diff --git a/src/Command/ImportCodesCommand.php b/src/Command/ImportCodesCommand.php
index 9ee3797..af00024 100644
--- a/src/Command/ImportCodesCommand.php
+++ b/src/Command/ImportCodesCommand.php
@@ -13,6 +13,8 @@
 
 namespace OpenCoreEMR\CLI\ImportCodes\Command;
 
+use OpenCoreEMR\CLI\ImportCodes\Config\ConfigAccessorInterface;
+use OpenCoreEMR\CLI\ImportCodes\Config\GlobalsAccessor;
 use OpenCoreEMR\CLI\ImportCodes\Service\CodeImporter;
 use OpenCoreEMR\CLI\ImportCodes\Service\OpenEMRConnector;
 use OpenCoreEMR\CLI\ImportCodes\Service\MetadataDetector;
@@ -31,13 +33,20 @@ class ImportCodesCommand extends Command
     private ?OutputInterface $output = null;
 
     public function __construct(
-        private readonly CodeImporter $importer = new CodeImporter(),
-        private readonly OpenEMRConnector $connector = new OpenEMRConnector(),
+        ?ConfigAccessorInterface $config = null,
+        ?CodeImporter $importer = null,
+        ?OpenEMRConnector $connector = null,
         private readonly MetadataDetector $detector = new MetadataDetector()
     ) {
+        $config ??= new GlobalsAccessor();
+        $this->importer = $importer ?? new CodeImporter($config);
+        $this->connector = $connector ?? new OpenEMRConnector($config);
         parent::__construct();
     }
 
+    private readonly CodeImporter $importer;
+    private readonly OpenEMRConnector $connector;
+
     protected function configure()
     {
         $supportedTypes = implode(', ', self::SUPPORTED_TYPES);
diff --git a/src/Config/ConfigAccessorInterface.php b/src/Config/ConfigAccessorInterface.php
new file mode 100644
index 0000000..3459c59
--- /dev/null
+++ b/src/Config/ConfigAccessorInterface.php
@@ -0,0 +1,42 @@
+<?php
+
+/**
+ * ConfigAccessorInterface.php
+ * Interface for accessing configuration values with type safety
+ *
+ * @package   OpenCoreEMR\CLI\ImportCodes
+ * @link      https://opencoreemr.com
+ * @author    Michael A. Smith <michael@opencoreemr.com>
+ * @copyright Copyright (c) 2026 OpenCoreEMR Inc
+ * @license   https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
+ */
+
+namespace OpenCoreEMR\CLI\ImportCodes\Config;
+
+interface ConfigAccessorInterface
+{
+    /**
+     * Get a configuration value
+     */
+    public function get(string $key, mixed $default = null): mixed;
+
+    /**
+     * Check if a configuration key exists
+     */
+    public function has(string $key): bool;
+
+    /**
+     * Get a configuration value as a string
+     */
+    public function getString(string $key, string $default = ''): string;
+
+    /**
+     * Get a configuration value as a boolean
+     */
+    public function getBoolean(string $key, bool $default = false): bool;
+
+    /**
+     * Get a configuration value as an integer
+     */
+    public function getInt(string $key, int $default = 0): int;
+}
diff --git a/src/Config/GlobalsAccessor.php b/src/Config/GlobalsAccessor.php
new file mode 100644
index 0000000..23c2109
--- /dev/null
+++ b/src/Config/GlobalsAccessor.php
@@ -0,0 +1,79 @@
+<?php
+
+/**
+ * GlobalsAccessor.php
+ * Centralized accessor for OpenEMR $GLOBALS with type-safe getters
+ *
+ * @package   OpenCoreEMR\CLI\ImportCodes
+ * @link      https://opencoreemr.com
+ * @author    Michael A. Smith <michael@opencoreemr.com>
+ * @copyright Copyright (c) 2026 OpenCoreEMR Inc
+ * @license   https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
+ */
+
+namespace OpenCoreEMR\CLI\ImportCodes\Config;
+
+class GlobalsAccessor implements ConfigAccessorInterface
+{
+    /**
+     * @inheritDoc
+     */
+    public function get(string $key, mixed $default = null): mixed
+    {
+        return $GLOBALS[$key] ?? $default;
+    }
+
+    /**
+     * @inheritDoc
+     */
+    public function has(string $key): bool
+    {
+        return isset($GLOBALS[$key]);
+    }
+
+    /**
+     * @inheritDoc
+     */
+    public function getString(string $key, string $default = ''): string
+    {
+        $value = $this->get($key, $default);
+        if (is_string($value)) {
+            return $value;
+        }
+        return is_scalar($value) || $value === null ? (string) $value : $default;
+    }
+
+    /**
+     * @inheritDoc
+     */
+    public function getBoolean(string $key, bool $default = false): bool
+    {
+        $value = $this->get($key, $default);
+        if (is_bool($value)) {
+            return $value;
+        }
+        return filter_var($value, FILTER_VALIDATE_BOOLEAN);
+    }
+
+    /**
+     * @inheritDoc
+     */
+    public function getInt(string $key, int $default = 0): int
+    {
+        $value = $this->get($key, $default);
+        if (is_int($value)) {
+            return $value;
+        }
+        return is_numeric($value) ? (int) $value : $default;
+    }
+
+    /**
+     * Get all globals (use sparingly)
+     *
+     * @return array<string, mixed>
+     */
+    public function all(): array
+    {
+        return $GLOBALS;
+    }
+}
diff --git a/src/Service/CodeImporter.php b/src/Service/CodeImporter.php
index 7562453..705a68b 100644
--- a/src/Service/CodeImporter.php
+++ b/src/Service/CodeImporter.php
@@ -13,6 +13,7 @@
 
