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HL7 Frequently Asked Questions

HL7 refers to data formats and standards used to structure and share medical data and patient health information (PHI). HL7 messages include information about specific medical or administrative events and are fundamental to interoperability. HL7 standards (e.g., V2, V3, CDA, FHIR) are created and supported by the non-profit standards organization Health Level Seven International. HL7 V2 is the most widely used version of the standard in healthcare.

What is HL7 data integration?

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.

How does an HL7 interface engine work?

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.

What is an HL7 message?

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.

What are the most popular HL7 message types?

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

What is the relationship between HL7 integration and healthcare analytics?

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.

What is HL7 CDA, and how is it used?

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.

How to Build HL7 Interface for HIE Video

HIE Interface Example with CDA and HL7 Data

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

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.

What is HL7?

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.

What is the difference between HL7 and FHIR?

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.

What is HL7 3.x?

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.

What is the HL7 v3 clinical document architecture standard?

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.

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

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.

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

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.

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

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.

Building an HL7 Interface

Building an HL7 Interface

How to convert HL7 2.x message into XML?

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.

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

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.

Routing and Mapping HL7 Messages with PilotFish Software

Routing and Mapping HL7 Messages with PilotFish Software (click to enlarge)

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

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.

HL7, EDI & FHIR Data Integration for Reporting & Analytics with PilotFish

HL7, EDI & FHIR Data Integration for Reporting & Analytics

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

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

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

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.

What is a typical HL7 integration workflow?

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.

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

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.

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

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.

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

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.

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?

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

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

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.

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

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.

How does PilotFish handle diverse data formats in HL7 feeds?

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.

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

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

What is interoperability in healthcare?

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.

Why is interoperability important in healthcare?

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.

What is an HL7 interface engine?

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.

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

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 that you need. Configuration just requires changing a handful of options in the application.

Can HL7 integration support real-time data exchange?

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.

Can HL7 messages be exchanged over different communication protocols?

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.

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

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.

How does PilotFish facilitate data transfer to PACS systems?

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.

What FHIR conversion capabilities does PilotFish offer?

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

Can PilotFish convert fax data to FHIR?

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.

How are HL7 messages parsed?

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.

HL7 Parsing Feature of PilotFish Interface Engine

HL7 to XML and XML to HL7 Transformation Module

How are HL7 message segments structured?

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).

What is a non-standard HL7 message?

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.

How do you parse a non-standard HL7 message?

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.

Differences in HL7 2.x Messages No Problem with PilotFish (click to enlarge)

How can I handle data mapping complexities in HL7 integration?

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.

How can I reduce the complexity of HL7 message processing?

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.

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

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.

How does PilotFish enable efficient modifications in HL7 message segments?

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.

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

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

How does PilotFish enable changes to HL7 message segments?

PilotFish facilitates modifications to HL7 message segments through its intuitive mapping interface, allowing for quick adjustments without the necessity for custom coding, redeployment, or system downtime.

Why is HL7 difficult to integrate?

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.

What are some common challenges in HL7 data integration?

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

How do I choose the right HL7 integration solution?

Consider factors such as compatibility with existing systems, ease of use, scalability, support for desired HL7 standards, and cost. Look for solutions with a strong track record and positive reviews from healthcare organizations. See Competitive Advantages of PilotFish’s integration engine.

What are the benefits of cloud-based HL7 integration solutions?

Cloud-based solutions offer scalability, flexibility, reduced infrastructure costs, easier updates, and remote accessibility, making them an attractive option for healthcare organizations looking to streamline HL7 data integration.

How do I validate HL7 messages for data quality and compliance?

Use validation tools to check HL7 messages for syntax, structure, and content compliance. Ensure that the data adheres to both HL7 standards and any regulatory requirements specific to your region or organization.

How can I ensure the reliability of HL7 data exchange?

Implement monitoring and alerting systems, error handling mechanisms, and message tracking to detect and resolve issues quickly. Establish clear processes for data exchange and involve relevant stakeholders in integration planning.

How do I troubleshoot issues with HL7 data integration?

Investigate message logs, error reports, and system configurations to identify potential issues. Perform testing and validation to confirm the problem, and work with integration analysts, developers, and vendors to resolve any issues promptly. eiDashboard provides real-time operational reporting and management of your HL7 interfaces.

How can I ensure the performance of my HL7 integration solution?

Monitor system performance, optimize message processing, and perform load testing to identify potential bottlenecks. Ensure adequate system resources and consider using a scalable cloud-based solution to handle fluctuations in demand. PilotFish offers on-demand licensing.

How do I handle versioning and backward compatibility in HL7 integration?

Maintain detailed documentation of HL7 versions and system configurations and use interface engines that support multiple HL7 versions. Implement version negotiation and conversion strategies to maintain interoperability and data quality.

How do I handle internationalization and localization in HL7 data integration?

Use character sets and encoding that support multiple languages, and consider regional differences in data formats, units of measure, and terminology. Utilize HL7 standards, such as FHIR, that have built-in support for internationalization and localization.

What pricing model does PilotFish use for hospital integration solutions?

PilotFish employs a hardware-based pricing model for hospital integration, where costs are determined by the resources utilized rather than the volume of messages exchanged or the number of connections established. This approach ensures that hospitals pay for the actual infrastructure used, providing a scalable and flexible pricing structure. See licensing for more info.

Can eligibility data be accessed through an API without integrating with EHR systems?

Access to eligibility data via an API, independent of EHR integrations, depends on the availability from payers or Pharmacy Benefit Managers (PBMs). PilotFish can either expose its own API or connect to existing ones, though the ease of setup may vary by vendor.

What information is required by PilotFish to initiate an eligibility transaction? Is it limited to basic patient demographics?

To initiate an eligibility transaction, PilotFish requires a clear understanding of the schema structure and needs a sample file. Basic patient demographics alone may not suffice depending on the specifics of the transaction and the data requirements.

If you have any additional questions or require further assistance, please don’t hesitate to contact our customer support team. Click on the button or jump into a chat.

HL7®, HEALTH LEVEL SEVEN®, CCD®, CDA®, and FHIR® are trademarks of Health Level Seven International.

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