When Data Standards Fail to Standardize Exchange: A Close Look at the Unique Challenges in Today’s Healthcare Data Standards

The primary standard used in healthcare data exchange is a data format called Health Level 7, or HL7. While the healthcare industry has made strides in adopting APIs and the HL7 International organization is working on the next generation FHIR standard, there still is a ways to go until we see full adoption across the industry to these more modern standards.

Data exchange around electronic health records (EHRs) has been a long challenge for health systems and each healthcare setting has their own requirements in dealing with data and their patients. This is where HL7 makes an impact because it simplifies the process by providing a framework and standards for the exchange and retrieval of patient information. The world before HL7 was one of inefficiency and unsafe integrations – moving data between systems was a long development project where each connection was custom. The process used by HL7 International to collect feedback from its more than 1,600 members across 50 countries has led to varied implementations per site. Each healthcare organization, often driven by their electronic health record vendor, can essentially choose which version or type of standard they want to adopt and complete a custom implementation of the standard leading to minimal overlap for external vendors that need to work with different health systems. 

This underpins one of the main issues in digital health adoption – the gap between the industry standards that have been around since the 80s and the developers who have spent their careers working on newer data exchange methods and don’t understand why HL7 is still a thing.  If you’re working in healthcare data exchange, it’s important to understand how HL7 International operates to develop a deeper insight into how this industry operates.

Step-by-Step Process of HL7 Standards

In brief, the process from standard ideation to implementation and use unfolds as follows:

1. Authorship:  HL7 collects feedback and input from healthcare organizations, software vendors, and other stakeholders to create the standard itself, which is effectively an academic set of specifications for how clinical data is transferred between applications.
2. Implementation: Software vendors such as EHRs providers implement those standards in their software.
3. Deployment: The EHR updates are deployed to the healthcare organizations using those EHRs.
4. Configuration: The systems need to be configured, whether by an in-house IT team, EHR team, or external support.
5. Use: Two parties exchange information using the standard, such as through an interaction with a new application or a connection to an existing external vendor.