes it as a platform for building healthcare solutions with "an extensible FHIR repository and comprehensive REST APIs", and says it includes all the interoperability features of Health Connect plus advanced FHIR support (InterSystems). Software vendors and health systems use it when they need both a database and a FHIR API in one product.

Health Connect

Health Connect is the InterSystems integration engine. It receives, transforms and routes HL7 v2, X12, CDA, FHIR and other messages, with monitoring and message tracking for high volumes. InterSystems has called it HealthShare Health Connect for years; its 2026.2 documentation uses the name InterSystems Health Connect (InterSystems docs, 2026.2). In the 2025 Best in KLAS integration engine report it scored 91.7 from 28 organizations, behind Corepoint and Rhapsody (KLAS, 2025).

HealthShare

HealthShare is a family of products for sharing data across organizations. The best known is the Unified Care Record, which InterSystems says is built with IRIS for Health at its core and creates a longitudinal record for each patient. It is used by health information exchanges and regional shared care records, for example in the UK. InterSystems reported in February 2026 that HealthShare won the Best in KLAS award for shared care records in Europe for the third year in a row (InterSystems, February 2026).

IRIS for Health vs Health Connect vs HealthShare compared

The main difference is scope: Health Connect moves messages, IRIS for Health stores and serves data, and HealthShare joins records across organizations.

One point needs care. Health Connect's 2026.2 documentation includes FHIR features such as the FHIR SQL Builder and bulk FHIR tools. InterSystems has also published an alert about upgrades failing on Health Connect instances "not licensed for HL7 FHIR". So which FHIR features you can use depends on your license. Ask InterSystems to list them in writing before you buy.

FHIR in IRIS for Health

IRIS for Health includes a FHIR server that supports FHIR STU3, R4 and R5, according to InterSystems (InterSystems FHIR Server). It adds three features buyers ask about most:

• SMART on FHIR (the standard way apps log in to a FHIR server), with OAuth client set-up and scope checks. Version 2026.2 adds audience settings for Microsoft Entra ID, Okta and Amazon Cognito.
• Bulk FHIR import and scheduled bulk export, used for payer and population data.
• FHIR SQL Builder, which turns FHIR resources into relational tables for reporting tools such as Power BI or Tableau.

InterSystems also sells a managed InterSystems FHIR Server on AWS Marketplace. For a comparison with HAPI, Azure, Google and AWS HealthLake, see our FHIR data store comparison. For FHIR build work, see our FHIR integration services.

Releases: Extended Maintenance vs Continuous Delivery

InterSystems ships two kinds of release, and the kind you run decides how often you upgrade. Extended Maintenance (EM) releases get maintenance updates for longer and suit most production systems. Continuous Delivery (CD) releases bring new features sooner but are replaced faster.

• 2026.1 is an EM release, generally available in March 2026. It removes historical database size limits and introduces table partitioning as an experimental feature through an early access program (InterSystems, March 2026).
• 2026.2 is a CD release, generally available on 22 July 2026. It adds a FHIR Explorer, the OAuth audience settings above, faster FHIR ingestion (InterSystems reports 25 to 30 percent in some scenarios) and removes the old UIMA integration (InterSystems, July 2026).

Choose EM or CD by the features you need, your supported platforms and how often you can upgrade, and confirm the maintenance policy for that release with InterSystems.

Caché and Ensemble: what the 2027 date means

InterSystems plans no maintenance releases for Caché or Ensemble after 31 March 2027. In a March 2023 announcement it also said those releases cover Windows and Red Hat Enterprise Linux only, and that it was not announcing an end date for product support (InterSystems Developer Community, March 2023).

In plain terms: after March 2027, a Caché or Ensemble system can still run, and InterSystems has not announced an end of product support, but no maintenance releases are planned. InterSystems describes any ad hoc corrections after that as discretionary and best effort, so a security flaw or operating system change found later may have no patch. Confirm your support agreement and patch options with InterSystems. Ensemble was the integration engine built on Caché; Health Connect and IRIS for Health replace it.

Two other changes affect teams still on old tools:

• Studio is removed from installation kits. InterSystems deprecated Studio, its old code editor, in 2023.2. From 2024.2 it is no longer included in installation kits, and upgrading removes any Studio installation tied to the instance (InterSystems 2024.2 release notes). InterSystems documents a separate 2024.1 Studio component; check its current status. The recommended tool is VS Code with the InterSystems ObjectScript extension.
• macOS ended earlier. InterSystems ended Caché and Ensemble maintenance on macOS in October 2024, with 2018.1.9 as the final macOS version.

