Question 1

What is HL7 data integration?

Accepted Answer

HL7 data integration is the process of sharing and exchanging healthcare information between different systems using the Health Level Seven International (HL7) standards, which define the format and structure of electronic health data. Read our HL7 Case Studies.

Question 2

How does an HL7 interface engine work?

Accepted Answer

An HL7 interface engine is a middleware tool that simplifies data integration by managing the communication, translation, and routing of HL7 messages between disparate healthcare systems.

Question 3

What is an HL7 message?

Accepted Answer

Each HL7 message indicates the healthcare trigger event defined by the HL7 Standard. It defines the specific healthcare information being exchanged in each message type. The HL7 Standard identifies hundreds of data elements for communicating patient demographic, clinical, and financial information and describes the specific set or combination of segments that make up a properly formed message.

Question 4

What are the most popular HL7 message types?

Accepted Answer

Each HL7 message sends information about a particular event – such as a patient admission via ADT (Admit, Discharge, Transfer). Message types have different sub-types. For example, there are over 50 different sub-types of ADT messages. Common HL7 message types include:

ACK – General acknowledgment
ADT – Admit, Discharge,Transfer
BAR – Add or change billing account
DFT – Detailed financial transaction
MDM – Medical document management
ORM – Order (Pharmacy/treatment)
ORU – Observation result (unsolicited)
SIU – Scheduling information unsolicited

Question 5

What is the relationship between HL7 integration and healthcare analytics?

Accepted Answer

HL7 integration enables the collection and exchange of healthcare data, which can be aggregated, analyzed, and used to generate insights for improving patient care, streamlining clinical workflows, and enhancing the overall efficiency of healthcare organizations. Read our HL7 and data analytics case study.

Question 6

What is HL7 CDA, and how is it used?

Accepted Answer

Clinical Document Architecture (CDA) is an HL7 standard for exchanging structured clinical documents, such as discharge summaries and progress notes. CDA documents are XML-based and combine human-readable content with machine-readable structured data.

Question 7

What is FHIR, and how does it relate to HL7?

Accepted Answer

Fast Healthcare Interoperability Resources (FHIR) is a modern, web-based standard developed by HL7 for exchanging healthcare data. FHIR uses RESTful APIs and supports JSON and XML formats, making it easier to implement and integrate.

Question 8

Does PilotFish provide guidance on building interfaces for multiple EHRs?

Accepted Answer

Yes, PilotFish offers a comprehensive training, implementation, and mentorship program to support teams in building their first interface. This program also provides the knowledge needed to replicate and scale interfaces across multiple EHR systems effectively.

Question 9

How does PilotFish compare to competitors like Cloverleaf or Rhapsody in healthcare integration?

Accepted Answer

Unlike competitors such as Cloverleaf and Rhapsody, which primarily focus on hospital integrations, PilotFish serves a broad spectrum of healthcare sectors, including biotech, Health Information Exchanges (HIEs), medical device companies, and healthcare technology solution providers. Its middleware solution is highly flexible, supporting HL7, X12 EDI, JSON, and other industry standards to meet diverse integration needs.

Question 10

How has PilotFish proven its capabilities against larger competitors?

Accepted Answer

PilotFish has won several direct competitive “bake-offs” against larger competitors by demonstrating its ability to handle complex workflows that others couldn’t, often within a single day. For example, PilotFish won over a major EMR vendor by showcasing its flexibility and speed in addressing complex integration needs. This shows that PilotFish can outperform even well-established competitors in high-stakes scenarios. See EMR Systems customers have integrated with using PilotFish.

Question 11

What is HL7?

Accepted Answer

HL7 is a language that enables the standard, consistent and uniform exchange and processing of health-related information between systems. HL7 standards are developed and maintained by the healthcare IT standard-setting authority HL7 International. HL7 Version 2 or HL7 V2 is the most widely used messaging standard, there is also an HL7 V3. It facilitates the exchange of high volumes of pre-defined patient and clinical data across healthcare applications reliably.

Question 12

What is the difference between HL7 and FHIR?