 namespace OpenCoreEMR\CLI\ImportCodes\Service;
 
+use OpenCoreEMR\CLI\ImportCodes\Config\ConfigAccessorInterface;
 use OpenCoreEMR\CLI\ImportCodes\Exception\CodeImportException;
 use OpenCoreEMR\CLI\ImportCodes\Exception\FileSystemException;
 use OpenCoreEMR\CLI\ImportCodes\Exception\DatabaseLockException;
@@ -24,6 +25,11 @@ class CodeImporter
     private int $lockRetryDelaySeconds = 30;
     private bool $waitedForLock = false;
 
+    public function __construct(
+        private readonly ConfigAccessorInterface $config
+    ) {
+    }
+
     /**
      * Validate temporary directory is writable
      *
@@ -283,11 +289,12 @@ public function cleanup(string $type): void
      */
     public function getStagingFiles(string $type): array
     {
-        if (!isset($GLOBALS['temporary_files_dir']) || !is_string($GLOBALS['temporary_files_dir'])) {
+        $tempDir = $this->config->getString('temporary_files_dir');
+        if ($tempDir === '') {
             return [];
         }
 
-        $stagingDir = $GLOBALS['temporary_files_dir'] . '/' . $type;
+        $stagingDir = $tempDir . '/' . $type;
         if (!is_dir($stagingDir)) {
             return [];
         }
diff --git a/src/Service/OpenEMRConnector.php b/src/Service/OpenEMRConnector.php
index 8ad4588..c37f4b8 100644
--- a/src/Service/OpenEMRConnector.php
+++ b/src/Service/OpenEMRConnector.php
@@ -13,6 +13,7 @@
 
 namespace OpenCoreEMR\CLI\ImportCodes\Service;
 
+use OpenCoreEMR\CLI\ImportCodes\Config\ConfigAccessorInterface;
 use OpenCoreEMR\CLI\ImportCodes\Exception\OpenEMRConnectorException;
 
 class OpenEMRConnector
@@ -21,6 +22,11 @@ class OpenEMRConnector
     private string $site;
     private bool $initialized = false;
 
