BizTalk alternatives for healthcare: what changed, and how QIE compares

Microsoft has announced that BizTalk Server 2020 is its final version. If you run HL7 or X12 interfaces on BizTalk, this page sets out what Microsoft has said, your options, and how teams move their interfaces to the Qvera Interface Engine (QIE).

The short answer

The Qvera Interface Engine (QIE) is a strong fit for healthcare teams running HL7 and X12 interfaces on BizTalk who want an engine built for healthcare and run by their own team: HL7 v2 over MLLP with acknowledgments, X12, FHIR and DICOM in one engine, running as a Windows service on the Microsoft SQL Server you already have, or in containers or your own cloud, with high availability included on every licensing model. BizTalk maps can be reused in QIE, the AI Companion converts BizTalk’s C# code to JavaScript, and Qvera engineers are available to assist with the move. If most of your BizTalk work is general business integration rather than healthcare, Microsoft’s successor, Azure Logic Apps, may suit you better. QIE is in production today at more than 600 sites, running more than 25,000 interfaces and processing more than 50 million messages a day.

What changed with BizTalk Server?

On 17 December 2025 Microsoft announced that “BizTalk Server 2020 will be the final version of BizTalk Server”, and named Azure Logic Apps as its successor. On 31 August 2026 it said it “expects sales of BizTalk Server 2020 and Host Integration Server 2020 to end March 31, 2027.”

Support runs out in stages, on the dates Microsoft’s lifecycle pages give:

  • BizTalk Server 2013 and 2013 R2: support ended in July 2023.
  • BizTalk Server 2016: support ends on 11 January 2027. For these versions Microsoft says: “We strongly encourage moving directly to Logic Apps rather than upgrading to BizTalk Server 2020.”
  • BizTalk Server 2020: mainstream support ends in April 2028. Extended support, which keeps security updates coming, runs to April 2030, when BizTalk Server reaches the end of support. Microsoft says: “Support beyond April 10, 2030, is not planned.”

For 2028 to 2030 Microsoft also plans an optional paid support offering, expected to cost the full license price each year. It expects that offering to leave out the industry accelerators, the HL7 accelerator among them, which “will not receive servicing, schema updates, or support under extended support.”

Nothing stops working on those dates. In Microsoft’s words: “Workloads will continue running but without Microsoft servicing.” What changes is how long a healthcare team can count on fixes for the software that carries its HL7 interfaces.

BizTalk 2020, Azure Logic Apps, or a different engine: what are your options?

A healthcare team on BizTalk has three choices:

  • Stay on BizTalk Server 2020 for now. Microsoft says “Customers can continue to rely on BizTalk Server for many years ahead”, and BizTalk Server 2020 receives security updates until April 2030. It runs on Windows Server with Microsoft SQL Server, and its HL7 accelerator handles HL7 v2 versions 2.1 to 2.6 with an MLLP adapter. Teams on BizTalk Server 2016 or earlier face the earlier dates above.
  • Move to Azure Logic Apps, Microsoft’s successor. Microsoft describes Logic Apps as “the successor to BizTalk Server” and offers a Migration Agent to help move BizTalk work across. For HL7, Microsoft’s documentation says the HL7 operations are “generally available and supported in all Standard workflows”, while the MLLP operations, which receive and send HL7 over a network connection, “are in public preview” and are “available only for Standard workflows created with the hybrid deployment”, the option that runs Logic Apps on a Kubernetes cluster you manage. Logic Apps parses HL7 acknowledgments but does not generate them (“Generation isn’t supported”), and its HL7 schemas must be uploaded to an integration account. Microsoft advises BizTalk customers to “Compare total cost of ownership rather than only the Logic Apps hosting charge.”
  • Move to a different engine. QIE, or another healthcare interface engine. The rest of this page compares QIE with BizTalk Server 2020.

What should you look for in BizTalk alternatives?

