First of all, we need to understand what is Health Level Seven (HL7)?  It is a set of international standards used to provide a set of guidelines for transferring and sharing data between various healthcare applications, devices and providers.

Health Level Seven International is a non-profit organization dedicated to providing a framework for the exchange, integration, sharing and retrieval of electronic health information.  The HL7 standards were developed by the Health Level Seven organization to define how the information is packaged and communicated between systems, setting the language and structure to facilitate a seamless exchange and integration between similar and disparate systems.  The HL7 organization continues to update the standard.

What is an HL7 interface and what is it used for?

An HL7 interface is a uni- or bi-directional connection that facilitates the communication between two or more clinical devices or systems.  Both parties exchange pertinent electronic health information via HL7 messages.  There are various types of HL7 messages, but the most common are ADT, ORM and ORU messages.  ADT stands for Admit, Discharge, Transmit and the function of ADT messages is the transfer of patient demographics such as name, date of birth, gender, address, insurance, etc.  ORM stands for Order Message and the function of ORM messages is to initiate the transmission of information about an order.  This includes information such as placing new orders, updating existing orders and canceling orders.  It can also include details such as procedures to be performed, date of the procedure and various physician information.  ORU messages are Observation Results messages and their function is to transmit information about a patient’s clinical data and observations.  Information passed in ORU messages could include EKG results, various lab test results as well as radiology reports for imaging procedures.

Why do you need an HL7 interface?

There are numerous benefits to establishing HL7 interfaces among the various clinical devices and systems within a healthcare facility.  It can start with the front desk admitting and setting appointments for patients and scheduling their procedures.   Once these patients and their tests and procedures are entered into the HIS/RIS/EMR systems, this information can be shared electronically to other clinical systems such as PACS, imaging modalities, and LAB devices automatically.  This automated exchange of information saves time and money by eliminating duplication of effort having to re-key the same information into these other systems, thereby saving time for healthcare personnel to perform other necessary tasks.  This automated exchange of data also eliminates or greatly reduces the number of data entry errors on lab collection equipment or image modality devices by facilitating modality worklists whereby the tech chooses from a list instead of manual typing, thus making more efficient use of the equipment.  Another benefit from using HL7 interfaces can be realized when there is communication and exchange of information outside the healthcare facility.  For instance, having the ability to receive radiology reports from external reading groups via HL7 messaging ensures the data received is in a consistent, standardized structure, with proper formatting and no chance for typographical errors.  Finally, HL7 messages can also be used to exchange patient history and clinical activity between the EMR and billing systems to facilitate and expedite accurate billing on behalf of the healthcare facility.  This is yet another reason for implementing HL7 interfaces since it serves reduced duplicate billing and accelerates timely receipt of payments.

Other things to consider

As you can tell, there are many benefits to implementing HL7 interfaces, however there some other things to keep in mind when considering HL7 interfaces, the main one being that HL7 interfaces involve at least two devices or applications and as such, involves multiple vendors.  Typically, both vendors will charge professional services fees for HL7 interfaces and you need to be aware of that.  Furthermore, it’s a good idea to reach out to your vendors to make sure they support HL7 interface capability if you’re considering it.  Just because many clinical devices and systems support HL7 communications, not all do or only on a limited basis.  HL7 interfaces are a mainstay in today’s healthcare industry and you should familiarize yourself with and weigh the possible benefits in your facility.

Danny Chin, Mar 2021