+    public function __construct(
+        private readonly ConfigAccessorInterface $config
+    ) {
+    }
+
     /**
      * Initialize connection to OpenEMR
      */
@@ -52,7 +58,7 @@ public function initialize(string $openemrPath, string $site = 'default'): void
         require_once $standardTablesPath;
 
         // Verify database connection (using OpenEMR's own validation method)
-        if (!isset($GLOBALS['dbh']) || !$GLOBALS['dbh']) {
+        if (!$this->config->get('dbh')) {
             throw new OpenEMRConnectorException(
                 "OpenEMR database connection failed - " .
                 "check database configuration and ensure MySQL is running"
@@ -60,7 +66,8 @@ public function initialize(string $openemrPath, string $site = 'default'): void
         }
 
         // Verify ADODB connection is working
-        if (!isset($GLOBALS['adodb']['db']) || !$GLOBALS['adodb']['db']) {
+        $adodb = $this->config->get('adodb');
+        if (!is_array($adodb) || !isset($adodb['db']) || !$adodb['db']) {
             throw new OpenEMRConnectorException("OpenEMR ADODB database connection not established");
         }
 
@@ -111,7 +118,8 @@ public function getTempDir(): string
             throw new OpenEMRConnectorException("OpenEMR connector not initialized");
         }
 
-        return $GLOBALS['temporary_files_dir'] ?? sys_get_temp_dir();
+        $tempDir = $this->config->getString('temporary_files_dir');
+        return $tempDir !== '' ? $tempDir : sys_get_temp_dir();
     }
 
     /**
diff --git a/tests/E2E/RealVocabularyImportE2ETest.php b/tests/E2E/RealVocabularyImportE2ETest.php
index 2a0e6ff..283a3db 100644
--- a/tests/E2E/RealVocabularyImportE2ETest.php
+++ b/tests/E2E/RealVocabularyImportE2ETest.php
@@ -22,6 +22,7 @@
 namespace OpenCoreEMR\CLI\ImportCodes\Tests\E2E;
 
 use OpenCoreEMR\CLI\ImportCodes\Command\ImportCodesCommand;
+use OpenCoreEMR\CLI\ImportCodes\Config\GlobalsAccessor;
 use OpenCoreEMR\CLI\ImportCodes\Service\OpenEMRConnector;
 use PHPUnit\Framework\Attributes\Group;
 use PHPUnit\Framework\Attributes\Test;
@@ -61,7 +62,7 @@ protected function setUp(): void
             $this->markTestSkipped('OpenEMR not available. Run inside Docker: task dev:start');
         }
 
-        $this->connector = new OpenEMRConnector();
+        $this->connector = new OpenEMRConnector(new GlobalsAccessor());
         try {
             $this->connector->initialize(self::OPENEMR_PATH, self::SITE);
         } catch (\Throwable $e) {
diff --git a/tests/E2E/VocabularyImportE2ETest.php b/tests/E2E/VocabularyImportE2ETest.php
index 61a2635..bc81716 100644
--- a/tests/E2E/VocabularyImportE2ETest.php
+++ b/tests/E2E/VocabularyImportE2ETest.php
@@ -17,6 +17,7 @@
 namespace OpenCoreEMR\CLI\ImportCodes\Tests\E2E;
 
 use OpenCoreEMR\CLI\ImportCodes\Command\ImportCodesCommand;
+use OpenCoreEMR\CLI\ImportCodes\Config\GlobalsAccessor;
 use OpenCoreEMR\CLI\ImportCodes\Service\OpenEMRConnector;
 use PHPUnit\Framework\Attributes\Group;
 use PHPUnit\Framework\Attributes\RequiresPhpExtension;
@@ -52,7 +53,7 @@ protected function setUp(): void
             );
         }
 
-        $this->connector = new OpenEMRConnector();
+        $this->connector = new OpenEMRConnector(new GlobalsAccessor());
         try {
             $this->connector->initialize(self::OPENEMR_PATH, self::SITE);
         } catch (\Throwable $e) {
@@ -268,7 +269,7 @@ public function cleanupRemovesTemporaryFiles(): void
         $this->assertEquals(0, $result);
 
