Saga IT

Mirth Connect development in VS Code and Cursor

MirthSync is now on Open VSX, so our Mirth Connect & OIE extension installs in Cursor, Windsurf, and VSCodium — not just VS Code. Here's why that took a second marketplace.

Mirth ConnectMirthSyncOpen Integration EngineDeveloper Tools

Short version: MirthSync — our extension for developing Mirth Connect and Open Integration Engine channels in a real editor — is now on the Open VSX Registry. If you write integration code in Cursor, Windsurf, or VSCodium, you can finally install it the normal way, straight from the Extensions panel.

That sounds like a one-line release note, but the reason it took a second marketplace is the genuinely interesting part — and it explains a thing a lot of Cursor users have quietly wondered about: why some extensions are simply missing. We’ll get there. First, for anyone meeting MirthSync for the first time, the sixty-second version.

What MirthSync does, in sixty seconds

The Mirth Connect Administrator — the Java desktop app that ships with the engine — is more capable than people remember. Its JavaScript editor has autocomplete, bracket matching, code folding, and find-and-replace. The editor was never really the problem.

The problem is everything around the code. A channel lives as XML inside the engine, not as a file you can open. There’s no git history, no pull request, no diff between what’s running on the dev box and what’s in production. Promoting a change means exporting XML from one server and importing it into another by hand. And the editor you’re typing into is the one the engine hands you — not the one you’ve configured, with your extensions and your AI assistant one keystroke away.

MirthSync turns channels into files. It pulls every channel, code-template library, and configuration map out of the engine onto disk, where they become ordinary git citizens — branch them, diff them, review them, revert them. It stores a connection profile per environment (credentials in VS Code’s Secrets API, not plaintext), so dev / staging / prod sit side by side and “is staging actually in sync with prod?” becomes a one-line diff.

SYNC · VERSION CONTROLMirthSync workspaceGitChannelsADT_Inbound.xmlORU_Results.xmlLab_Router.xmlCodeTemplatesFHIR_Helpers.xmlmain3 channels · 1 templatedevlocalhost:8443runningstagingstaging.mirth.internalrunningprodmirth.hospital.orgrunningpull · push
Channels live as version-controlled files in your editor and sync — pull and push — to dev, staging, and production servers.

It also ships IntelliSense for Mirth’s JavaScript API — channelMap, globalMap, msg, the message aliases — so the engine’s globals get type signatures and hover docs in your editor. And it can stand up a complete throwaway Mirth on Docker in one command.

INTELLISENSEORU_Results.js12345var mrn msg[‘PID’][‘PID.3’];channelMap.fput(key, value): voidfget(key): ObjectfcontainsKey(key): booleanfsize(): intchannelMap.putStore a value on thechannel-scoped map.
Autocomplete, type signatures, and hover docs for Mirth’s JavaScript API, surfaced inside your own editor.

That’s the tour. The full feature deep-dive — diagnostics, the Java debugger, the Local Mirth Docker stack, the snippet catalog — lives in MirthSync for VS Code: a modern IDE for Mirth Connect & OIE. This post is about where you can now run it.

Now on Open VSX — which is why it runs in Cursor

Here’s the part worth the detour. If you use Cursor or Windsurf and have ever searched for an extension that “should” exist and found nothing, this is why.

Microsoft’s Visual Studio Marketplace — the place VS Code installs extensions from — has Terms of Use that restrict it to Microsoft’s own “Visual Studio products.” A VS Code fork — Cursor, Windsurf, VSCodium, Gitpod’s editor — is not a Microsoft product, and cannot legally pull from that marketplace. So an extension that lives only on Microsoft’s marketplace does not exist, at all, for any of those editors.

WHY TWO MARKETPLACESVS Code MarketplaceMicrosoft · Terms restrict toMicrosoft’s own productsVS CodeCursorblocked by ToSWindsurfblocked by ToSVSCodiumblocked by ToSOpen VSX RegistryEclipse Foundation ·vendor-neutral, open sourceVS CodeCursorWindsurfVSCodium
Microsoft restricts its marketplace to its own products, so forks like Cursor rely on the Eclipse Foundation’s vendor-neutral Open VSX.

The forks solve this with a different registry: Open VSX, a vendor-neutral, open-source marketplace run by the Eclipse Foundation. It’s the default extension source in Cursor, Windsurf, VSCodium, and Gitpod. Publishing there is the only way to reach those editors.