Accepted Answer

HL7 FHIR, based on modern RESTful web services and open web technologies, including XML, JSON and RDF, makes it easier for new apps and legacy systems to exchange very specific information, e.g., lab results. HL7 V2, HL7 V3, and CDA (part of HL7 V3) messaging standards are mature standards and remain in wide use for large volume push transactions.

Question 13

What is HL7 3.x?

Accepted Answer

HL7 3.x is a newer standard that has not supplanted HL7 2.x. HL7 V3 messages are based on XML. The Reference Information Model (RIM) is the foundation for HL7 V3 development. The HL7 V3 messaging standard defines a series of Secure Text messages (called interactions) to support healthcare workflows. Version 3 is not backward compatible with Version 2.

Question 14

What is the HL7 v3 clinical document architecture standard?

Accepted Answer

HL7 2.x is in wide use; HL7 3.x is not. HL7 V2 (also called pipe hat) is based on older technology & is a delimited format separated by a pipe with headers and multiple segments. HL7 V3 messages are in XML format. Version 3 is not backward compatible with Version 2. The two versions work within completely different data structures.

Question 15

How many different versions are there of HL7 2.x?

Accepted Answer

HL7 2.8 is the latest version. HL7 2.x versions include 2.1, 2.2, 2.3, 2.3.1, 2.4, 2.5, 2.5.1, 2.6, 2.7, 2.7.1, 2.8, 2.8.1 and 2.8.2. The v2.x standards are backward compatible. HL7 2.x earlier versions are currently the most widely used, but middleware solutions should support newer versions 2.7.1, 2.8, 2.8.1, and 2.8.2.

Question 16

How does the HL7 protocol function and what is its update frequency?

Accepted Answer

The HL7 protocol operates as a highly structured, pipe-delimited format, designed for robust and consistent data exchange across healthcare systems. Updates to the protocol are released periodically in the form of new versions, with enhancing features and capabilities to meet evolving healthcare information needs. See Release Notes.

Question 17

How to create an HL7 interface end-to-end?

Accepted Answer

An HL7 interface for different message types has an import endpoint(s) for receiving messages, an export endpoint(s) for sending messages and a method of moving data between the two endpoints. Click on the video below to see how an HL7 ORU message coming from a hospital is then sent to a database using PilotFish's Interface Engine IDE to build the HL7 Interface.

Question 18

How to convert HL7 2.x message into XML?

Accepted Answer

The HL7 2.x message is converted to a common XML representation so that a single open-source W3C language, XSLT, can be used to transform the data. In the PilotFish eiConsole, a unique 3-pane graphical Data Mapper generates the XSLT transform to affect the data transformation to the XML or another format consumable by the target system.

Question 19

How to convert HL7 2.x message into XML and then convert XML into JSON?

Accepted Answer

The sequence would be HL7 message (either from directory listener or LLP) -> [Source Transform] HL7 Transformer (to convert HL7 to XML) -> [Target Transform] XSLT transform (to convert XML to JSON XML) -> JSON Transformer (to create JSON) -> Directory Transport (to write the file) via the PilotFish eiConsole automated assembly line process.

Question 20

How can I integrate different data formats like HL7, EDI and FHIR JSON into a single route and post to a database?

Accepted Answer

Interface Engines integrate different data formats to target systems by transforming them into a common format and then routing the data into the database. Watch the PilotFish Data Analytics & Reporting Video to see this demonstrated.

Question 21

Can data formatted as HL7 be converted to HL7 FHIR within PilotFish?

Accepted Answer

Yes, PilotFish enables seamless data format conversion between different data formats, including converting data from HL7 2.0 to HL7 FHIR.

Question 22

Do you have a transformer to create outbound FHIR JSON, not just for ingestion?

Accepted Answer

For FHIR JSON we have JSON format builder that can take a sample FHIR JSON message as a sample and you can use that as your target mapping. The mapping generated from that will be translated to a normal JSON string in a target transformation transformer.

Question 23

What is a typical HL7 integration workflow?

Accepted Answer

A typical HL7 integration workflow involves receiving HL7 messages from a source system, parsing and mapping the data to a target system's format, validating and transforming the data, and finally sending the data to the target system. See How to Build HL7 Interface in 10 Steps.

Question 24

What application software converts XML to HL7 and HL7 to XML?

