HL7, FHIR, and other Healthcare Standards
The fastest path to interoperability
Healthcare organizations worldwide use InterSystems software to seamlessly integrate information across the care continuum while streamlining clinical and administrative processes. Support within our products for global and national standards is one reason for this success. Supported standards include:
- ADHA (replaced NEHTA) (Australia)
- CDA® and CCD®
- Direct Secure Messaging
- DMP (France)
- eHealth Exchange
- HL7® FHIR®
- HL7® Version 2
- HL7® Version 3
- ITK (United Kingdom)
- My Health Record (replaced PCEHR) (Australia)
- SS-MIX (Japan)
- xDT (Germany)
Tasked with improving health outcomes for Australians through the delivery of digital healthcare systems and the national digital health strategy for Australia, the Australian Digital Health Agency (the Agency) commenced operations on 1 July 2016.
The Agency is responsible for all national digital health services and systems, with a focus on engagement, innovation and clinical quality and safety. Its goal is to put data and technology safely to work for patients, consumers and the healthcare professionals who look after them.
In healthcare, ASTM (American Society for Testing and Materials) is a set of standards used in the transfer of information between clinical instruments and computer systems.
CDA (Clinical Document Architecture) and CCD (Continuity of Care Document) are specifications from the HL7 organization. According to HL7, CDA is an XML-based “document markup standard that specifies the structure and semantics of ‘clinical documents’ for the purpose of exchange between healthcare providers and patients.” CCD is “an implementation guide for sharing Continuity of Care Record (CCR) patient summary data using… CDA. CCD establishes a rich set of templates representing the typical sections of a summary record….”
According to the HL7 organization, “The Consolidated CDA (C-CDA) implementation guide contains a library of CDA templates, incorporating and harmonizing previous efforts from Health Level Seven (HL7), Integrating the Healthcare Enterprise (IHE), and Health Information Technology Standards Panel (HITSP). It represents harmonization of the HL7 Health Story guides, HITSP C32, related components of IHE Patient Care Coordination (IHE PCC), and Continuity of Care (CCD).
The Digital Imaging and Communications in Medicine (DICOM) standard is used to ensure the interoperability of systems that produce, store, display, process, send, retrieve, query or print medical images, and to manage related data and workflow.
The Direct Project was created to specify a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. Direct focuses on the technical standards and services necessary to securely push content from a sender to a receiver and not the actual content exchanged. For example, a primary care physician who is referring a patient to a specialist can use Direct to provide a clinical summary of that patient to the specialist and to receive a summary of the consultation.
DMP (Dossier Médical Personnel) is the Internet-accessible French national electronic health record aimed at improving health information sharing and care coordination. Electronic medical record and other clinical systems communicate and share data with DMP via published specifications based on the French health information systems interoperability framework (CI-SIS), which is itself based on IHE profiles.
The Electronic Data Interchange For Administration, Commerce, and Transport standard (EDIFACT) is also known as the International Standards Organization (ISO) Standard ISO 9735-6. United Nations rules for EDIFACT comprise a set of internationally agreed standards, directories, and guidelines for the electronic interchange of structured data, and in particular that relate to trade in goods and services between independent, computerized information systems. In healthcare EDIFACT is used primarily for exchange of administrative data.
The eHealth Exchange is a rapidly growing network of exchange partners who securely share clinical information over the Internet across the US, using a standardized approach. By leveraging a common set of standards, legal agreement and governance, eHealth Exchange participants are able to securely share health information with each other, without additional customization and one-off legal agreements. The eHealth Exchange connectivity spans all 50 states and is now the largest HIE Network in the US.
InterSystems and a growing number of organizations are adopting the emerging FHIR (Fast Healthcare Interoperability Resources) standard, originally specified by the HL7 organization. When fully specified FHIR will complement other standards, such as those from IHE, which are essential for interoperability and exchange of complete health information documents today. In the near term FHIR will likely play a major role in granular exchange of health information in mobile applications.
Health Level Seven (HL7) was developed as a standard language for the sharing and integration of electronic health information. InterSystems is a member and benefactor of the HL7 organization, with one seat on the HL7 board.
Integrating the Healthcare Enterprise (IHE) is focused on improving the ways computer systems in healthcare share information, and is the de-facto standard for complete and composite health information exchange. The IHE organization continually improves these interoperability standards, and current IHE certification of products is essential for ensuring interoperability. IHE certification goes beyond what’s demonstrated at a single “connectathon” event (another important test of interoperability) and is more reflective of a product’s ability to interoperate, right now, in the real world.
The Interoperability Toolkit (ITK), developed by the United Kingdom’s National Health Service (NHS), is a set of common specifications, frameworks and implementation guides to support interoperability within local organizations and across local health and social care communities. ITK uses open international standards and is aligned with HL7 and Integrating the Healthcare Enterprise (IHE).
InterSystems was the first company to receive official accreditation for its ITK implementation.
The Australian Government’s My Health Record is the new name for the Personally Controlled Electronic Health Record system, which was launched on 1 July 2012. Health information for a patient is currently distributed across a wide range of locations including their general practices, hospitals, imaging centres, specialists, and allied health practices.
A My Health Record is a digital health record for a patient that contains a summary of their health information. It is a key element of the national health reform agenda around making the health system more agile and sustainable.
With the introduction of the My Health Record system, healthcare organisations will have faster, easier access to more health information, creating a more efficient system, making continuity of care easier and improving treatment decisions.
NCPDP is an organization providing standards for information exchanges related to medications, supplies, and services within the healthcare system. These standards help improve safety, privacy and healthcare outcomes for patients and healthcare consumers, while reducing costs in the system.
SS-MIX (Standard Structured Medical Information eXchange) is a standard for health information exchange published by the Japanese Ministry of Health, Labor and Welfare. SS-MIX is based in part on HL7.
X12 is a standard for business-to-business electronic data interchange (EDI). It covers business transactions such as order placement and processing, shipping and receiving information, invoicing, payment and cash application data, and data to and from entities involved in finance, insurance, transportation, supply chains and state and federal governments.
xDT is a set of standards used in Germany for the exchange of health information between healthcare providers and insurance companies.
HL7, HEALTH LEVEL SEVEN, CCD®, CDA®, FHIR®, and the [FLAME DESIGN]® are trademarks owned by Health Level Seven International.