FHIR vs HL7: Here’s What You Need To Know

23 Dec, 20 | illumisoftadmin

When it comes to improving patient outcomes, most medical professionals would agree there’s one key differentiator: data. Whether you’re looking for patterns in a person’s medical history or monitoring their real-time responses to an experimental drug, having a holistic view into a patient’s background can substantially enhance the quality of care provided. Electronic Health Records (EHR) play an important role in enabling access to this data, serving as a digitized version of a patient’s paper chart. 

Because of the way healthcare works in America, one of the most important factors in effectively utilizing EHR records is ensuring they’re formatted in a way that preserves interoperability across the healthcare ecosystem, from lab to clinic. 

As a result, staying up to date on the latest trends and changes on the software side is critical for healthcare IT managers— particularly when it comes to understanding HL7 and the creation of FHIR. Here, we’ll break down the FHIR vs. HL7 dynamic, walking you through the evolution and utilization of each EHR technology.


Even if you’re not a technical healthcare IT professional, you’ve probably heard of HL7 (known more formally as ‘Health Level Seven’). HL7 served as an early encoding framework for supporting secure messaging and document exchange between healthcare organizations.

Originating in the late 1980s, HL7 is a set of international data-sharing standards popularized by Health Level Seven International, a non-profit organization focused on brokering systems for healthcare interoperability. 

Although these guidelines were first standardized by HL7 International, they have since been adopted by other industry authorities such as the American National Standards Institute and the International Organization for Standardization. Today, they’re the de facto encoding format for almost all modern medical recordkeeping.

Our healthcare system is made up of hundreds of thousands of loosely-associated public and private providers, each with their own unique way of operating. For this reason, standards like HL7 are critical for interfacing between these organizations— EHR systems would be entirely incapable of interoperating otherwise. 

Nonetheless, while the development of HL7 has been an important step in the right direction for the standardization of health records, implementation still varies dramatically between each organization, and integration challenges remain all too common.

The Creation of FHIR

Recognizing the need to further modernize industry EHR standards, in 2014 the HL7 International Organization published FHIR (Fast Healthcare Interoperable Resource) as the next iteration of their interoperability framework. 

Developed in conjunction with a broad cross-section of industry stakeholders, HL7 focused on distilling the existing recordkeeping paradigm into a set of more simple, modular, and interoperable data exchange standards. And, within a few years, FHIR had quickly gained acceptance from high-profile healthcare institutions, including CommonWell Health Alliance, SMART (Substitutable Medical Applications, Reusable Technologies), and even Apple with the integration of FHIR into the iPhone Health app. 

By 2020, the U.S. Centers for Medicare & Medicaid Services (CMS) had codified FHIR as a required framework for a variety of CMS-regulated payers, making it one of the most widely-supported standards in the healthcare industry to date.


So how exactly should we view the juxtaposition between FHIR and HL7? Is FHIR just a new and improved version of HL7, or is the contrast even bigger than that? 

While FHIR shares a common ancestry with HL7, leveraging many of the formats pioneered by the earlier framework, FHIR takes a more web-focused view of EHR interfacing. Rather than facilitating the direct exchange of individual documents and data, FHIR enables access to healthcare records through the use of “resource identifiers,” which act like browser URLs within an EHR ecosystem. This not only provides greater standardization and accessibility across the entire lifecycle of patient records but it also provides application developers with a more flexible suite of options for building dynamic, user-friendly EHR interfaces. As a result, the amount of innovation in EHR implementation has exploded, all thanks to the versatility of open FHIR standards and APIs.

Migrating to FHIR

The incentives for transitioning from an HL7-based system to FHIR are clear— by implementing this new standard, EHR applications gain increased levels of interoperability, openness, and interconnectivity. 

When migrating to FHIR, however, there are a number of challenges and considerations users should keep in mind:

  • Unlike HL7, which has been a widely-accepted document sharing standard for decades, FHIR is still young and dynamic. Some experts worry the protocol may become “balkanized” by differing versions and implementations over time.
  • FHIR still struggles with data vocabulary, and many organizations have differing standards for critical functions like matching patient identifiers and communicating lab results.
  • Inconsistent implementation by healthcare organizations, for example, mismatches in the specific FHIR APIs used by two EHR vendors, can undermine efforts to achieve interoperability.
  • Although there’s plenty of enthusiasm around FHIR, healthcare organizations are risk-averse and may wish to see more case studies before fully embracing a new operational standard.

Although the path from traditional HL7 to a FHIR-ready system certainly presents challenges, industry leaders are nonetheless excited for the future of interoperability in EHR systems. FHIR represents the cutting-edge of medical recordkeeping innovation, and with each new wave of adoption, healthcare professionals will unlock increasingly powerful methods for monitoring and managing patient data. 

Utilizing The Most Intuitive Technology

When it comes to EHR systems, there’s no understating the importance of the FHIR framework. While HL7 provided a robust foundation for standardizing patient recordkeeping practices across the healthcare industry, FHIR sets forth a more modern roadmap for integration and interoperability, unlocking groundbreaking new capabilities in areas like mobile health applications, cloud communications, and cross-industry collaboration. By giving EHRs the ability to talk to each other (a critical capability in a fragmented network of public and private providers), FHIR has emerged as an essential building block for the next generation of patient care.

Healthcare organizations are eager to adopt innovative new platforms and standards across their EHR investments, which makes the ability to trust in your IT infrastructure of paramount importance. In this respect, illumisoft can help you get the results you need. From medical record management to patient monitoring software, we’ve worked with dozens of healthcare providers, enhancing their operations with best-of-class technology solutions. 

If you’re ready to invest in the next big upgrade for your organization, illumisoft is here to help you unlock value at every level.