Caitlin Clement|11/24/2022|4 min read

What is HL7 and FHIR?

Interoperability standards defined

graphic image of laptop with lines of code showing the integration help HL7 FHIR and HL7 Standard give through interconnected lines going in and our of the laptop

If you’re reading this, it’s likely you’re on the journey toward building a more interoperable healthcare system. As you might have already noticed in previous research, there currently isn’t a universal set of standards in the U.S., which can make obtaining interoperability a bit of a guessing game if you don’t know where to look. 

Thankfully, there are a set of international standards made by Health Level Seven (HL7) International, a non-profit organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing and retrieval of electronic health information.

As you look toward building a more interoperable system, this blog will define HL7 and FHIR, how they relate to each other and where they fit into your health organizations interoperability goals. 

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Who is Health Level Seven (HL7) International?

Before we get into the details of the two sets of standards, let’s first dive into who the organization is and why they would create such a set of standards. If you’re already familiar with the organization, feel free to skip ahead to the standards. 

As mentioned above, HL7 was founded in 1987 as a nonprofit organization to provide the framework and regulations needed to encourage communication between systems. They are currently supported by more than 1,600 members, 50+ countries, including 500+ corporate members representing healthcare providers, government stakeholders, payers, pharmaceutical companies, vendors/suppliers and consulting firms. 

On their website, they also mention that “level seven” refers to the seventh level of the International Organization for Standardization (ISO) seven-layer communications model for Open Systems Interconnection (OSI) - the application level.

This layer is where the user directly interacts with a software application, so it is closest to the end user. 

Their vision:

A world in which everyone can securely access and use the right health data when and where they need it.

Their mission:

To provide standards that empower global health data interoperability.

You can find more detailed information about the organization, like goals, objectives and a 3-year plan, by visiting their website.

What is HL7?

Alright, time to get into what you came here for. HL7 is a set of international standards used to provide guidance with transferring and sharing data between various healthcare providers.

There are several versions, but HL7 v2 is largely implemented and developed in almost every hospital or clinic, with 95% of U.S. Healthcare organizations using it. V2 is designed to support a central patient care system as well as a more distributed environment where data resides in departmental systems.

V2 Messaging Standard was first released in October 1987 as an Application Protocol for Electronic Data Exchange in Healthcare Environments. Version 2.9 represents the latest update to the V2 Standard and was published in 2019.

Some of the benefits of HL7 v2:

  • Supports most of the major interfaces used in the healthcare industry globally

  • Provides a structured framework for what is not the standard

  • Reduces the cost of implementation

  • Generally backward compatible 

While HL7 has shown its worth in holding healthcare systems accountable, the HL7 organization has since come up with a new set of standards using existing solutions from HL7 v2. This new standard is called FHIR (pronounced “fire”).

What is HL7 FHIR?

This is the most recent version of standards coming from Health Level Seven International. FHIR, or Fast Healthcare Interoperability Resources, combines the best features of HL7’s existing solutions, while leveraging the latest web technologies and applying a critical focus on implementation.

It can be used for mobile devices, cloud communications, EHR-based data sharing, server communication in large institutions and more. It’s easier to implement because FHIR uses a modern web-based suite of API technology, including a HTTP-based RESTful protocol, and a choice of JSON, XML or RDF for data representation. According to the HL7 website, some of the benefits of FHIR include:

  • Creates a common specification by which healthcare participants can share information

  • Enables the development of applications that benefit from access to high quality information in a manner that implementers find as easy to use as possible

  • Supports improvements in the delivery of healthcare including new initiatives such as Value Based care

Some major players like Apple, Google and Microsoft have implemented FHIR into their own systems. This high-level adoption has created a “social contract” of sorts among companies, organizations and health systems to utilize these sets of standards in order to create some cohesion among systems. Promoting a bandwagon approaches since no universal standards exist. 

How to implement FHIR?

The HL7 website has great implementation resources when it comes to implementation and getting started. Additionally, cloud providers offer services that can add a FHIR layer with relative ease. 

One of the more well known ones is Amazon’s FHIR Works solution — an open source software toolkit that can be used to create a FHIR interface over existing healthcare applications and data. It uses serverless implementation that provides FHIR APIs and supports the majority of FHIR resource types and operations. 

Why are they important?

Both HL7 and FHIR are standards put in place to make healthcare for providers and patients more virtually compatible without sacrificing any of the security. Think about it, why is it when you see multiple different providers that you have to fill out the same paperwork over and over again? Or how come it can take months for your previous provider to finally send over your vaccination records? 

Not only is this frustrating for the patients, but it can also impede on the provider’s ability to prescribe the right treatments and medications. Putting the patient's safety at risk.   

Most of the healthcare industry is working with outdated systems that were built to work independently from one another. These standards were created with the thought of giving healthcare organizations the resources they needed to build API integrations that would enable systems to communicate with one another more cohesively. Making the flow of patient information more secure, with less bottlenecks, while supporting better patient safety and outcomes in the long run.

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OpenLoop is dedicated to better patient outcomes

Interoperability has its barriers to implementation, but the expansive benefits are why we need to continue to work towards it. A seamless and universal transfer of information across systems could offer up new discoveries and innovative solutions to patient care and patient safety.

Speaking of innovative healthcare solutions, we’d like to take a moment to introduce OpenLoop! We provide intuitive telehealth technology customized for your business and your patients. Our private label technology platform offers seamless integrations, comprehensive tools and HIPAA-compliant functionality built with interoperability in mind!

Interested in what our services can offer your organization? Get in touch here!

Our full suite of Telehealth Support Services include:

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