HL7 Integration: A Reference for Its Benefits, Implementations, and Applications


Tons of healthcare data are produced and analyzed for important insights every second. Currently, around 30% of the world’s data is being created from healthcare industries. And the estimated compound annual growth rate is set to hit 36% by 2025. Hospitals and healthcare institutions have various computer systems for various activities, such as billing and patient tracking. These ecosystems need to connect when new information is sent or pulled. Yet, not all of them can do that.

HL7 International provides a range of standards, guidelines, and methods for healthcare systems to connect. These data standards ensure information is shared and processed in a uniform and consistent way. The ultimate goal is to lower the geographic barriers and variability that can come from medical care. Despite its importance in today’s interconnected world, healthcare providers may need to know the advantages of integrating HL7. This post discusses the core relevance of HL7 integration, its benefits, and various cases where it can be used in medical practice.

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hl7 fhir

What is HL7?

HL7 (Health Level Seven) is a set of standards formulated to enable sharing of healthcare-related information between different systems, such as EHRs (Electronic Health Records), healthcare providers, and insurers. Created in 1989 to tackle the interoperability issue among healthcare systems, this standard provides guidelines to facilitate data sharing and bridge the gap between healthcare applications. 

Currently, two versions are being used: HL7 v2, which is still most widely employed and uses a delimited format to transfer data, and HL7 v3, which utilizes eXtensible Markup Language (XML) to represent self-describing data.

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The seven-step communication process used by HL7 to ensure compatibility between systems is as follows:

  1. The physical connection to a transmission medium.
  2. Data linking to control errors between adjacent nodes.
  3. Network routing of information.
  4. Control of end-to-end communication.
  5. Non-communication problem-solving.
  6. Conversion of information.
  7. Provision of services to applications

An interface engine uses all the layers mentioned above to collect and distribute HL7 data, with layers 1 through 4 handling communication and 5 through 7 handling functionality.

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hl7 fhir integration

What is the Difference between API and HL7?

APIs and HL7 facilitate communication and data sharing between differing programs. However, a firm grasp of health level seven and application programming interfaces is required to appreciate the distinctions between the two.

Health Level 7 (HL7) was the initial standardized data interchange format utilized in healthcare. It supplied a uniform structure that applications could use for transmitting data about patients to each other. Despite this, encryption and strong integrity checking were not incorporated when the format was first introduced. Nevertheless, many applications are still relying on it.

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The Final Rule of the 21st Century CURES Act is a significant development in healthcare data transfer. It allows patients to use Application Programming Interfaces (APIs) to access their health data via their preferred application, thereby fulfilling the original purpose of the Health Insurance Portability and Accountability Act (HIPAA). The Security Rule requires organizations to secure data transmission, imposing additional controls to protect the integrity and detect any tampering in real-time. APIs offer a modernized alternative to HLA, using a uniform authentication format for applications to identify users correctly. Many websites and applications are currently employing this format.

If you want to know more about HL7 FHIR integration, you should definitely listen to our CareMinds podcast, particularly the episode with Redox specialist Nick McKenzie.

Nick went on to work with the EHR integration architecture, which he compares to building a house, where an entire team of contractors, roofers, electricians, and plumbers work cohesively under an architect. 

“I was always fascinated with this idea of being the translator helping clinicians translate their requirements into what they wanted the system to be designed and then translating back to the technical teams how to execute and interestingly enough. It’s all that product management really is.”

Watch other episodes as well!

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Difference

API

HL7

Meaning

Application Programming Interface

Human Level 7

Support 

APIs, including SMART and FHIR, can support standard medical portals

Does not provide comprehensive support for technologies

Patient outcome

Due to the convenience of “on-demand” data retrieval, APIs are favored over HL7

Data is provided by HL7 on a subscription basis, implying that it will be obtained regardless of whether or not it is immediately required

Security

More precise definitions of security rules are provided by APIs, further facilitating interoperability between systems

HL7 can secure data but with limitations in encryption and robust integrity checking

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Benefits of HL7 for Medical Facilities 

The following are reasons why using HL7 is so important in the healthcare industry.

Healthcare professionals can utilize HL7 to quickly and conveniently access patient data from multiple sources, making savvy decisions promptly. 

HL7 provides a standardized language for data and information exchange, thus promoting unification in the healthcare system by ensuring that all data is registered, stored, and exchanged in the same way.

By taking advantage of HL7, medical facilities can better administer their patients’ care by providing an encompassing view of their medical history; thereby allowing caregivers to readily access patient information and make the best decisions for their treatment. 

