If you are unfamiliar with HL7, then you are in the right place. Let’s learn all that there is to know about this virtual interface used in the healthcare industry. HL7 helps meet the unique needs of healthcare organizations, such as data sharing and integrated care management. The introduction of HL7 in healthcare has streamlined the workflow and supported new technologies.  

So, what does the HL7 interface mean?

HL7 stands for Health Level-7, which is an international set of standards that establishes a network for sharing electronic health records (EHRs) between software platforms in the healthcare sector. HL7 standards are de facto standards in healthcare IT. HL7 was created by Health Level Seven International, which is a non-profit organization that strives to provide a comprehensive framework and standards supporting sharing and retrieval of electronic data. It is used by many large institutions in over 55 countries, which agreed upon a standard format for all types of patient data exchange. HL7 was accredited by the American National Standards Institute (ANSI) in 1994 to govern the healthcare system stakeholders and vendors’ standards developed. Health level 7 standards supply formats and frameworks for promoting data exchange in clinical settings. 

There are four main HL7 standards: HL7 version 2, version 3 CDA, EHR-PHR, and FHIR

Four versions of HL7
  • HL7 Version 2 (V2) is the most commonly used messaging standard for the exchange of electronic health records. It is a database query language that helps healthcare providers to send messages asking for and storing patient data.
  • HL7 version 3 (V3) is also emerging and it varies significantly from V2.
  • CDA (Clinical Document Architecture) is an ISO-approved standard creating an exchange model for clinical documents such as discharge summaries and progress notes. CCD and consolidated CDA (C-CDA) are associated with CDA. CCD consists of a record of patient discharge and admission in different facilities. On the other hand, C-CDA is applicable in certified EHRs for consolidating CDA templates into a single document.
  • The EHR-PHR System Functional Models supply standard language parameters used for creating EHR systems and their components.
  • Fast Health Interoperability Resources (FHIR) is a Web-based data exchange language that speeds interoperable healthcare applications and makes them simpler and easier.

More details about HL7 FHIR

HL7 FHIR
  • FHIR that stands for Fast Healthcare Interoperable Resource, is pronounced as “fire”
  • Unlike the HL7 standards, FHIR standard was established for the web. 
  • FHIR is an upcoming and still-developing method of integration. 
  • HL7 FHIR brings together the topmost characteristics of HL7 versions like HL7 V2, HL7 V3, and CDA
  • FHIR is created based on modular components known as resources that can be combined to overcome clinical and administrative challenges. It is possible to extend the resources for promoting adaptation to develop manageable solutions for optionality and customization. 
  • Healthcare systems can easily interpret the extensions by employing a similar framework to other resources.

What are the differences between HL7 V2 and V3?

HL7 V3 addresses certain problems that are inherent in HL7 V2, which also gives rise to some new challenges. Let’s see the benefits and challenges posed by each of these versions.

Difference between HL7 V2 and V3

Some key features

HL7 represents the seven-layer International Standards Organization (ISO) Communications Model:

  • It connects the entity to online transmission media
  • Provides error control between adjacent nodes
  • Moves data across a network 
  • Provides communication control for the end-users
  • Tackles other problems apart from communication issues
  • Converts data into a form that users can interpret
  • Offers a variety of services to the applications

Why was HL7 developed in the first place?

Past challenges: In the past, data interchange across different healthcare systems took place through customized interfacing systems. These interfaces needed a lot of programming at the sending and receiving applications, which complicated the process. The difficulty with interfaces arises when healthcare teams and software vendors develop new applications. Each of these applications is created with no input or collaboration with other application systems. 

The innovation of HL7: Some clinical interface specialists in the healthcare industry decided to invent a better and cost-effective approach for interface applications. Few acute care hospitals and software vendors came together as a volunteer group to innovate a standard way of building interfaces. Their goal was to reduce the price of building interfaces substantially. This is how HL7 came into existence.

The objective of HL7: 

Objective of HL7

The main purpose of creating HL7 was to simplify the implementation of interfaces involved between healthcare software applications and various vendors. Doing so would decrease the cumbersomeness and expenditure towards custom interface programming that would support compatible applications. The focus was on making it adaptable to allow simpler data exchange and significantly reduce the costs. Implementing HL7 resolved 80% of the clinical interfacing problem flexibly. 

