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Interoperability of HL7 and EMR / EHR

Paul Kovalenko Paul Kovalenko | December 14, 2021 | 8 min

Electronic health records were created to make information travel between hospitals, doctors, and patients easier and more reliable. The idea was great and would have been revolutionary, but there was an obvious flaw. Different hospitals use different EHR systems and types of EMR systems and data formats, so what will be displayed perfectly well in one institution will not work in the other. Because of this data jumble, the US spends $30 billion a year alone to deal with the consequences of the lack of orderly data flow.

The difficult task of interoperability was accepted by Health Level Seven. In this blog post, we are going to give you a glimpse into the standards developed by this organization and HL7 impact on healthcare interoperability.

Interested in using of EMR in hospital management? Learn more from our article about how EMR systems can improve hospital management.

For What Purposes Was the Health Level Seven International Created?

Health Level Seven International is a non-profit organization that was founded in 1987, and since then has grown to having members in over 50 countries. The “7” stands for Layer 7, the final layer in the Open Systems Interconnection (OSI) reference model, also known as the application layer. HL7 works with that layer specifically to standardize communication between different health systems, which is why they went for that name.

Being the main purpose of the organization, HL7 and EMR interoperability go hand in hand together. However, it offers many different standards for other purposes. For example:

Version 2 Messaging

It is a standard for messaging in administration, logistics, finance, and clinical processes. The messages are made with a query language that requests and contains information. It enables standardized message exchange between electronic Patient Administration Systems (PAS), Electronic Practice Management (EPM) systems, Laboratory Information Systems (LIS), Dietary, Pharmacy and Billing systems as well as Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems.

Clinical Document Architecture (CDA)

It is an XML-based standard that defines the encoding, structure, and semantics of clinical documents that will later be included in medical records (for example, discharge summaries, medical history, progress notes, examination results, and specialists’ reports). The documents consist of two parts: the text part for human readability and structured parts for software.

Arden Syntax

Arden Syntax is a language that was designed specifically to make representing and communicating of healthcare knowledge easier. The standard supports clinical decision support systems that issue alerts, interpretations, and messages for medical staff. It sends alerts if a clinician’s patient got alarming test results, helps doctors to interpret the results, and helps to find participants of clinical trials based on their health data. Overall, Arden Syntax helps make more informed treatment decisions for patients.

Creation of Guidelines on Interoperability

HL7 also plays a notable part in providing information and guidelines on interoperability, development, and adoption of the solution. Their website offers numerous educational resources for developers, medical workers and administration.

The headquarters of Health Level Seven is in US, Michigan. It has a Board of Directors and around 40 workgroups to deliver different standards. There they vote for new standards in a balloting system where they go in rounds to get all the wrinkles ironed out. After this, the standard is sent to other countries to get approved by local standardization bodies. HL7 is accepted as a standard developing organization by American National Standards Institute (ANSI) and The International Organization for Standardization (ISO).

Need help establishing HL7 interoperability?
Reach out to Langate

HL7 Standard – Data Exchange Without Loss and Its Business Benefits

HL7 standards were developed to help healthcare institutions get helpful digitalization. Their guidelines helped laboratories, registries, pharmacies, payors, local and state departments of health, healthcare institutions, and developers create solutions that matter, and stay for a long time to support the huge diversity of healthcare systems. Thus, HL7 EMR interoperability offers numerous benefits.

Establishing Smooth Data Exchange Between Different Parties

Before health records moved to electronic form, the process of exchanging information between hospitals or doctors had lots of obstacles. Doctors had to send photos of records via email or fax, or patients had to take physical records from one place or specialist to another. Even after EHR/EMR were introduced, there was still the problem of different systems not being able to read the same data, so email and fax were still widely used.

Using HL7 to achieve interoperability in health IT made it possible to view a patient’s history, test results, or examination notes from anywhere. Moreover, there was no delay, as the information gets updated in real-time!

Eliminating Any Errors

When data goes through different systems, it is likely to arrive with mistakes. It is also common in healthcare when medical staff cannot find a health record because of system differences and they create a new one, resulting in a significant number of duplicate records and lost background that can be essential to the patient’s treatment. HL7 EHR interoperability eliminates these issues and allows for error-free transfer of information.