Hospitals can establish a standard data-sharing methodology between various systems, guaranteeing that data is accurately and securely shared and enabling healthcare providers to make informed decisions concerning patient care.

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data interoperability

HL7 Applications in Healthcare

Here are some examples of its application in the healthcare industry.

Integrating their existing patient records system with an HL7-compatible system allows a medical center to access patient records and information stored in multiple departments swiftly and effortlessly. This facilitates a hospital’s ability to identify and treat patients quickly and reduces expenditure and time on needless paperwork.

Implementing HL7 integration allows laboratories to rapidly and accurately process patient data and results. It promotes the rapid detection of potential issues and addresses them instantly, resulting in enhanced accuracy and effectiveness in testing results.

Linking their existing patient records and billing systems to an HL7-compatible system helps a healthcare provider quickly and easily process patient claims. This enabled the healthcare provider to save time and money on manual data entry while ensuring a higher accuracy rate.

HL7 integration allows for interoperability between providers, making it possible to share clinical and administrative data. For instance, physicians can conveniently send laboratory results to specialists for a second opinion.

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hospital information systems

HL7 integration enables EMR systems  to communicate with one another and share patient data. This helps reduce the time spent inputting information manually and eliminates the possibility of data entry errors.

What Does It Mean to Integrate HL7 and FHIR?

As already discussed, HL7 are standards used to define how healthcare information is collected, interpreted, and shared, making data integration more efficient and free of errors. Running a healthcare organization requires using multiple systems and technologies by doctors, administrative staff, accounting, and pharmacy staff. Most of these platforms are isolated and written in different programming languages, resulting in communication hiccups that can negatively affect patient care. Implementing HL7 integration allows 80% of the interface to be defined, leaving 20% of the interface available for customization.

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FHIR (fast health interoperability resources), developed in 2011 by HL7, is the latest development in HL7 standards. Its integration allows improved security measures and larger data formats. FHIR incorporates functionalities of previous HL7 standards and additional features to make interoperability among healthcare applications even more efficient. Using web standards, communication across all systems can be achieved irrespective of system languages and specifics while removing the need to connect interfaces manually. Some technologies known to run using this standard include:

  • HTTPS
  • REST
  • XML
  • JSON
  • ATOM
  • OAuth
health information systems

HL7 Interfaces, Engines, and Strategies

With different technologies used in various areas of a healthcare facility, a need for a standard approach to the handling of medical data resulting in substantial productivity delays and increased patient risks. With the segregation of data resulting in several inefficiencies, the need for a healthcare industry-accepted standard way of sharing healthcare data among several departments was apparent, resulting in the creation of HL7.

An interface defined in healthcare IT structures refers to programs implemented to facilitate seamless data transfer between systems using different messaging protocols. A typical example of an interface will be one connecting systems in the lab, pharmacy, registration, and an electrocardiogram machine.

Interface engines (integration engines) act as the guide to the exchange of data across systems from which it gets its nickname as the “traffic cop.” These engines act as the hub of a healthcare data exchange in a health facility. They are responsible for receiving, routing, and translating messages into the right formats to be understood by the recipient system, simplifying health integration processes. 

Other ways interface engines communicate include; File transfer protocols (FTP), Direct database updates, and XML.

Examples of highly rated interface engines include;

  • IGUANA
  • Datagate
  • Rhapsody
  • Corepoint
  • Cloverleaf
manual interface coding

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Several strategies are employed in the integration of HL7.

  • The development of a method of interoperability standards from a reference information model
  • Creation of awareness on the benefits of information standardization to the healthcare providers and the public
  • Creation of clear standards in health information sharing between systems
  • Encourage HL7 interoperability use through affiliation with establishments
  • Ensure HL7 standards are up to standard through collaboration with healthcare IT users
  • Foster the participation of healthcare industry experts in HL7 to develop healthcare data standards in their various areas of expertise
    duplicate paper records

    FHIR Integration: Elevating Healthcare Information Exchange

    Instead of rushing to implement the latest phase of your HL7 data integration, you should assess your health system and design a custom interface solution that meets your specific needs while still being affordable and scalable as your organization grows. Successfully integrate HL7 calls for a specialized interface team and coordinated testing from industry professionals.

    Integration of FHIR entails three main steps:

    • Interface planning
    • Developing an interface
    • Final testing and validation

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    Data entry duplication can be reduced, while user workflow is enhanced by employing application interoperability if HL7 interfaces are properly integrated. In a healthcare setting, HL7 interfaces can be found everywhere. Among these are “Admission, Discharge, and Transfer” (ADT), “Detailed Financial Transaction” (DFT), “Observation Results,” “Orders,” “Medical Document Management” [MDM]), “Master Files Notification” [MFN] and “Billing Account Record” [BAR] and so on.

