Introduction to HL7 FHIR

HL7 FHIR (Fast Healthcare Interoperability Resources) is a standard for digital information exchange in healthcare, enabling fast and secure transmission of medical data between various healthcare systems. FHIR is the latest of the widely used standards facilitating interoperable medical data exchange and is being implemented by healthcare organizations worldwide. With FHIR, diverse systems can communicate effectively with each other, significantly improving the quality of patient care and the operational efficiency of medical facilities. This standard supports JSON and XML formats, simplifying integration with existing IT systems.

Why is data processing standardization in medical data exchange important?

In the healthcare industry, system interoperability is the foundation of modern technological solutions. Standards play a crucial role in ensuring interoperability and efficient data exchange in healthcare. The diversity of formats and the lack of consistent standards hinder data exchange among healthcare providers. Standards developed by the HL7 organization—such as HL7 v2, HL7 v3, and FHIR—help overcome these challenges, enabling fast and secure data processing.

HL7 standards: The evolution of interoperability

HL7 v2 – messaging in ASCII

The HL7 v2 standard, developed in 1989, facilitates message exchange between systems. While these messages are widely used, they rely on textual ASCII structures, making interpretation and integration challenging in complex environments.

Example of an HL7 v2 message:

MSH|^~\&|SENDING_APP|SENDING_FACILITY|RECEIVING_APP|RECEIVING_FACILITY|202306180930||ORU^R01|123456789|P|2.5\r

PID|||12345||Doe^John^J||19700101|M|||123 Main St^^Anytown^CA^12345||(555)555-5555||S||N\r

OBX|1|NM|100779^eGFR^L||84|mL/min/1.73||N|F

HL7 v3 – complexity that failed to gain popularity

The attempt to introduce semantic interoperability in HL7 v3 (based on XML) was unsuccessful due to the complexity of its specifications and the high implementation costs.

FHIR – A next-generation standard

FHIR (Fast Healthcare Interoperability Resources) combines the simplicity of HL7 v2 with the semantic interoperability of HL7 v3. Its use in various healthcare applications, such as telemedicine and national health data infrastructures, highlights its flexibility and modularity. Based on RESTful APIs, FHIR supports data in JSON and XML formats. It shifts the focus from healthcare institutions to the patient, facilitating improved management and data processing throughout the care cycle.

FHIR in practice: a project for 9amHealth

9amHealth is a U.S.-based startup offering online healthcare services for patients with diabetes, obesity, and hypertension. The project’s goal was to develop a system that integrates medical data from multiple sources, including laboratories and medical devices, while ensuring compliance with regulations such as HIPAA.

Scope of work carried out by fireup.pro:

✔️ Backend and Frontend Implementation

Developed a scalable architecture enabling real-time processing of large volumes of medical data.

✔️ Integration with Laboratory Providers

Leveraged HL7 v2 and FHIR standards to automate the exchange of laboratory test results in compliant formats.

✔️ Data Storage

Implemented a dual approach where data in HL7 v2 format was converted to FHIR R4, allowing for reuse in other contexts.

Technical aspects of implementing FHIR

Treatment, patient data processing, test results, and fhir hl7 standard in the healthcare industry.

FHIR (Fast Healthcare Interoperability Resources) is a standard designed to enable the exchange of healthcare data between various information systems. Its primary goal is to improve interoperability and facilitate real-time access to patient data.

In the context of FHIR’s technical implementation, document architecture plays a key role. HL7 standards, such as Clinical Document Architecture (CDA), are used to manage complex healthcare information systems. This is particularly evident in Poland with the introduction of e-prescriptions.

HAPI FHIR – Tool Ecosystem

fireup.pro, in collaboration with the client, utilized the HAPI FHIR library, which supports both HL7 v2 and FHIR. This enabled the following:

  • Parsing HL7 v2 messages into Java objects.
  • Creating and processing FHIR resources in JSON and XML formats.
  • Exposing a RESTful server for FHIR resources.

Code Example:

FhirContext ctx = FhirContext.forR4();

Observation observation = new Observation();

observation.setCode(new CodeableConcept().setText(„Blood Glucose Level”));

observation.setValue(new Quantity(5.5).setUnit(„mmol/L”));

Converting HL7 v2 to FHIR

Using the HL7ToFHIRConverter, data from HL7 v2 messages were transformed into FHIR resources, ensuring compatibility and enhanced reusability.

HL7ToFHIRConverter converter = new HL7ToFHIRConverter();

Bundle fhirBundle = converter.convert(hl7Message);

Data Storage and Processing

FHIR data was stored in JSON format across databases such as PostgreSQL and MySQL, as well as in NoSQL systems like MongoDB to handle larger data volumes effectively.

Standardized Coding

SNOMED CT (Systematized Nomenclature of Medicine – Clinical Terms)

  • Used for coding clinical symptoms, such as high blood pressure.
  • Ensures consistency and interoperability in describing medical conditions and procedures.

LOINC (Logical Observation Identifiers Names and Codes)

  • Focused on defining laboratory test results and observations.
  • Facilitates standardized reporting and sharing of lab data across systems.

UCUM (Unified Code for Units of Measure)

  • Provides a standard for representing units of measurement, ensuring accuracy in data interpretation.
  • Example: Standardizing units like „mmHg” for blood pressure or „mL/min” for lab results.
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Data Security and Privacy in FHIR

Data security and privacy are critical aspects of healthcare, and FHIR is designed to ensure both. FHIR supports security protocols such as HTTPS and OAuth, which enable secure transmission of medical data. Additionally, FHIR provides advanced access control mechanisms, allowing precise management of data permissions. The standard also complies with international data security regulations, such as HIPAA, ensuring that patient data is protected according to the highest standards.

Why FHIR?

➡️ Interoperability
FHIR enables integration with various healthcare systems worldwide, ensuring seamless data exchange between solutions.

➡️ Data Flexibility
Support for JSON and XML formats allows data adaptation to diverse IT environments.

➡️ Performance and Scalability
With RESTful API and tools like HAPI FHIR, systems can efficiently process data and integrate with other solutions, facilitating scalability under increasing workloads.

➡️ Security
FHIR complies with international standards like HIPAA, ensuring the protection of patient data.

The Future of FHIR in Healthcare

FHIR holds immense potential in healthcare, as it enables fast and secure transmission of medical data across various healthcare systems. In the future, FHIR could be instrumental in developing new healthcare applications and services capable of utilizing real-time medical data. This will enable better patient health monitoring, faster response to changes in their condition, and more personalized care. Furthermore, FHIR can contribute to improving the quality of healthcare and reducing costs by enhancing interoperability and enabling more efficient medical data management.

Technical Summary

The implementation of FHIR in the 9am.Health project demonstrates that this standard is the future of healthcare. Fireup.pro successfully integrated legacy HL7 v2 standards with modern FHIR, providing the client with scalability, interoperability, and regulatory compliance.

🚀 If your company needs a technological partner to implement modern IT solutions in the healthcare industry, contact fireup.pro – experts in medical data processing.