Accepted Answer

PilotFish eiConsole's graphical drag & drop data mapper component which is a graphical editor used to generate the XSLT transformations that transform the data format to any other data format. PilotFish provides a unique, robust triple-pane paradigm that supports mappings of any length and any complexity. Mapping remains graphically functional throughout.

Question 25

How do you ingest HL7 files and export to a flat file?

Accepted Answer

PilotFish software supports HL7 ingestion over MLLP (Minimal Lower Layer Protocol). From there, the HL7 messages can be parsed into a common format that can be converted to an XML or flat file format.

Question 26

With the PilotFish platform, can JSON data be directly inserted into the EMR?

Accepted Answer

Absolutely, JSON data can be transmitted to the PilotFish server through a REST endpoint. Following this, the data would be mapped and forwarded to the EMR.

Question 27

Regarding a high-frequency data exchange (e.g., 1000 data per second), can PilotFish handle it, and what about converting to XML for ingestion in EMRs?

Accepted Answer

PilotFish is equipped to manage high-frequency data transactions, efficiently transforming data into XML or any other specified format suitable for EMR ingestion.

Question 28

How does PilotFish enhance HL7 messages by integrating specific data from a client’s database?

Accepted Answer

PilotFish is equipped to enrich HL7 messages by seamlessly incorporating targeted data retrieved from client databases. This capability allows for the creation of more comprehensive and customized HL7 messages, optimizing data integration and communication processes within healthcare systems.

Question 29

How does PilotFish integrate with hospital workflows using various data formats and methods?

Accepted Answer

PilotFish streamlines integration with hospital workflows through the use of DICOM queries for generating patient lists and REST services for efficient data transmission. It supports essential data formats like DICOM and HL7, ensuring seamless communication and data exchange within healthcare environments.

Question 30

How does PilotFish handle diverse data formats in HL7 feeds?

Accepted Answer

PilotFish uses a template system to manage various data formats in HL7 feeds, allowing for duplication and modification to suit different hospital requirements. See HL7 Interface Templates for Reuse.

Question 31

Can PilotFish integrate selective HL7 data with queries from a replica database to generate a comprehensive HL7 message?

Accepted Answer

Yes, PilotFish can integrate HL7 messages with database queries to produce comprehensive HL7 messages, facilitating enhanced data amalgamation.

Question 32

Can PilotFish handle both HL7 and API-based EHR integrations?

Accepted Answer

Yes, PilotFish supports HL7 messaging and FHIR APIs, allowing seamless data exchange across various EHR systems. This flexibility enables integration with both traditional HL7 and modern API-based EHR platforms, accommodating diverse interoperability needs.

Question 33

What is interoperability in healthcare?

Accepted Answer

Interoperability is the ability of different information technology systems, devices, and software applications in healthcare to communicate, to exchange data accurately, effectively, and reliably, and to use the information that has been exchanged. Progress in data interoperability and digitization in healthcare addresses both syntactic and semantic interoperability.

Question 34

Why is interoperability important in healthcare?

Accepted Answer

Healthcare data interoperability is key to the ability of healthcare data to flow securely from one internal or external system to another, as needed, for patient care and patient use. Interoperability in healthcare must handle patient identification and privacy issues, complexities of messaging standards, data silos, legacy systems and technologies, and adaptation to modern applications.

Question 35

What is an HL7 interface engine?

Accepted Answer

HL7 Interface Engines are software systems tuned to exchange healthcare information in huge varieties of use cases involving disparate systems communicating over different protocols. HL7 Interfaces Engines must adeptly handle data transformation and exchange of not only large batch-oriented data and all versions of HL7 messaging but also highly conversational XML and JSON APIs – including HL7 FHIR.

Question 36

Does PilotFish accept HL7 transactions and also have the capability of API calls?

Accepted Answer

PilotFish provides a consistent means to adeptly handle not only large batch-oriented data and standards transaction messaging, but also highly conversational XML and JSON APIs – including new versions of data formats or industry standards. Configuring the application simply involves adjusting a few settings.

Question 37

Can HL7 integration support real-time data exchange?