    Your business model and the features of each interface should be carefully evaluated before you settle on an integration strategy. This procedure will help you determine what features your ideal interface must have. Proper project execution also necessitates identifying and including the appropriate staff and clinicians.

    After these have been discovered, a thorough examination of the procedure is necessary to detect data errors.

    This step is further subdivided into:

    • Execution phase during which interface engineers are hard at work developing and specifying each port and its associated data
    • Interface building entails creating and incorporating necessary interface specifications, data types to be processed by the interface, and record numbering schemes
    • Testing: as the name suggests, testing is where flaws in the flow of information from its originator to its intended recipient are discovered
    seamless integration fhir

    The complete HL7 integration is examined in this stage, from its structure to its content. To put it simply, this is the most crucial stage. It is also sub-divided into:

    • Unit testing: The goal is to catch mistakes the interface engineer may have missed, resulting in more precise data.
    • Integrated testing: During this testing stage, data is examined both from the upstream and the downstream perspectives.

    Final Thoughts 

    In conclusion, HL7 integration is an important process for the healthcare industry, enabling hospitals to access and share patient data in a secure and efficient manner. With the right tools and expertise, organizations can easily implement HL7 integration and benefit from its many advantages. We recommend you start by assessing your needs and resources for the project. The team at The APP Solutions has years of experience in the healthcare IT industry and is highly knowledgeable in the complexities of data integration. We work with you every step of the way to ensure that the process goes smoothly and that all of your needs are met.

    EMR Integration in 2023: What You Need to Know

    EMR integration’s significance is undeniable; it enables better decision-making, reduces medical errors, and boosts patient engagement. Electronic Medical Systems function independently, but for optimal results, they need to interact. Regrettably, many hospitals don’t practice this.

    Our experience with Bueno clarified the issue. Bueno applies machine learning to analyze user’s EHR data, ensuring timely preventive care. The app shares this data with the healthcare team to advise patients on check-ups, lab tests, or symptom watch.

    But there was a hurdle. Healthcare providers could see the data, but accessing records from different platforms was a struggle. To solve this, we merged various solutions, consolidating all data in one spot. We used platforms like Orb Health, Validic, and Mayo Clinic.

    Today, we’re aware that EMR integration issues still persist in many medical firms. In this article, we’ll guide you on connecting different EMRs, explain its necessity, and discuss potential challenges.

    What is the EMR system?

    An EMR system is a digital platform stored in the cloud, holding patient medical data. In the not-so-distant past, medical data was etched on paper, stored in bulky folders, and piled high on shelves. Clinicians had to leaf through these volumes, laboriously seeking the information they needed to make swift diagnoses. However, with EMR systems, this relic of a practice is no longer a necessity.

    Imagine no longer battling with ink and paper, but rather smoothly navigating a sleek digital platform. This digital library, or EMR, neatly organizes and securely stores patient data. It’s a resource for medical history, diagnostic data, lab test results, appointments, billing details, and more.

    It’s not only doctors who have access to this knowledge. Patients, too, can step into this library. Through a digital door known as a patient portal, they can glance at their health story unfolded.

    Every prescribed medicine, every immunization, every treatment plan is at their fingertips, as well as the doctors’. Informed decisions can then be made, not only based on a single page of information but the entire medical narrative of the patient. The EMR system, hence, is a potent tool empowering both the healthcare provider and the recipient, and typically includes:

    • Medical history
    • Diagnostic information
    • Lab test results
    • Appointments
    • Billing details
    • Prescription and refill data from pharmacies
    • Patient portals
    • Treatment plans
    • Immunization records

    What Are Examples of EMR Platforms?

    There are over 600 EMR vendors according to review sites. However, we’ll focus on discussing those we’ve successfully integrated at The APP Solutions. We’ll share our experiences with CernerAmbulatory, Epic EMR, DrChrono, and eClinicalWorks.

    Cerner

    Cerner, a US medical software titan, delivers digital health data solutions. It caters to multispeciality and smaller practices. Key offerings include Cerner Powerchart, Caretracker, and Cerner Millenium.

    Key Features: population health, revenue cycle, medical reporting, lab information, and patient portal.

    Cerner Pros:

    • Strong interoperability promotes collaboration.
    • Cost-effective for small practices.
    • Advanced patient portal for health information.
    • Software can mimic practice’s branding.

    Cerner Cons:

    • Fewer integrations, such as CRM.
    • Regular updates can pose learning challenges.

    Epic EMR

    Epic EMR is a hospital favorite, holding medical records for over 253 million Americans. It shines in large settings. Notable features are telemedicine, billing, e-prescription, templates, and analytics.

