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If you want bidirectional integrations, vendors must subscribe to a resource to receive immediate updates on the resource. Current supported resources are here: https://docs.elationhealth.com/reference/webhooks. When a resource is saved/deleted/signed off, an HTTP/POST request is sent to your target URL. The target URL should accept a JSON string in the POST body of the request. The subscription object looks like the following: 
{
  "id": 123,
  "resource": "patients",    // The resource for this object. 
  "target": "https://requestb.in/18pqnk11",  // Target URL where we would send the POST request on new events
  "created_date": "2017-01-01T01:05:00Z",
  "deleted_date": null,
  "signing_pub_key": "abcQINrsOkKXRwNrZ5zemkHqcM5gwmnwRZOKO8YXV7Q="
}