Accepted Answer

Yes, HL7 integration can facilitate real-time data exchange, enabling healthcare providers to access up-to-date patient information and make more informed decisions, improving patient care and outcomes.

Question 38

Can HL7 messages be exchanged over different communication protocols?

Accepted Answer

Yes, HL7 messages can be exchanged using various communication protocols, such as TCP/IP, HTTP, Web Services, and FTP, depending on the requirements of the healthcare systems involved in the data integration. PilotFish middleware includes 40+ Listeners.

Question 39

Can HL7 integration support data exchange between EHRs and other healthcare IT systems?

Accepted Answer

Yes, HL7 integration enables interoperability between Electronic Health Records (EHRs) and other healthcare systems, such as laboratory information systems (LIS), radiology information systems (RIS), and pharmacy management systems. PilotFish supports healthcare integration solutions for all lines of business.

Question 40

How does PilotFish facilitate data transfer to PACS systems?

Accepted Answer

PilotFish ensures efficient data transmission to PACS systems using DICOM outbound protocols. This process includes the creation of secondary captures that encapsulate relevant content, streamlining the integration and enhancing the utility of medical imaging data within healthcare workflows.

Question 41

What FHIR conversion capabilities does PilotFish offer?

Accepted Answer

PilotFish fully supports the FHIR standard, including conversions from X12 to FHIR, and handles all types of X12 EDI transactions.

Question 42

Can PilotFish convert fax data to FHIR?

Accepted Answer

Yes, PilotFish can convert fax data to FHIR, provided the fax is in a digital format on a fax server and contains the necessary information.

Question 43

How does PilotFish handle the integration of scanned documents into EHR/EMR systems like Epic or Cerner?

Accepted Answer

PilotFish's integration platform seamlessly converts scanned documents into the required digital formats and securely transmits them to EHR/EMR systems such as Epic and Cerner.

Question 44

Can PilotFish integrate with multiple EHR/EMR systems on one platform?

Accepted Answer

Yes. PilotFish supports integration with multiple EHR and EMR systems through a single platform using configurable interface templates. This enables streamlined onboarding, system-specific mappings and efficient data exchange across diverse environments.

Question 45

How does PilotFish handle integration with Epic?

Accepted Answer

PilotFish supports integration with Epic using flexible connectors that handle HL7, EDI, FHIR and RESTful APIs. Its architecture enables rapid configuration of interfaces to accommodate Epic’s integration points, including support for both traditional HL7 messaging and modern API-based workflows.

Question 46

Is PilotFish an out-of-the-box solution for integrating with Epic?

Accepted Answer

No, PilotFish is not an out-of-the-box solution. Instead, it provides a highly configurable platform that can be tailored to meet the specific requirements of different Epic implementations, offering a custom-fit integration solution.

Question 47

Can the same interface be reused for different Epic implementations?

Accepted Answer

Yes, while each Epic instance may have unique configurations, PilotFish's platform allows for the reuse of core interface components. This capability significantly reduces development time and effort for subsequent Epic integrations, providing a scalable solution.

Question 48

How does PilotFish integrate with EHR systems that use different protocols?

Accepted Answer

PilotFish seamlessly integrates with any EHR system by supporting a wide range of communication protocols, including HL7, FHIR, and API-based interactions. Its flexible architecture enables connections with systems using various standards, ensuring compatibility and streamlined data exchange.

Question 49

Does PilotFish charge additional fees for each customer integration?

Accepted Answer

No, PilotFish's licensing model is based on hardware usage, including cores and memory (GB), rather than per customer or connection. This approach allows clients to scale integrations without incurring additional costs per customer.

Question 50

Is PilotFish suitable for hospital-based HL7 integration?

Accepted Answer

Yes, PilotFish is fully capable of handling hospital-based HL7 integration, but it is also designed to go beyond hospitals to serve a wider range of healthcare sectors, including medical device companies, healthcare technology solution providers, and biotech firms. Its flexibility allows it to be adapted to various healthcare needs, making it suitable for clients seeking a versatile integration engine.

Question 51

How are HL7 messages parsed?

