HL7 and FHIR Integration
Diatom Enterprises has extensive experience in healthcare IT, including involvement in the development process for the Latvian National e-Health system, which leveraged HL7 standards. We have cultivated an innovative and efficient approach to integrate with 3rd party external web services utilizing various HL7 interfaces, including modern FHIR-based APIs. Our Senior Software developers possess deep expertise across the HL7 standard family, ensuring robust solutions through strict built-in quality control, heavy usage of Unit tests, Integration tests, and Functional testing solutions (such as SoapUI products).
About HL7 Standard
Health Level Seven (HL7) is a non-profit organization dedicated to developing international healthcare informatics interoperability standards. The term “HL7” also refers to the specific standards created by the organization, which provide a comprehensive framework for the exchange, integration, sharing, and retrieval of electronic health information. Key standards include HL7 v2.x, HL7 v3.0, HL7 CDA (Clinical Document Architecture), and the increasingly prevalent HL7 FHIR (Fast Healthcare Interoperability Resources). While HL7 v2.x versions have historically been the most widely adopted globally for supporting clinical practice and health service management, newer standards like FHIR are rapidly gaining traction due to their modern approach to interoperability.
Organization
HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information.
HL7 standards
HL7 offers a range of standards with varying accessibility models. While some older HL7 standards or certain aspects of their implementation might have historically involved membership for full access to specifications or tooling, the modern approach, particularly with FHIR, emphasizes openness. The core HL7 FHIR specifications are freely available for use, promoting widespread adoption and innovation in healthcare interoperability. HL7 International maintains an Intellectual Property Policy that balances the need for sustainable development with broad accessibility. Organizational membership in HL7 provides additional benefits, such as participation in work groups, access to advanced tooling, and voting rights, which contribute to the ongoing evolution of the standards.
Hospitals and other healthcare provider organizations typically have many different computer systems used for everything from billing records to patient tracking. All of these systems should communicate with each other (or “interface”) when they receive new information but not all do so. HL7 specifies the number of flexible standards, guidelines, and methodologies by which various healthcare systems can communicate with each other. Such guidelines or data standards are a set of rules that allow information to be shared and processed in a uniform and consistent manner. These data standards are meant to allow healthcare organizations to easily share clinical information. Theoretically, this ability to exchange information should help to minimize the tendency for medical care to be geographically isolated and highly variable.
HL7 develops conceptual standards (e.g., HL7 RIM), document standards (e.g., HL7 CDA), application standards (e.g., HL7 CCOW), and messaging standards (e.g., HL7 v2.x and v3.0). Messaging standards are particularly important because they define how information is packaged and communicated from one party to another. Such standards set the language, structure and data types required for seamless integration from one system to another.
HL7 encompasses the complete life cycle of the standards specification including the development, adoption, market recognition, utilization, and adherence. HL7 International currently asserts that business use of the HL7 standards requires a paid organizational membership in HL7, Inc. HL7 Members can access standards for free, and non-members can buy the standards from HL7, ANSI, or for some standards, ISO.
The Reference Information Model (RIM) and the HL7 Development Framework (HDF) are the basis of the HL7 Version 3 standards development process. RIM is the representation of the HL7 clinical data (domains) and the life cycle of messages or groups of messages. HDF is a project to specify the processes and methodology used by all the HL7 committees for project initiation, requirements analysis, standard design, implementation, standard approval process, etc.
HL7 FHIR: The Modern Standard
HL7 FHIR (Fast Healthcare Interoperability Resources) represents a significant evolution in healthcare interoperability standards, designed to be modern, flexible, and easy to implement. Built on contemporary web standards, FHIR leverages RESTful APIs, JSON, and XML for data exchange, making it highly compatible with internet-based applications and mobile platforms.
Key characteristics and advantages of FHIR include:
- Modern Web Technologies: Utilizes familiar web technologies like RESTful APIs, JSON, and XML, reducing the learning curve for developers.
- Resource-Based: Data is organized into granular, self-contained “resources” (e.g., Patient, Observation, Medication), which are easily manageable and can be combined to solve clinical and administrative problems.
- Interoperability: Designed for rapid implementation and broad interoperability across diverse systems and organizations, supporting real-time data access.
- Extensibility: Allows for customization and extension to meet specific local or regional requirements without breaking core compatibility.
- Open and Free: The core FHIR specification is freely available for use, fostering a vibrant ecosystem of developers and implementers.
FHIR is rapidly becoming the standard of choice for new healthcare IT initiatives, driving innovation in areas such as patient access to data, mobile health applications, clinical decision support, and public health reporting. Many healthcare organizations operate in hybrid environments where HL7 v2 and FHIR coexist, with FHIR often preferred for new applications and patient-facing solutions.
Clinical Document Architecture – ISO/HL7 27932
The HL7 Clinical Document Architecture (CDA) is an XML-based markup standard intended to specify the encoding, structure and semantics of clinical documents for exchange.
Methods applied by HL7
Services Aware Interoperability Framework
The HL7 Services-Aware Enterprise Architecture Framework (SAIF) provides consistency between all HL7 artifacts, and enables a standardized approach to Enterprise Architecture (EA) development and implementation, and a way to measure the consistency.
SAIF is a way of thinking about producing specifications that explicitly describe the governance, conformance, compliance, and behavioural semantics that are needed to achieve computable semantic working interoperability. The intended information transmission technology might use a messaging, document exchange, or services approach.
SAIF is the framework that is required to rationalize interoperability of other standards. SAIF is an architecture for achieving interoperability, but it is not a whole-solution design for enterprise architecture management.
Arden syntax
The Arden syntax is a language for encoding medical knowledge. HL7 adopted and oversees the standard beginning with Arden syntax 2.0. These Medical Logic Modules (MLMs) are used in the clinical setting as they can contain sufficient knowledge to make single medical decisions.[citation needed] They can produce alerts, diagnoses, and interpretations along with quality assurance function and administrative support. An MLM must run on a computer that meets the minimum system requirements and has the correct program installed. Then, the MLM can give advice for when and where it is needed.
MLLP
A large portion of HL7 messaging is transported by Minimal Lower Layer Protocol (MLLP), also known as Lower Layer Protocol (LLP). For transmitting via TCP/IP, header and trailer characters are added to the message to identify the beginning and end of the message because TCP/IP is a continuous stream of bytes. Hybrid Lower Layer Protocol (HLLP) is a variation of MLLP that includes a checksum to help verify message integrity. Amongst other software vendors, MLLP is supported by Microsoft and Oracle.
CCOW
CCOW, or “Clinical Context Object Workgroup,” is a standard protocol designed to enable disparate applications to share user context and the patient context in real-time, and at the user-interface level. CCOW implementations typically require a CCOW vault system to manage user security between applications.
Full Article link: http://en.wikipedia.org/wiki/Health_Level_7