What is the HL7- FHIR standard for the health sector?
HL7 or Health Level Seven refers to Level 7 of the OSI (The Open Systems Interconnection model is a conceptual model which has the goal of standardizing the communication between devices) the level of application for the health sector. Level 7 offers the applications the possibility of accessing the services of the rest of the layers and defining the protocols that the health applications use to exchange data.
Therefore, Health Level Seven means “Application level in Health” and refers to the protocols and standards for the exchange of information between applications. HL7 was founded in 1987 and more than 1,600 members in 50 countries participate in it. Among the members, there are more than 500 organizations in all health fields. Different international branches of HL7 exist, for example, the Spanish and LATAM branches.
You can learn more about HL7 as an organization here.
What is the purpose of HL7?
HL7 is in charge of defining the work brand and standards for the exchange, the integration and the access to the electronic health information.
The HL7 standard works so that health applications can communicate regardless of the language or architecture with which they were developed and can share necessary information with those involved in order to interoperate.
The HL7 standards or protocols indicate how to organize and communicate the information between two parts. These standards define the language, structure and the types of data required for a fluid integration between health systems.
Thousands of hospitals all over the world use these standards to exchange information between their systems every day. If we talk about HL7 standards, we are talking about the interoperability of health.
What other standards exist?
Alongside the HL7 standards many others often appear next to them.
The most important HL7 standards are HL7 V2, HL7 V3, CDA, HL7 FHIR and CCOW. These five are those that are known as the primary standards (HL7 primary standards) and are the most used for system integration and interoperability.
What is FHIR?
FHIR® – Fast Healthcare Interoperability Resources (FHIR) is a new generation of health data standard created by HL7 to depict data formats and elements (called “resources”) and the interfaces of programmation of applications (APIs) to exchange health data (clinics, diagnostics, medicines, flows, funding, etc.)
F – Fast (to design & to implement)
H – Healthcare
I – Interoperability
R – Resources
HL7 FHIR® is an interoperability standard that combines the best of HL7 V2, HL7 V3 and CDA y to focus on facilitating implementation. In addition, it uses the most frequent web standards such as XML, JSON and HTTP.
FHIR was born in 2011 and evolved rapidly until the first version with FIHR Release 4 (version 4.0.1) normative content was published in 2019. It is possible to continue the evolution of the distinct published versions in the history of FHIR versions.
FHIR is the abbreviation of Fast Healthcare Interoperability Resources. The resources are the key pieces of FHIR. The ¨Resources¨ are the building blocks for all exchanges of information in FHIR. Every resource represents a concept of the reality of healthcare such as patients, appointments, organizations or test results.
The resources can represent as much in XML as in JSON and all have certain characteristics in common:
- A URL that identifies a resource.
Some common metadata. - A legible summary for humans.
- A brand of extensibility (extensibility framework) allowing the assumption of the differences in healthcare.
The challenge of interoperability in the health sector
The main challenge to overcome is that the organizations in the health sector are committed to providing the best patient experience, taking advantage of technology as a means to achieve sustainable and interoperable medical information for each of the patients and that this empowers them through the digital platforms that they are using daily.
- Leverage the standard data model instead of building a tailor-made schema.
- Use standard FHIR to access, search for and realize data operations
Create, Read, Actualize and Delete
History, Search, Validation, Patient registration and transactions - Easily consume data from different systems
Electronic Sistemas de registro de salud electrónico
Health insurance plans
Laboratories
Pharmacies
Other health apps like nutrition, Smart watches, etc.
Using the SMART method
Substitutable Medical Applications and Reusable Technologies.
- Open standard to integrate third party Apps with electronic records / patient portals
- OpenID Connect and OAuth2
- Reusable Apps
- Only write once in whichever patient electronic record
- Run in different contexts (patient electronic records, portals etc.)
- Secure and frictionless access to electronic patient data in Apps
SMART standardizing health applications