         // Verify temp directory was cleaned up
-        $tempDir = $GLOBALS['temporary_files_dir'] . '/CQM_VALUESET';
+        $tempDir = $this->connector->getTempDir() . '/CQM_VALUESET';
         $this->assertDirectoryDoesNotExist($tempDir, 'Temp directory should be removed after cleanup');
     }
 
diff --git a/tests/Integration/ImportCodesIntegrationTest.php b/tests/Integration/ImportCodesIntegrationTest.php
index 15cbc11..01fb174 100644
--- a/tests/Integration/ImportCodesIntegrationTest.php
+++ b/tests/Integration/ImportCodesIntegrationTest.php
@@ -17,6 +17,7 @@
 namespace OpenCoreEMR\CLI\ImportCodes\Tests\Integration;
 
 use OpenCoreEMR\CLI\ImportCodes\Command\ImportCodesCommand;
+use OpenCoreEMR\CLI\ImportCodes\Config\GlobalsAccessor;
 use OpenCoreEMR\CLI\ImportCodes\Service\CodeImporter;
 use OpenCoreEMR\CLI\ImportCodes\Service\MetadataDetector;
 use OpenCoreEMR\CLI\ImportCodes\Service\OpenEMRConnector;
@@ -54,7 +55,7 @@ protected function setUp(): void
         }
 
         // Try to initialize the connector
-        $this->connector = new OpenEMRConnector();
+        $this->connector = new OpenEMRConnector(new GlobalsAccessor());
         try {
             $this->connector->initialize(self::OPENEMR_PATH, self::SITE);
             $this->openemrAvailable = true;
@@ -92,7 +93,7 @@ public function openEmrConnectorCanGetTempDir(): void
     #[Test]
     public function codeImporterCanCheckIfVocabularyLoaded(): void
     {
-        $importer = new CodeImporter();
+        $importer = new CodeImporter(new GlobalsAccessor());
 
         // Should not throw exception when database is available
         $result = $importer->isVocabularyLoaded('RXNORM');
@@ -103,7 +104,7 @@ public function codeImporterCanCheckIfVocabularyLoaded(): void
     #[Test]
     public function codeImporterCanCheckIfAlreadyLoaded(): void
     {
-        $importer = new CodeImporter();
+        $importer = new CodeImporter(new GlobalsAccessor());
 
         // Check with fake data - should return false
         $result = $importer->isAlreadyLoaded(
diff --git a/tests/Unit/Command/ImportCodesCommandTest.php b/tests/Unit/Command/ImportCodesCommandTest.php
index 828d6b5..8f6733b 100644
--- a/tests/Unit/Command/ImportCodesCommandTest.php
+++ b/tests/Unit/Command/ImportCodesCommandTest.php
@@ -39,6 +39,7 @@ protected function setUp(): void
         $this->detectorMock = $this->createMock(MetadataDetector::class);
 