InterSystems Caché to IRIS migration and Ensemble migration

For InterSystems Caché, assess database and application compatibility. For InterSystems Ensemble, also inventory productions, adapters, transformations and outside connections. InterSystems supports in-place migration from Caché and Ensemble to IRIS, which means your existing databases are not exported and reloaded (InterSystems). The detailed steps are in the official "How to Migrate to InterSystems IRIS" guide, which InterSystems makes available to customers through its WRC support portal (InterSystems docs). Follow that guide for your exact versions.

Around the technical conversion, a safe migration has six steps:

1. Inventory. List every instance, its version, operating system, databases, productions (interfaces), custom code and outside connections. Note anything on macOS or unsupported operating systems.
2. License. IRIS needs a new license key. Agree the IRIS license, and whether you need IRIS, IRIS for Health or Health Connect, with InterSystems before you start.
3. Test conversion. Convert a copy of each instance in a test environment, following the official guide. Never start with production.
4. Code and tools. Fix code that uses removed or changed features, rebuild your developer set-up in VS Code, and move source code into Git if it is not already there.
5. Parallel testing. Replay captured messages and queries into an isolated test copy and compare outputs: query results for databases, and message by message for Ensemble productions. If you run old and new live at the same time, stop the new system from sending duplicate messages downstream.
6. Cutover and rollback plan. Pick a low-traffic window. Before cutover, decide how data written to the new system would be reconciled and how duplicate messages would be prevented if you have to roll back. Watch queues and errors closely for the first weeks.

How long it takes depends on the number of instances, custom code and interfaces. Plan from your inventory, not from a rule of thumb, and leave time for testing before March 2027.

Leaving InterSystems instead

Some teams use the 2027 date to leave InterSystems altogether. That is a bigger project than an upgrade, because ObjectScript code, globals and Ensemble productions have no direct equivalent elsewhere.

• Ensemble interfaces can move to another integration engine such as Mirth Connect, Rhapsody or Corepoint, but each interface must be rebuilt and retested. Our guide to the best healthcare interface engines compares the options.
• Caché databases can move to a relational database such as PostgreSQL, but the application code that uses them usually needs a rewrite.

For most teams with large ObjectScript applications, moving to IRIS is the lower-risk path. Leaving makes most sense when the application is being replaced anyway.

Skills: ObjectScript, Python and productions

IRIS development still centers on ObjectScript, InterSystems' own language, but Python is now a first-class option. Embedded Python has been generally available since IRIS 2021.2 (ODBMS.org, October 2021), so developers can write logic and interoperability components in Python inside IRIS.

Integration work in Health Connect and IRIS for Health is organized as productions: business services receive messages, business processes apply logic and routing, and business operations send messages out. Mappings are usually written as data transformations (DTL) and processes as business process logic (BPL). Teams moving from Ensemble will find these concepts unchanged.

ObjectScript is a specialist skill. Check how easily you can hire or contract for it before you commit to a large custom build.

Who uses InterSystems

InterSystems products run in hospitals, HIEs and national programs in many countries. Public examples include North West London ICS, which chose Health Connect Cloud in 2022 (Business Wire, September 2022), and regional shared care records in England built on HealthShare. Epic's core database has long run on InterSystems technology; infrastructure guides from NetApp describe Epic moving from Caché to IRIS (NetApp). We have not seen a statement from Epic or InterSystems confirming this, so treat it as reported by third parties.

Pricing

InterSystems does not publish prices for IRIS, IRIS for Health, Health Connect or HealthShare. Prices are quoted per deal and depend on cores, users, features such as FHIR, and hosting. A free Community Edition offers a limited license suited to evaluation and testing; review its current license terms and resource limits before any other use. Ask for quotes that list every feature you need, including FHIR, and the support level.

Planning a Caché or Ensemble move, or choosing between Health Connect and another engine? We review your inventory and send back a written migration plan with risks and options. Request an InterSystems migration review.

Where Nirmitee fits

Nirmitee is a healthcare integration services company. We do not resell InterSystems licenses.

• What we do: migration planning and inventories, HL7 v2 and FHIR mapping, FHIR API builds, interface rebuilds when teams move between engines, and testing and parallel runs.
• Where we are strongest: HL7 v2 and FHIR integration, and engine migrations, including to and from Mirth Connect, Rhapsody and Corepoint. See our HL7 integration services.
• A limitation: we have less hands-on depth in ObjectScript than InterSystems specialist firms. For a large ObjectScript application rewrite, we will say so and can work alongside a specialist.

Conclusion

Use Health Connect when you need an integration engine, IRIS for Health when you need a healthcare database with a FHIR API, and HealthShare when you need a shared record across organizations. If you still run Caché or Ensemble, start your inventory and test conversion now: maintenance releases are planned to stop after 31 March 2027, and a careful migration needs time for testing.

Related guides

• Best healthcare interface engines in 2026
• FHIR data stores compared
• HL7 v2 to FHIR migration guide
• How to choose a healthcare integration platform