    Epic EMR Pros:

    • Detailed patient information reports.
    • Telehealth for remote consultations.
    • AI and analytics to enhance decision-making.

    Epic EMR Cons:

    DrChrono

    DrChrono provides web and app-based EMR systems. It assists with appointments, reminders, and billing, automating routine tasks.

    Key Features: patient charting, telehealth, appointment scheduling, and reminders.

    DrChrono Pros:

    • Affordability benefits small or new practices.
    • Comprehensive training for software admins.
    • Secure direct messaging for patients and doctors.

    DrChrono Cons:

    • No Android app for doctors.
    • Limitation on appointment reminder methods.

    eClinicalWorks

    eClinicalWorks supplies digital health records, patient management, and population health solutions. It caters to over 4000 US clients. Key features are revenue cycle management, patient portal, wellness tracking, activity dashboard, and telehealth.

    eClinicalWorks Pros:

    • Operates on multiple platforms like Mac and Windows.
    • User-friendly interface.
    • Interoperability connects with other systems.

    eClinicalWorks Cons:

    • Pricey for small practices.
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    Why Is EMR Integration Important for Healthcare Companies?

    The healthcare sector is one of the world’s top data generators. It is critical that the data generated is collected and accessible from a single point. The main reasons why integrating EMR is important will be discussed below.

    Securing Sensitive Information 

    Healthcare, a prime target for cyberattacks, experienced 5.8% of total cyber-attacks in 2022. They focused on health records. EMR systems, HIPAA-compliant, strengthen data security. They safeguard patient records against cyber threats and natural disasters.

    Streamlining Data Access

    EMR integration offers a solution for data fragmentation. It consolidates patient records, making them easily accessible. So, doctors can view complete patient histories at a glance. This aids in accurate diagnoses.

    Enhancing Workflow

    Consider the effect of a unified report system. It would compile laboratory, pharmaceutical, and dental department data. This results in efficiency. Doctors make quicker decisions. They don’t wait for paper-based results. Automated record collection lightens staff workload too.

    Safeguarding Patient Safety

    Keeping patient data in different systems can cause errors. In fact, medical mistakes are the third leading cause of death in the U.S. EMR integration helps. It detects errors in record keeping, thereby promoting patient safety.

    Improving Healthcare Outcomes

    Access to complete patient information benefits healthcare providers. It leads to better understanding of patients’ conditions and helps doctors diagnose accurately. Also, timely access to records informs the design of preventive measures.

    Boosting Patient Engagement

    EMR systems do not just serve healthcare professionals. Patients also access their information. This breeds interest and empowerment. Patients become proactive in managing their health. Plus, easy doctor access via telehealth lessens the stress of physical consultations.

    Are There Any Challenges?

    Healthcare providers often hesitate to integrate Electronic Medical Records due to its complexity. Let’s explore the most common issues.

    Cost Barrier: How Affordable Are EMR Solutions?

    Deploying an EMR system can burn a hole in your pocket. Initial implementation may require you to shell out around $100,000. Small-sized practices might find this cost daunting. But, don’t worry. More wallet-friendly options like pre-built systems exist. Take Dchrono for instance. With a monthly fee of just $19, it’s a suitable pick for growing establishments.

    However, be mindful if you’re eyeing free EHRs. In fact, we don’t recommend open source systems. They usually come with restrictions – lack of customization and a ceiling on patient data storage. Moreover, the choices for free EHR systems are slim. Due to their vital role in healthcare – with lives at stake – most prefer not to risk relying on a totally free, open-source EMR.

    Compatibility with Legacy Systems 

    Facilities already having EMR systems might wish to unite them through a single solution. However, finding one that fits all systems like a glove is a considerable challenge. The different systems might store data in diverse formats, complicating the integration process.

    Transitioning Data

    Migrating data from paper to digital, while linking it all, demands considerable effort. It might take weeks or months to transfer all health information completely. During this phase, potential information loss could shake patient trust. Careful planning and adequate time allocation can help manage this issue effectively.

    Data Protection 

    A tough nut to crack in EMR integration is securing private data. With medical records susceptible to breaches, it’s crucial to ensure watertight security. As an illustration, in 2021 alone, cyber-attacks exposed over 45 million records. To combat this, opt for a HIPAA-compliant vendor with a strong security framework.

    Human Errors (Training and Adaptation)

    Human-related challenges could put a spoke in the wheel of EMR integration. Resistance from staff towards the new system, incorrect data entry, and lack of training are common obstacles. Implementing a thorough training regimen can help staff adjust to the EMR software, ensuring accurate health record entry.