An example of HL7 integration

HL7 Integration

A healthcare communications company utilized HL7 integration to obtain inputs from various hospital systems. The data included the EHR, patient care devices, laboratory, radiology, nurse call systems, and much more. This information was communicated to the healthcare teams through various mobile devices, such as smartphones and tablets.

What is the role of HL7 in the healthcare sector?

Healthcare professionals often need to go through multiple electronic data systems for correctly diagnosing patients. This process can become more difficult if the healthcare providers offer services in outpatient clinics separate from the local hospital system. FHIR and HL7 interoperability standards, including HL V2 make things easier for clinicians. These standards provide a common language for handling and sharing patient data across EHRs without risk of misinterpretation or duplication.

What are the Benefits of HL7 implementation?

Besides helping you optimize EHR systems and make them cost-effective, HL7 offers many advantages:

  • Creates a single, flexible, worldwide standard for the movement of clinical data. 
  • Allows easy sharing of complex and private patient data, including records, lab reports, test results, etc., through clinical applications. 
  • Smoothens the process of electronic data exchange so that the end-uses can interpret the data. 
  • Makes integrated healthcare solutions possible, thus improving the care services delivered by healthcare networks. 
  • HL7 standards are healthcare-specific formatted messages that support different healthcare system integrations and interoperability.
  • These standards allow EHRs to communicate with many systems operating outside the EHR.

How can HL7 help with EHR/EMR interoperability?

EMR/EHR Interoperability

Modern healthcare technology aims at healthcare automation and data sharing at different point sources. One of the major concerns in allowing secure and smooth sharing of electronic health records is avoiding interoperability issues. Electronic medical record (EMR) or electronic health record interoperability will reduce medical errors, improve clinical performance, and enhance patient access to healthcare. Data interoperability is a crucial component for communicating health data. There are two ways of transferring health data across platforms: legacy and web approaches. 

Legacy approach:

  • Legacy systems require agreed-upon file formats for recording health data, so that everyone knows what goes where. The files can be used and reported.
  • Legacy systems have to depend on compiling different data into a single text file and transmitting it securely. HL7 is the primary standard for these files.
  • HL7 has established Messaging Standards and standards for Continuity of Care Documents (CCD) and Clinical Document Architecture (CDA) files. 
  • The various HL7 standards explain structured data put together into a text file
  • HL7 also interprets reporting of lab results, data exchange, and more.

Web approach:

  • Web applications are designed for sharing it widely.
  • Web-based IT is emerging, and it is used for communicating data. Keys are needed for protecting data privacy.
  • Web applications do not require legacy methods, including HL7.

Now that you know the importance of HL7 in emerging healthcare applications, let’s take a look at some of the problems that may arise while integrating HL7.

Does HL7 integration come with challenges?

HL7 may seem simple, but HL7 is associated with many challenges for software vendors and healthcare organizations. The flexibility due to HL7 enabling different environments to use different versions and aspects of HL7 can also make interfacing between unrelated systems very difficult. Here’s a list of challenges that you may come across while integrating HL7 in your healthcare system:

HL7 Challenges

Integration is vital for application viability: 

  • Any application, no matter how essential it is, will require the extra effort of Clinicians and Healthcare experts. They will need to be convinced to use it, and a simple just won’t work.
  • It is not easy for clinicians to stop using a certain EHR platform and login to an unrelated system and duplicate the existing data. This integration and asking healthcare experts to use a new tool may not be practical.
  • As it is, healthcare professionals have tight schedules. For HL7 to be viable, the applications must have a closed-loop integration, with data being extracted from the electronic health records and stored in it.
  • This problem can be overcome by hiring HL7 integration experts. They will help you make the applications readily accessible to the clinicians. You will no longer need data duplication.

Integration may consume time and resources due to HL7: 

You may observe a significant variance in the application of HL7 standards, which slows cycles, and integration becomes a time-consuming and expensive process. As a result, it requires resources for developing and simplifying integration.

If interfaces are added or replaced, then each application interfacing with the updated version is affected. This can impact the functioning of the whole system.

Adequate implementation of HL7 can be facilitated by changing each endpoint for the updated app.

Additionally, all software vendors having interfaces linked to the app should also replace or alter their endpoints. You need experts for the successful implementation of HL7 interfaces that will allow seamless communication between the interfaces.

