HL7 FHIR Integration Process for Better Interoperability

Healthcare is increasingly moving online, with data flowing from mobile apps, web platforms, and smart devices. Healthcare companies now share patient data, vaccination information, and other vital details through software systems.

The primary goal of leveraging modern technology in healthcare is to enhance the patient experience, but this cannot happen without seamless data exchange across systems.

Given the complexity of achieving interoperability and HL7 FHIR-specific expertise, it's better to delegate implementation to a third-party vendor. Binariks has extensive experience in healthcare services , with expertise in HL7 FHIR regulation and compliance with the latest security regulations.

This post covers the meaning of FHIR, its origin, and its services. We also highlight the main challenges and tasks solved by the FHIR integration process.

What are Fast Healthcare Interoperability Resources

Fast Healthcare Interoperability Resources (FHIR) is a novel specification among HL7 API standards created to regulate electronic data exchange in health information systems. FHIR for healthcare can be applied as a stand-alone standard or a specification connected to other HL7 compliance principles.

The main purpose is to regulate APIs for quick and secure health information exchange.

As the newest HL7 EMR integration specification, FHIR allows adapting the main principles of previous standards to the most relevant industry trends and provides interoperability for health networks. Moreover, FHIR electronic health information exchange (HIE) specification is free, which means all resources to become compliant are freely available.

The essentials of the FHIR healthcare specification

FHIR integration in healthcare make the following types of data available in a health information system:

• adjudicated claims;
• provider payment;
• enrollee cost-sharing;
• laboratory results and other clinical data.

The standard is based on FHIR EMR integration resources. Healthcare providers use modular components to solve clinical and administrative problems. FHIR resources include:

• a built-in extension mechanism that works with the defined types of data;
• readable FHIR documentation for human use,
• a common set of metadata.

In different combinations, healthcare companies use resources to define information contents and structure information sets for most common use cases.

The story of HL7 standards and FHIR

The predecessor of FHIR, HL7 V2, was developed in 1989 to address interoperability issues. It streamlined communication between various systems with different functions, such as electronic medical records (EMR), hospital information, radiology and image archiving, laboratory information, and billing systems.

The exchange of patient information between different parts of the healthcare process (such as care - pharmacy - billing) was complicated before this data formatting standard. Transferring between specialists and hospitals was also time-consuming because patients had to carry paperwork, create a new medical record, and undergo examinations and testing. For all parties in the healthcare industry, data sharing was a nightmare.

HL7 software integration provides clear instructions on integrating healthcare systems with multiple components. The standard defines 80% of the interface, leaving the remaining 20% open for customization: local data variations introduced by optional fields, extra messages, etc. HL7 used ASCII-based (American Standard Code for Information Interchange) messages with encoding rules, groupings, cardinality, and the default character set to achieve messages' standard look and meaning.

The standard was a significant step toward interoperability, and developers could avoid substantial manual interface coding. According to HL7 International, 95% of healthcare institutions in the United States currently use HL7 V2 (Source ).

The HL7 FHIR API is the latest word in the HL7 standards. FHIR supports more data formats, provides better security, and enables developers to connect practically any health app. It includes everything the previous standards offer and even more, making healthcare interoperability easier to achieve.

HL7 FHIR integration challenges

HL7 integration and data interoperability standards may be confusing if you have never worked with them. As a result, there are still numerous challenges for data interoperability in healthcare systems.

There is far too much variation

Traditional FHIR HL7 integrations allow for too much customization and much-unspecified data semantics, resulting in data variance. Essentially, different values may have different meanings in different systems. For example, in one system, the value "3" may be used for smokers and in another for former smokers. It leads to misinformation and confusion about a patient's health, which can have disastrous consequences.

Complicated interface programming

To connect two systems, a great deal of programming and knowledge of both systems are required. You also have to monitor and test the interfaces for any disruptions constantly.

Normalizing data is still difficult

Even though FHIR is much more universal than other HL7 standards, challenges still exist in normalizing the data from multiple sources. For example, claims or clinical data is not sure to return brief and clear information via the API. It may result in unnecessary information being sent and received and privacy concerns.

The standard is sometimes detached from reality

Traditional HL7 FHIR data integration was created in response to clinical interface specialists' recommendations. It was mostly about "how it's supposed to work and help," rather than asking end-users about their problems. The latter's complaints were only heard while creating HL7 integration software, but it was too late. As a result, hypotheses became too detached from reality and failed to address most issues.

How to ensure adequate FHIR integration?

Integrating certified health information technology into your healthcare API processes requires solid technical HL7 integration expertise. Secure warehousing and a thoroughly planned step-by-step approach are essential for healthcare providers focused on successful data integration.

Cloud-based technologies are a tried and trusted solution for integrating FHIR APIs into digital healthcare systems . For example, Amazon provides its Platform as a Service (PaaS) that can be used by healthcare vendors interested in embracing FHIR implementation . One can also mention large numbers of open-source FHIR implementations that ensure interoperability of AWS technologies and FHIR software integration management.