         $this->command = new ImportCodesCommand(
+            null,
             $this->importerMock,
             $this->connectorMock,
             $this->detectorMock
diff --git a/tests/Unit/Config/GlobalsAccessorTest.php b/tests/Unit/Config/GlobalsAccessorTest.php
new file mode 100644
index 0000000..19789f6
--- /dev/null
+++ b/tests/Unit/Config/GlobalsAccessorTest.php
@@ -0,0 +1,196 @@
+<?php
+
+/**
+ * GlobalsAccessorTest.php
+ * Unit tests for GlobalsAccessor
+ *
+ * @package   OpenCoreEMR\CLI\ImportCodes\Tests
+ * @link      https://opencoreemr.com
+ * @author    Michael A. Smith <michael@opencoreemr.com>
+ * @copyright Copyright (c) 2026 OpenCoreEMR Inc
+ * @license   https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
+ */
+
+namespace OpenCoreEMR\CLI\ImportCodes\Tests\Unit\Config;
+
+use OpenCoreEMR\CLI\ImportCodes\Config\ConfigAccessorInterface;
+use OpenCoreEMR\CLI\ImportCodes\Config\GlobalsAccessor;
+use PHPUnit\Framework\Attributes\Test;
+use PHPUnit\Framework\TestCase;
+
+class GlobalsAccessorTest extends TestCase
+{
+    private GlobalsAccessor $accessor;
+
+    protected function setUp(): void
+    {
+        $this->accessor = new GlobalsAccessor();
+        // Clear test globals before each test
+        unset($GLOBALS['test_string'], $GLOBALS['test_int'], $GLOBALS['test_bool'], $GLOBALS['test_array']);
+    }
+
+    protected function tearDown(): void
+    {
+        // Clean up globals after each test
+        unset($GLOBALS['test_string'], $GLOBALS['test_int'], $GLOBALS['test_bool'], $GLOBALS['test_array']);
+    }
+
+    #[Test]
+    public function implementsConfigAccessorInterface(): void
+    {
+        $this->assertInstanceOf(ConfigAccessorInterface::class, $this->accessor);
+    }
+
+    #[Test]
+    public function getReturnsValueWhenKeyExists(): void
+    {
+        $GLOBALS['test_string'] = 'hello';
+
+        $this->assertEquals('hello', $this->accessor->get('test_string'));
+    }
+
+    #[Test]
+    public function getReturnsDefaultWhenKeyNotExists(): void
+    {
+        $this->assertEquals('default', $this->accessor->get('nonexistent', 'default'));
+    }
+
+    #[Test]
+    public function getReturnsNullWhenKeyNotExistsAndNoDefault(): void
+    {
+        $this->assertNull($this->accessor->get('nonexistent'));
+    }
+
+    #[Test]
+    public function hasReturnsTrueWhenKeyExists(): void
+    {
+        $GLOBALS['test_string'] = 'hello';
+
+        $this->assertTrue($this->accessor->has('test_string'));
+    }
+
+    #[Test]
+    public function hasReturnsFalseWhenKeyNotExists(): void
+    {
+        $this->assertFalse($this->accessor->has('nonexistent'));
+    }
+
+    #[Test]
+    public function getStringReturnsStringValue(): void
+    {
+        $GLOBALS['test_string'] = 'hello';
+
+        $this->assertEquals('hello', $this->accessor->getString('test_string'));
+    }
+
+    #[Test]
+    public function getStringConvertsIntToString(): void
+    {
+        $GLOBALS['test_int'] = 42;
+
+        $this->assertEquals('42', $this->accessor->getString('test_int'));
+    }
+
+    #[Test]
+    public function getStringReturnsDefaultForNonScalar(): void
+    {
+        $GLOBALS['test_array'] = ['foo' => 'bar'];
+
+        $this->assertEquals('default', $this->accessor->getString('test_array', 'default'));
+    }
+
+    #[Test]
+    public function getStringReturnsDefaultWhenKeyNotExists(): void
+    {
+        $this->assertEquals('default', $this->accessor->getString('nonexistent', 'default'));
+    }
+
+    #[Test]
+    public function getBooleanReturnsBoolValue(): void
+    {
+        $GLOBALS['test_bool'] = true;
+
+        $this->assertTrue($this->accessor->getBoolean('test_bool'));
+    }
+
+    #[Test]
+    public function getBooleanConvertsStringTrue(): void
+    {
+        $GLOBALS['test_string'] = 'true';
+
+        $this->assertTrue($this->accessor->getBoolean('test_string'));
+    }
+
+    #[Test]
+    public function getBooleanConvertsStringFalse(): void
+    {
+        $GLOBALS['test_string'] = 'false';
+
+        $this->assertFalse($this->accessor->getBoolean('test_string'));
+    }
+
+    #[Test]
+    public function getBooleanConvertsNumericOne(): void
+    {
+        $GLOBALS['test_int'] = 1;
+
+        $this->assertTrue($this->accessor->getBoolean('test_int'));
+    }
+
+    #[Test]
+    public function getBooleanConvertsNumericZero(): void
+    {
+        $GLOBALS['test_int'] = 0;
+
+        $this->assertFalse($this->accessor->getBoolean('test_int'));
+    }
+
+    #[Test]
+    public function getBooleanReturnsDefaultWhenKeyNotExists(): void
+    {
+        $this->assertTrue($this->accessor->getBoolean('nonexistent', true));
+        $this->assertFalse($this->accessor->getBoolean('nonexistent', false));
+    }
+
+    #[Test]
+    public function getIntReturnsIntValue(): void
+    {
+        $GLOBALS['test_int'] = 42;
+
+        $this->assertEquals(42, $this->accessor->getInt('test_int'));
+    }
+
+    #[Test]
+    public function getIntConvertsNumericString(): void
+    {
+        $GLOBALS['test_string'] = '123';
+
+        $this->assertEquals(123, $this->accessor->getInt('test_string'));
+    }
+
+    #[Test]
+    public function getIntReturnsDefaultForNonNumeric(): void
+    {
+        $GLOBALS['test_string'] = 'not a number';
+
+        $this->assertEquals(99, $this->accessor->getInt('test_string', 99));
+    }
+
+    #[Test]
+    public function getIntReturnsDefaultWhenKeyNotExists(): void
+    {
+        $this->assertEquals(99, $this->accessor->getInt('nonexistent', 99));
+    }
+
+    #[Test]
+    public function allReturnsGlobalsArray(): void
+    {
+        $GLOBALS['test_string'] = 'hello';
+
+        $all = $this->accessor->all();
+
+        $this->assertIsArray($all);
+        $this->assertArrayHasKey('test_string', $all);
+        $this->assertEquals('hello', $all['test_string']);
+    }
+}
diff --git a/tests/Unit/Service/CodeImporterTest.php b/tests/Unit/Service/CodeImporterTest.php
index f35a3ef..9a29c03 100644
--- a/tests/Unit/Service/CodeImporterTest.php
+++ b/tests/Unit/Service/CodeImporterTest.php
@@ -13,6 +13,7 @@
 