So we publish to both. The VS Code Marketplace listing covers VS Code itself; the Open VSX listing covers everyone else. If you do healthcare-integration work in Cursor — and a growing number of people do — MirthSync now installs like any other extension, with the same channel sync, IntelliSense, and Local Mirth you’d get in VS Code.

Mirth, NextGen, and the Open Integration Engine

A bit of context for anyone who’s been away from this corner of healthcare IT for a year. In March 2025, NextGen Healthcare moved Mirth Connect to a closed-source, commercial license starting with version 4.6; 4.5.2 was the last open-source release. In response, the community forked that last open version into the Open Integration Engine — a vendor-neutral, openly governed continuation of the engine a generation of integration teams already knew.

THE FORKMirth Connect 4.5.2last open-source releaseNextGen Connect 4.6closed source · Mar 2025Open Integration Enginecommunity fork · open sourceMirthSyncthe open lineage
Mirth Connect 4.5.2 was the last open-source release; 4.6 went commercial, and the community forked the Open Integration Engine — MirthSync works with the open lineage, not the closed-source NextGen Connect.

MirthSync sits one layer up from that split. It speaks the standard Mirth REST API, so it works against the open-source Mirth® Connect, the Open Integration Engine, and BridgeLink equally — your channels, your servers, your choice of engine. Saga IT maintains the open-source mirthsync CLI the extension is built on, and we contribute to the Open Integration Engine project alongside the rest of the community. (If you just want an engine running locally to point it at, our Docker quickstart covers the five-minute path.)

A month on Open VSX

We pushed the first Open VSX build on May 4, 2026. About a month later, the listing has crossed 1,100 downloads. The honest caveat: Open VSX counts downloads, not unique installs — every update and every CI pull is in that number, so it isn’t 1,100 distinct humans. But for a tool aimed squarely at people who write Mirth channels for a living, in roughly a month, it’s a good sign that “my channels belong in my editor” is a widely shared itch.

MONTH ONE1,100+downloads on Open VSXsince the first release, May 4, 2026cumulative downloadsREACHESVS CodeCursorWindsurfVSCodium
More than 1,100 cumulative downloads on Open VSX in the first month, reaching VS Code, Cursor, Windsurf, and VSCodium.

Try it

Open the Extensions panel in VS Code, Cursor, Windsurf, or VSCodium and search MirthSync, or install it directly:

Point it at a server, pull your channels, and commit them. For the full feature tour, see the deep-dive post or the product page; if you hit a rough edge or want a feature, the mirthsync repository is the place to tell us.


MirthSync is an independent, community-built extension. It is not affiliated with, endorsed by, or sponsored by NextGen Healthcare. Mirth® and Mirth Connect® are trademarks of NextGen Healthcare.

Frequently Asked Questions

Does MirthSync work in Cursor and Windsurf?

Yes. MirthSync is published on the Open VSX Registry, the extension marketplace that Cursor, Windsurf, VSCodium, and Gitpod install from by default. Search “MirthSync” in your editor's Extensions panel, or install it from the Open VSX listing.

Why isn't MirthSync just on the VS Code Marketplace?

It is — but Microsoft's Visual Studio Marketplace Terms of Use restrict it to Microsoft's own products, so VS Code forks like Cursor and Windsurf can't install from it. They use the vendor-neutral Open VSX Registry instead, which is why we publish to both.

Does MirthSync work with the Open Integration Engine?

Yes. MirthSync talks to the standard Mirth Connect REST API, so it works with the last open-source Mirth® Connect (4.5.2), the community Open Integration Engine, and BridgeLink — not the closed-source NextGen Connect (4.6+). The one-command local stack it can spin up uses Open Integration Engine.

Is the MirthSync VS Code extension open source?

The extension is a published product and is free to install. It is built on the open-source mirthsync command-line tool, which Saga IT maintains under the EPL — so your workspace is just files and Git history, with no proprietary lock-in.

Is MirthSync affiliated with NextGen Healthcare?

No. MirthSync is an independent, community-built extension. It is not affiliated with, endorsed by, or sponsored by NextGen Healthcare. Mirth® and Mirth Connect® are trademarks of NextGen Healthcare.

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