Now, physicians can also integrate lab test results and make examination notes on any device, straight from the patient’s room. This practically eliminates the possibility of human error that existed before because of the manual transfer of data from paper to the computer.

Saving Time Needed to Retrieve Data or Develop New Tools

Doctors no longer need to figure out how to share information; no need to choose the right format or sending method. With interoperability, they can just go to the database and find the right patient from any device or system.

It is also time-effective when it comes to developing new healthcare software and integrating it with the existing EHR/EMR systems. HL7 already has a set of instructions with must-have features and their FHIR standard makes integration as simple as it can get.

Promoting Innovation by Simplifying EHR/EMR Integration Processes

One of the reasons why healthcare software was not the fastest to progress was interoperability issues. When creating a new practice management software or telehealth app, you have to integrate an EHR/EMR system to deliver the full experience. Otherwise, the app will not be function properly and be pretty much useless. It was very difficult to integrate the system before but with Health Level 7 interoperability and FHIR API, it is as simple as in any other digitally developed industry. It will definitely contribute to the rise of health tech and new types of software which will truly embrace every single aspect of managing healthcare institutions.

Interested in EMR/EHR integration? Learn more from our article about process and cost of EMR integration.

How Do HL7 and EMR/EHR Interact?

Health Level Seven interoperability offers many different standards for EMR/EHR, but the discussion should be focused on the two most important ones: the EHR-PHR System Functional Models and FHIR HL7 interoperability integration.

  • EHR-PHR System Functional Models offer language parameters, EHR functions, record lifecycle events for system designing, developing, implementing, and supporting EHR systems. As for PHR (Personal health records), the standard offers guidelines about the must-have features and functionality for the long life of the system and how to send and receive information from and to absolutely different systems like EHR/EMR, insurance providers, payment systems, public health systems, health education sites, clinical trials systems, etc.
  • Fast Health Interoperability Resources (FHIR) is a set of data formats and elements, combined with an API for the exchange of electronic health records. It has reached all principles of health interoperability with HL7. FHIR has a lot of benefits compared to previous systems; it is a more modern approach to interoperability through API, it connects even legacy systems, allows exchange between all kinds of devices, and moves away from a document-centric approach. One of the main benefits is that now, healthcare software developers can easily integrate EHR systems in their apps. FHIR is currently one of the most popular standards provided by HL7.

Overall, HL7 fast healthcare interoperability enhances EHR/EMR system development and maintenance by:

  • Providing information about must-have features of EHR and PHR
  • Offering guidelines for data exchange between absolutely different systems without loss
  • Creating API for easy connection between systems, even legacy ones
  • Releasing guides on implementation strategies
  • Allowing medical staff and administration to run healthcare applications on any device, even smartphones, and tablets that they can carry around at any time
Want to reap all the business benefits of HL7 Standard?
Langate can help

Our Services and Solutions

Our team of more than 100 software experts has extensive experience in creating health tech solutions and enhancing interoperability. Langate has worked in healthcare development for over 17 years, has its own HIPAA-compliant developing center, and fully embraces new interoperability using HL7 and FHIR standards.

Our client, Approved Admissions, a premier provider of data validation, insurance eligibility, and revenue risk mitigation services in the healthcare industry have turned to us with the problem of data exchange. They received data from different sources: EMRs, practice management, billing, therapy, etc. and it was not transported properly, with some files lost or displayed inadequately. We have created data maps that allowed clean data transfer, notified employees in case of mistakes and typos, and provided full HL7 and EMR compliance. Currently, our solution serves more than 700 facilities and enables 1 million transactions in a day.


HL7 standards for interoperability is a necessary step in health tech development. Hospitals can finally get all the promised benefits out of EHR/EMR systems, embrace solutions that fully integrate all healthcare processes in one place, and avoid complicated data exchange with input and transfer. Patients can now easily transfer between doctors and hospitals all while being sure that all of their previous examinations and test results will get to a new place safe and sound.

Do you want to enjoy all the benefits of interoperability through integration of EMRs and compliance with HL7? Do not hesitate to reach out to Langate, where we will figure out a custom solution to help you provide faster and more reliable care. Get to work with our passionate and amazing teams of developers, testers, and project managers who all have years of health tech development and will take care of all the processes while taking into account all of your unique preferences.

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