Six things healthcare teams on BizTalk ask about when they evaluate an alternative:

  • HL7 in the engine, not added on. Ask whether HL7 v2, MLLP connections and acknowledgments are part of the core product or an add-on with its own support plans. In QIE they are part of the engine.
  • Everything else in the same engine. X12, FHIR, CDA and DICOM networking, plus databases, files, web services, message queues and network shares, without a second product.
  • It runs on what you already run. QIE runs as a Windows service and keeps its data in Microsoft SQL Server 2016 to 2025, including Azure SQL Database, or in MySQL or MariaDB. Users sign in with their Active Directory accounts or through Microsoft Entra ID single sign-on. It also runs in containers or in your own AWS, Azure or Google Cloud account.
  • A team, not one specialist. If one person understands your BizTalk estate, ask how quickly someone else could take over. QIE interfaces are built in a channel editor in the browser, and Qvera offers training and support around it.
  • High availability without a premium edition. Microsoft’s terms bar BizTalk’s Standard and Branch editions from clustered servers, so a BizTalk failover cluster takes the Enterprise edition. With QIE, high availability is included on every licensing model.
  • A vendor you can check. A SOC 2 Type 2 report, a support phone number, published support hours, and cover around the clock when a system is down.

Can you move your BizTalk interfaces to QIE?

Yes, one interface at a time. BizTalk applications map onto QIE’s channel model, and Qvera engineers are available to assist your team with moving them, so messages keep flowing while each one is checked.

  • Receive locations and send ports become receivers and destinations. What a BizTalk application receives lines up with a QIE channel’s receiver node, and its send ports with destination nodes.
  • Orchestrations become channels. Mapping and condition nodes carry the steps. A channel can call a web service or a database partway through, send copies of a message down several paths, hand messages to other channels, and hold a caller’s request open until the reply is ready.
  • Maps can be reused. A BizTalk map compiles to an XSL stylesheet, and QIE can run that stylesheet in a mapping step. Where a map calls C# code, the AI Companion converts that code to JavaScript.
  • C# becomes JavaScript. The AI Companion converts BizTalk’s C# code into QIE JavaScript, and an engineer reviews each script before it goes live.
  • The HL7 accelerator’s work is built in. QIE receives and sends HL7 v2 over MLLP, returns acknowledgments before or after processing, and handles batch files whole or one message at a time, with no separate accelerator.
  • X12 stays X12. QIE reads and builds X12 messages and handles batch files whole or one message at a time.
  • Credentials are entered again. Connection passwords and keys are not carried over; they are entered in QIE.
  • Each interface is tested with your own messages before it goes live, while the rest keep running in BizTalk.

How does QIE compare with BizTalk Server?

BizTalk Server cells come from Microsoft’s own documentation, lifecycle pages, product terms and announcements, reviewed on 16 October 2026. “Not documented” means nothing was found in Microsoft’s documentation, not that the feature is proven absent.