Accepted Answer

Out-of-the-box, the eiConsole lenient parsing component handles anything that looks even remotely like an HL7 v2.x message – including "byzantine" sets of fields, components and sub-components that are not part of the standard. The lenient parser is exposed and enabled in the Transformation module. The HL7 message including any custom segments converts easily to XML.

Question 52

How are HL7 message segments structured?

Accepted Answer

An HL7 message in the v2.x format is a collection of concatenated segments, each terminated by a carriage return. Segments occur in a defined sequence. Pipes | delimit fields, carets ^ are subfields. Depending on the type of field, each field can have multiple optional repetitions (separated with ~ by default), can be made out of multiple components (separated with ^ by default) where each of them can also have subcomponents (separated with & by default).

Question 53

What is a non-standard HL7 message?

Accepted Answer

The HL7 Standard specifies a data structure based on trigger events, segments, fields, and data types. Non-standard HL7 messages are created when different systems and applications require customizing and extending the standard. HL7's structure allows optional fields or additional portions of messages. HL7 allows Z-segments (miscellaneous) for data elements defined locally.

Question 54

How do you parse a non-standard HL7 message?

Accepted Answer

Middleware can handle the differences in data formats, varying versions of standards, and incompatibilities of working with extended versions. A highly lenient parser should easily deal with non-standards compliant and extended versions of HL7.

Question 55

How can I handle data mapping complexities in HL7 integration?

Accepted Answer

Utilize data mapping tools, create comprehensive mapping documentation, and involve domain experts to ensure accurate data mapping. Regularly review and update mapping rules to maintain data quality and address changes in source and target systems.

Question 56

How can I reduce the complexity of HL7 message processing?

Accepted Answer

Use an HL7 parser to extract, process, and manipulate message content more easily. Simplify message structures by removing unnecessary elements and using message templates to standardize the creation of HL7 messages.

Question 57

What is the HL7 Consolidated Clinical Document Architecture (C-CDA)?

Accepted Answer

C-CDA is a set of standardized templates based on the HL7 CDA framework, designed to streamline the creation, exchange, and integration of electronic clinical documents, such as care summaries, consultations, and referral notes.

Question 58

How does PilotFish enable efficient modifications in HL7 message segments?

Accepted Answer

PilotFish streamlines the process of modifying HL7 message segments by leveraging its intuitive drag & drop data mapping tool. This graphical interface eliminates the necessity for custom coding, thereby facilitating rapid adjustments without the need for system redeployment or causing any downtime.

Question 59

What happens if PilotFish crashes after acknowledging an HL7 message but before processing it?

Accepted Answer

Messages are stored in memory and processed after the system restarts. A queuing system manages these messages to ensure delivery continuity.

Question 60

How does PilotFish enable changes to HL7 message segments?

Accepted Answer

PilotFish allows users to modify HL7 segments through a visual mapping interface. Changes can be made quickly without custom code, redeployments, or downtime—streamlining maintenance and updates.

Question 61

How are HL7 connections monitored in PilotFish?

Accepted Answer

PilotFish enables comprehensive HL7 connection monitoring through configurable alerts via transaction monitoring. Additionally, the eiDashboard provides visual monitoring and custom reporting capabilities for real-time insights and proactive management.

Question 62

Can PilotFish handle real-time error tracking and resolution during document processing?

Accepted Answer

Yes. PilotFish supports real-time error tracking with automated handling and alerts. Errors can be logged, flagged and routed for resolution without disrupting document processing—ensuring data integrity and continuous system uptime.

Question 63

Why is HL7 difficult to integrate?

Accepted Answer

HL7 is dubbed the "non-standard standard." Every HL7 2.x implementation encountered will be different. HL7 messages typically contain a large number of specified data segments to start. The segments each can contain large numbers of individual fields. Segments and fields can be customized. To interface with another system or application, the messages need to map a common representation and not lose information. PilotFish's eiPlatform lenient HL7 parser converts virtually any HL7-like message into XML without complex configuration.

Question 64

What are some common challenges in HL7 data integration?

Accepted Answer

Common challenges include variations in HL7 message formats, data mapping complexities, data quality issues, maintaining compliance with privacy regulations, and integrating with legacy systems.

Healthcare HL7 FAQ

HL7 Frequently Asked Questions