    Navigating Interoperability

    Interoperability lets healthcare providers share patient data. For interoperability to be comprehensive, FHIR and HL7, and other interoperability standards come into play.  

    If you want to know more about them, check out our post on the differences between HL7 and FHIR

    That said, achieving smooth data exchange isn’t that simple.

    Firstly, not all systems speak the same ‘language’. We’ve got multiple data formats to deal with. Translating them so they align is a Herculean task.

    Additionally, ensuring data safety while exchanging it between systems is tough. Security has to be top-notch. A single leak can breach patient privacy.

    It’s also about change – old habits die hard. Many healthcare providers are still adjusting to new protocols. It takes time to shift from traditional methods.

    Step-By-Step Guide to EMR Implementation 

    Here’s a roadmap to help you through integrating your EMR.

    Phase 1: Blueprint of Preparation

    Begin your EMR integration journey with meticulous planning. Identify the needs of your practice, devise your strategy, set goals, and allocate time for staff training and the overall implementation process. The size of your practice and the volume of data to handle are crucial to your planning.

    Phase 2: Structuring the Design

    The next stage is design. You’ll need to consider the features you want in your EMR system. Focus on developing a tailor-made solution that connects all your EMRs and ensures an easy-to-navigate interface for your staff.

    Should you desire a patient portal and telehealth functionalities, incorporate a mobile-friendly design. Consider engaging a development team to help with coding architecture at this stage.

    Phase 3: Building the Infrastructure

    Next, transform your design into functional software. This phase entails converting data from diverse formats across various EMRs. Given the potential risk of errors, which could compromise patient safety, it’s paramount to ensure accurate conversion of data. Always double-check to mitigate mistakes.

    Phase 4: Testing the Functionality

    Post-construction, the system needs to be rigorously tested. This step aims to identify any bugs, gauge user interactions, and evaluate the system’s reliability, data precision, and impact on your operations.

    Phase 5: Activation and Launch

    Finally, you’re ready to go live. Ensure your system complies with HIPAA regulations for health data security. Be open to feedback from users to facilitate continuous improvement.

    Upon successful implementation, your new system should improve operational efficiency for your staff and enhance patient health outcomes.

    Phase 6: Empowering through Training

    Staff training is a critical aspect of EMR integration. Compile a comprehensive training manual to guide your staff through the new system. As not all employees may be tech-savvy, split the training into manageable segments for ease of comprehension.

    EHR Vs. EMR Integration: Which Is Right for Your Practice?

    Before going digital, you must pick. Is EHR or EMR right for you? Here’s how they compare. 


    EMR

    EHR

    Data Scope

    Records patient data in one practice.

    Stores patient data from all providers.

    Sharing

    Shares data within one practice.

    Shares data with multiple health professionals.

    Data Transfer

    Transferring data is difficult.

    Transferring data is easier.

    Data Focus

    Focuses on diagnosis and treatment.

    Gives a broad view of patient’s care.

    Patient Access

    Mainly for providers’ use.

    Patients can also access their records.

    Care Continuity

    Good for tracking data in one practice.

    Better for sharing updates with other caregivers.

    Your choice between an EHR and an EMR depends on the needs of your practice and your patients. If you value a comprehensive, shareable, and patient-involved approach, an EHR might be a better fit. On the other hand, if you’re a single practice focusing on diagnosis and treatment, an EMR may suit you best.

    Choosing a Healthcare Integration Service

    Healthcare integration services, like EMR, ERP, and EHR, manage health information. When selecting one, you need to consider several key factors:

    Growth Capability

    When setting up an integration system, think long-term. Partner with an experienced vendor. They can help you grow your operations without losing data.

    Data Safety

    You will handle private data. So, your vendor must prioritize security. They should have proper industry certification. Also, they must understand HIPAA and other compliance needs.

    Trustworthiness

    Don’t entrust data management to an inexperienced vendor. Read reviews of different vendors. Talk to their current or past clients to judge their skills.

    Adaptability

    Avoid vendors with slow, inflexible systems. Choose a vendor that can adapt to your specific needs. This prevents unnecessary additions and keeps costs down.

    Customer Service

    Your vendor should provide excellent support. Fast responses to issues can prevent major downtime. This keeps your patients satisfied.

    Conclusion

    Implementing an EMR system brings great benefits to healthcare providers. Despite challenges like costs, the rewards are greater. To implement the steps we discussed, you need a skilled software development company.

    The APP Solutions is that company. We’re qualified to build your EMR integration system. We support you through every development stage, from defining business goals to selecting the best vendor for your practice.

    Connect with us to discuss your project

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