The product QIE BizTalk Server 2020
Vendor’s plans In active development; see the release notes Final version, announced 17 December 2025; sales expected to end 31 March 2027; mainstream support ends April 2028, end of support April 2030; Microsoft names Azure Logic Apps as its successor
Building interfaces QIE BizTalk Server 2020
How an interface is built Channel editor in a web browser: receiver, mapping, condition and destination nodes Visual Studio projects (orchestrations, maps, schemas and pipelines), managed in the BizTalk Server Administration Console
Custom code JavaScript, which can call Java libraries; the AI Companion writes, explains and converts code C# and the .NET Framework; orchestrations use XLANG/s, “a messaging language with some of the expression capabilities of C#”
Maps Mapping nodes and the Standard Mapping Wizard; XSL stylesheets, including those BizTalk maps compile to BizTalk Mapper, compiled to XSLT 1.0 stylesheets
Testing with sample messages ✓ step a sample message through a channel one node at a time not compared here
Healthcare standards QIE BizTalk Server 2020
HL7 v2 ✓ in the engine ✓ through the BizTalk Accelerator for HL7 (versions 2.1 to 2.6), included with BizTalk Server, Enterprise and Standard editions
HL7 over MLLP ✓ receiver and sender, with a TLS-secured variant ✓ MLLP adapter in the HL7 accelerator
HL7 acknowledgments ✓ returned before or after processing; destinations can wait for each acknowledgment ✓ original mode and enhanced mode
HL7 v3 and CDA ✓ not documented
FHIR ✓ as a client and producer, JSON and XML not documented
X12 ✓ reads and builds X12; batch files whole or one message at a time ✓ built in, with HIPAA 4010 and 5010 transaction sets
DICOM networking (store, query, retrieve, verification, worklist) ✓ in the engine not documented
Running it QIE BizTalk Server 2020
Operating system Windows, as a service, or Linux; Docker and Kubernetes Windows Server 2016, 2019 or 2022 (2022 needs cumulative update 6)
Database Microsoft SQL Server 2016 to 2025, including Azure SQL Database, or MySQL or MariaDB Microsoft SQL Server, required for the MessageBox and the other BizTalk databases
Where it runs On-premise, in containers, or in your own AWS, Azure or Google Cloud account Your own Windows servers, or Azure virtual machines
High availability ✓ two or more QIE nodes share one database, with automatic failover; included on every licensing model At least two BizTalk servers plus clustered SQL Server; Microsoft’s terms bar the Standard and Branch editions from clustered servers
Message tracking and errors Message history per channel, searchable by field; error queue with replay; email alerts Tracking database and Business Activity Monitoring (BAM); Microsoft’s paid 2028 to 2030 offering is expected to exclude BAM
Support and licensing QIE BizTalk Server 2020
Vendor support 24/7 for system-down emergencies; phone support (8am to 5pm Mountain), email, customer portal and knowledge base Mainstream support to April 2028; then security updates and paid support to April 2030; an optional paid offering for 2028 to 2030, expected at 100% of the license cost each year
Licensing and price Channel-based, Enterprise or OEM; production, test and developer licenses included; Channel-based licensing starts at $9,980 per year for 2 channels; see pricing below Licensed per processor core, at least four per processor; Enterprise, Standard, Branch and Developer editions; Windows Server and SQL Server bought separately; no price published by Microsoft

Does QIE cover imaging, FHIR and cloud too?

Yes, in one engine. Anything QIE does for HL7 v2 it also does for HL7 v3, FHIR, DICOM including native DIMSE and DICOMweb, X12, ASTM, CDA and IHE profiles, over MLLP, REST, SFTP, file, database, message queue and network share. The Qvera DICOM Router is that same engine configured for imaging. Microsoft documents no FHIR or DICOM support in BizTalk Server.

It runs on Windows or Linux, in Docker or Kubernetes from images Qvera maintains, or on AWS ECS: on-premise, in containers, or in your own AWS, Azure or Google Cloud account, against Microsoft SQL Server, MySQL or MariaDB. Running engines at more than one site, or inside networks you do not control, is what the Remote Management Hub (RMH) is for.

The Qvera Interface Engine · The Qvera DICOM Router · Remote Management Hub

How should you compare the engines on your shortlist?

Whichever engines are on your shortlist, ask every vendor, Qvera included, to show the move using one of your own BizTalk applications. Ask what carries over, what is rebuilt, how the result is tested, and what the complete cost is once support, high availability, test and development environments, and the database the engine needs are included.

Running Mirth Connect?

See how QIE converts Mirth channels, and how it compares with Mirth 4.5.2, Mirth 4.6+ and the community forks.

What does QIE cost, and how is it licensed?

Qvera offers Channel-based, Enterprise, and OEM licensing models. Channel-based licensing starts at $9,980 per year for 2 channels and does not limit message volume. View Qvera Licensing and Pricing.

Who already relies on QIE?

QIE is in production at more than 600 sites, running more than 25,000 interfaces and processing more than 50 million messages a day. Qvera has built healthcare interface engine software since 2008 and is SOC 2 Type 2 attested. The following BizTalk users have already switched to using QIE:

 
AdvancedMD
Tegria
US Anesthesia Partners
NSI

How this comparison is sourced: Qvera publishes this page and sells QIE. What this page says about QIE comes from Qvera’s own product documentation and production deployments; about BizTalk Server and Azure Logic Apps, from Microsoft’s own documentation, lifecycle pages, product terms and announcements. All Microsoft information was last reviewed on 16 October 2026. Vendors change their products, so check their current documentation before relying on any single claim. Found something out of date? Tell us and we will correct it.

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