Likelihood of data misinterpretations caused by poor HL7 semantics: 

  • If data is misinterpreted, it can create problems, especially in the healthcare industry.
  • Applications must understand data values and interpret them correctly.
  • HL7 interfaces should clearly communicate the interpretation of the standard used for preventing data misinterpretation. For instance, does a value of NA mean No Allergies or Not Applicable?
  • If misinterpreted, such data can hamper the quality of the entire dataset and have severe implications on patient care delivery.

Transforming to a new EHR may lead to loss of legacy data: 

  • While moving data for migration, it is important to prioritize the data.
  • You need to choose what you would like to keep and what to discard.
  • It may not be feasible to convert certain data, and errors may be produced during migration via HL7.
  • HL7 integration may result in unexpected expenses and consume a lot of time.

How to overcome the issues with HL7?

Overcoming issues with HL7
  • Interface engines are commonly used as an HL7 integration solution, but they have their downfall. Interface engines require PHI to be stored in a second database, which can result in risks to data security. 
  • One of the most effective ways of dealing with HL7 challenges is utilizing healthcare APIs. EHR integration with API allows electronic data exchange without lowering PHI security. 
  • Standardizing data integration via real-time APIs and a standard model will assist you in managing the problems. API successfully manages the HL7 interface, so it avoids the waiting period and fastens the HL7 implementation process. Software vendors and healthcare professionals need to agree on an API solution that will resolve HL7 integration issues and eliminate EHR interoperability.
  • Planning strategies for dealing with HL7 problems along with coordinated testing can allow the successful implementation of HL7 interfaces. Such interfaces can decrease the chances of duplicated data entry, and enhance the workflow of end-users. 

What is the future of HL7?

  • HL7 standards were introduced to allow integration of advanced tools to transfer critical information with. 
  • HL7 integration is expected to increase the efficiency of each healthcare sector and reduce the scope for errors.  
  • HL7 certainly will continue to support technological advancements such as integrated healthcare. However, healthcare providers must ensure that HL7 standards are HIPAA Compliant.
  • HIPAA compliance as per the new guidelines of the EHRs will improve, and healthcare centers will have a streamlined workflow.
  • HL7 will be recognized as an essential component of healthcare integration.
  • Development of applications supporting both versions of HL7: V2 and V3.

Do you need assistance with HL7 implementation?

We, at OSP Labs, have experts who can resolve challenges related to HL7. These are some of the HL7 services we can help you with:

  • Configuration, monitoring, and support for HL7 integration
  • DICOM image connectivity, security, storage solutions
  • Streamlining workflow using HL7
  • Solutions for technical issues
  • And much more

Conclusion

The healthcare industry is evolving with the development of the HL7 standards because they enhance integrated healthcare applications’ usability. Health level 7 or HL7 stimulates data interoperability, thus promoting data sharing between different health professionals. Healthcare informatics requires HL7 to ensure cost-effectiveness and efficacy. The incorporation of healthcare APIs assist the smooth functioning of applications operating through HL7. There are different types of HL7 standards, among which, V2 is more popularly used. However, systems supporting both versions V2 and V3 may develop. Although HL7 has its many benefits and crucial application, it does come with challenges. With appropriate planning and strategies in place, it is possible to develop relevant solutions for the problems.

Key takeaways

  • HL7 stands for Health Level-7.
  • It is a standard developed by an international organization for sharing patient information between software platforms in the healthcare sector.
  • There are different kinds of HL7 standards. V2 is commonly used and HL7 FHIR is associated with web-based applications.
  • HL7 interface supports EHR integration and allows easy migration of data.
  • Healthcare APIs avoid waiting periods and speeds the HL7 implementation process. 
  • HL7 has its set of challenges, but with adequate planning and resources, they can be resolved.

References

https://datica.com/blog/hl7-integration-challenges-and-how-to-solve-them
https://www.fortherecordmag.com/archives/ftr_01082007p22.shtml
https://www.citetech.com/learn/everything-you-need-to-know-about-hl7-interfaces
https://blog.interfaceware.com/hl7-overview/
https://blog.smartbuildingsacademy.com/everything-need-know-hl7-healthcare-informatics
https://healthstandards.com/blog/2013/03/26/hl7-fhir/
https://healthstandards.com/blog/2013/03/26/hl7-fhir/
https://www.practicefusion.com/blog/how-does-hl7-fit-into-emr/
https://searchhealthit.techtarget.com/definition/Health-Level-7-International-HL7
https://blog.orionhealth.com/what-is-hl7-and-why-does-healthcare-need-it/
https://www.lyniate.com/knowledge-hub/evolution-hl7/

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