The lack of technical expertise and appropriate technology stack may lead to failure in HL7 FHIR integration with API. The most dependable decision is to outsource the integration of secure health information exchange mechanisms to credible health IT vendors. A reputable technology partner can enhance this process by providing the following benefits:

• Quality
• Expertise
• Relevant insights and far-reaching ideas
• Shorter time-to-market
• Security
• Cost-efficiency

HL7 FHIR API will accelerate your success by providing a ready, smart, plug-in platform that already runs three-quarters of the race to build outstanding FHIR interfaces for you and your customers.

Simplifying EMR to FHIR integration

FHIR EMR integration is simplified by following best practices. Here are some of the key ones:

1. Configure EMR interface: Identify source and target systems for smooth data exchange between EMR and FHIR.
2. Map EMR data to FHIR: Use APIs or middleware to map EMR data fields (e.g., patients, observations) to corresponding FHIR resources.
3. Define data route: Determine the source, apply necessary operations (decryption, formatting), and prepare the data for routing.
4. Route data to target systems: Direct data to the appropriate target system and use transaction monitors to catch and address errors.
5. Convert data to XML: Map source and target data to HL7 standards and convert it to a standardized XML format.
6. Transport data: Secure and send the data using HTTP post or HL7 message over MLLP after encryption and compression.
7. Test and deploy: Thoroughly test the interface to identify and fix errors, then deploy to enable FHIR-integrated, interoperable EMR systems.

What EMRs can be integrated with HL7 FHIR?

Many EMRs (Electronic Medical Records) can be integrated with HL7 FHIR due to the widespread adoption of FHIR as a standard for healthcare data exchange. Below are some of the most commonly used EMRs that support or can be integrated with HL7 FHIR:

Epic Systems

Epic provides a FHIR-based API called Epic on FHIR, a robust, highly documented API with broad FHIR resource coverage (e.g., Patients, Appointments, Medications, Labs). It is deeply integrated with the core to the point of real-time data exchange.

Cerner

Cerner supports FHIR through its Cerner Ignite APIs (access to patient data, medications, lab results, and more). It is just as well-integrated as Epic. Cerner also supports a marketplace for third-party applications that integrate through FHIR, allowing healthcare organizations to build custom apps on top of its API.

Read more about Cerner EHR integration .

Allscripts

Allscripts provides a FHIR API through its Allscripts Developer Program, offering access to clinical data, medications, allergies, and more. It’s less comprehensive than Epic or Cerner, but it covers essential resources. Allscripts is generally focused on ambulatory and outpatient care, so its FHIR API might not be as deeply integrated into hospital workflows. However, it offers good coverage for clinical and administrative data.

MEDITECH

MEDITECH has integrated FHIR into its system. The scope is more limited compared to larger systems like Epic or Cerner. It provides access to key data such as patient records and clinical data. MEDITECH primarily serves smaller healthcare organizations and has a less sophisticated API structure. FHIR implementation is solid but less comprehensive in terms of bidirectional data exchange.

eClinicalWorks

eClinicalWorks provides FHIR API support for patient data, clinical summaries, and lab results, making it a popular option for clinics and ambulatory care settings. It’s integrated well into outpatient workflows and is primarily focused on ambulatory and specialty care rather than large hospitals.

Overall, EPIC and Cerner offer the most robust FHIR integration. EMRs like Athenahealth and NextGen provide decent FHIR support but focus more on smaller healthcare settings like outpatient clinics.

Tasks that can be solved using HL7 integration with API

The HL7 FHIR integration in healthcare increases the quality of many tasks, including:

Patients get more control over their health records

87% of patients want access to medical data such as X-rays in their EHRs (Source ).

The 21st Century CURES Act Final Rule allows patients to use APIs to download their health data into their preferred applications, enhancing control over their medical records. Patients can access and manage data like X-rays, prescriptions, and dietary restrictions, helping them understand their condition, manage treatments, identify errors, and make informed health decisions.

Researchers get more quality data on patients and their treatments

Researchers gain access to structured, high-quality data essential for public health analysis, treatment evaluations, and AI training in diagnostics.

Complying with FHIR APIs ensures that this data is exchanged seamlessly and securely. With HL7 integration API capabilities, researchers can access well-structured data in real-time, while technologies like OAuth2 and SHA-256 cryptographic hashing maintain secure access and data integrity, supporting compliance with the latest security standards. FHIR enables the easy flow of well-structured data suitable for analysis.

The staff becomes more mobile

With FHIR, healthcare staff can integrate HL7 data with mobile devices, improving communication and reducing paperwork duplication. HL7 and API integration allow staff to access and update patient data from anywhere, enhancing workflow efficiency.

By leveraging modern security technologies like TLS and adhering to the CURES Act Final Rule, organizations ensure that sensitive patient data is securely accessed across departments, providing better care coordination and robust data protection. Doctors can also avoid duplicate paper records by simply updating a patient's health status at any point of care, such as in their room, emergency room, or doctor's office.

Conclusion

Integrating systems following FHIR standards is necessary to provide the best patient care and experience in an increasingly digitized world.

Binariks is ready to assist your organization in creating HL7 FHIR integration software and making the entire process easier by providing ready-made assets, converters, and libraries. We have expertise in working with various technologies and a significant list of satisfied healthcare clients .

Do not hesitate to contact us if you want to take that step toward HL7 integration data and interoperability in your organization.