 namespace OpenCoreEMR\CLI\ImportCodes\Tests\Unit\Service;
 
+use OpenCoreEMR\CLI\ImportCodes\Config\GlobalsAccessor;
 use OpenCoreEMR\CLI\ImportCodes\Exception\CodeImportException;
 use OpenCoreEMR\CLI\ImportCodes\Exception\FileSystemException;
 use OpenCoreEMR\CLI\ImportCodes\Service\CodeImporter;
@@ -25,7 +26,7 @@ class CodeImporterTest extends TestCase
 
     protected function setUp(): void
     {
-        $this->importer = new CodeImporter();
+        $this->importer = new CodeImporter(new GlobalsAccessor());
     }
 
     #[Test]
diff --git a/tests/Unit/Service/OpenEMRConnectorTest.php b/tests/Unit/Service/OpenEMRConnectorTest.php
index 5d01cf1..4fa2bde 100644
--- a/tests/Unit/Service/OpenEMRConnectorTest.php
+++ b/tests/Unit/Service/OpenEMRConnectorTest.php
@@ -13,6 +13,7 @@
 
 namespace OpenCoreEMR\CLI\ImportCodes\Tests\Unit\Service;
 
+use OpenCoreEMR\CLI\ImportCodes\Config\GlobalsAccessor;
 use OpenCoreEMR\CLI\ImportCodes\Exception\OpenEMRConnectorException;
 use OpenCoreEMR\CLI\ImportCodes\Service\OpenEMRConnector;
 use PHPUnit\Framework\Attributes\Test;
@@ -24,7 +25,7 @@ class OpenEMRConnectorTest extends TestCase
 
     protected function setUp(): void
     {
-        $this->connector = new OpenEMRConnector();
+        $this->connector = new OpenEMRConnector(new GlobalsAccessor());
     }
 
     #[Test]