HL7 Standards – An Insight into Secure Data Exchange in Healthcare

Numerous and frequent changes in regulations and distributed information systems force healthcare professionals to be constantly concerned about the security of patient data. The exchange of patient health data between entities is crucial for a successful treatment process. For managers, it means managing complex information systems that often rely on different standards and technologies. There is only one solution, in this situation – interoperability.

The term interoperability refers to the ability of different information systems, devices, and applications (internal and external) to access, exchange, interpret and use data in a coordinated and secure manner. Interoperability means that a patient's health information is available to all clinicians who treat the patient, regardless of where they are located or what information systems they use.

The Role of HL7 in Orchestrating Patient Data Flow

Imagine the healthcare system as an orchestra. Composed of various seemingly incompatible instruments. These instruments are the different information systems (local and global). HL7 (Health Level Seven) addresses this orchestra by providing a score describing how they should 'work together.' As well as setting the rules for data exchange, HL7 ensures the integrity and flow of data, becoming a true 'conductor' of medical data exchange.

The use of HL7 standards ensures effective communication between the systems and apparatus of different healthcare providers. It’s necessary for the complex information systems that support healthcare worldwide to communicate and collaborate effectively.

What is the implementation of HL7 like in Poland, with special emphasis on the Polish National Implementation of HL7 CDA (PIK HL7 CDA) and the latest HL7 standard - which has the potential to revolutionize remote medical care - namely FHIR?

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Improving Patient Care with HL7 in Poland

In Poland, HL7 has been present for many years, but due to the distributed healthcare information system, its application was mainly in teleradiology and laboratory results data exchange. A significant step towards the interoperability of information systems in the Polish market was the introduction 2019 of the possibility of issuing e-prescriptions, the implementation of which is based precisely on one of the HL7 standards, the Clinical Document Architecture (CDA).

This opened the way for further standardization of medical records. As early as mid-2021, the reporting of Medical Events and the exchange of Electronic Medical Records was imposed on healthcare providers. The introduction of these regulations obliged all entities in the health care system (pharmacies, hospitals, clinics, diagnostic laboratories, etc.) to produce and exchange medical records under strictly defined rules. This is how the Polish National Implementation of HL7 CDA came into being. The HL7 CDA PIK is a formal set of rules for maintaining and storing electronic medical records. This template contains more than 200 CDA templates, as well as dictionaries that are used in validation rules.

The use of PIK HL7 CDA in Poland brings many benefits:

• Firstly, it enables the standardization of medical records, which facilitates the exchange of information between different systems.
• Secondly, it improves the quality of patient care by allowing doctors to access a patient's entire medical history quickly. This means clinical decisions can be made based on comprehensive and up-to-date data.
• Thirdly, it contributes to operational workflow efficiency by reducing the time and effort needed to manage medical records. In addition, patients can redeem e-prescriptions and e-referrals by entering only a 4-digit PIN. With these tools, tele-visits would undoubtedly have gained such popularity.

HL7 FHIR – A Breakthrough Standard for Web and Mobile Applications

HL7 FHIR (Fast Healthcare Interoperability Resources) is a standard focusing on application programming interfaces (APIs) that represent and exchange health information. FHIR is increasingly chosen as the standard for connecting systems and data in various ways, including web and mobile applications.

FHIR is groundbreaking because it is the first standard in the HL7 family to use modern web technologies such as RESTful APIs and JSON. This makes it very useful in web and mobile application development. API-based integration - the first and only HL7 standard to use this way of communicating - enables the creation of solutions that can exchange data with different EHR (Electronic Health Record) systems. FHIR is more modular and can be easily adapted to different usage scenarios. This allows for greater integration between other systems, applications, and devices, making it easier to manage patient data. Its flexibility and modularity make it ideal for use in remote healthcare, enabling more straightforward and more secure sharing of patient data.

One of the critical aspects of FHIR is that it is a resource-based standard. Each type of health data (patient, doctor, prescription, test result, etc.) is defined as a 'resource.' Each resource has its own unique data structure and set of operations that can be performed on it, facilitating the creation of consistent and interoperable health systems.

FHIR is used worldwide in a variety of health applications and systems. For example, in the US, FHIR is a critical component of the ONC's (Office of the National Coordinator for Health IT) patient data-sharing initiative. Many countries, including the UK, the Netherlands, and Sweden, use FHIR to create national health data infrastructures in Europe. Many large technology companies like Microsoft and Google actively use FHIR in their health products. Google uses FHIR in its Google Cloud Healthcare.

The Future of HL7 in Shaping the Healthcare Technology

The development of digital technologies and artificial intelligence in healthcare is inevitable, and HL7 standards (such as CDA and FHIR) will play a key role in enabling these innovations. For example, with FHIR, we can create mobile and web-based applications that seamlessly communicate with different healthcare systems, giving patients better access to their medical data and facilitating remote care.

HL7 standards also facilitate the management of large medical data sets generated by modern technologies such as genomics and precision medicine. By enabling the efficient exchange and analysis of this data, they can accelerate the development of new therapies and better personalization of healthcare.

In addition, HL7 standards contribute to greater transparency and accountability in healthcare by facilitating the sharing and tracking of healthcare information. In the future, they may enable more democratic and equitable healthcare systems where patients have more control over their medical data.

HL7 Is Revolutionizing Healthcare Through Interoperability

In the face of rapidly developing technology and growing patient expectations, HL7 standards are becoming a tool and a necessity in modern healthcare. Following global trends, Poland is successfully implementing these standards, which translates into tangible benefits for the healthcare system.

It is worth remembering that technology is only a tool to serve man. In this context, proper training of medical personnel and education of patients becomes crucial. They are the ultimate users of HL7-based systems. Even the most advanced technology will only deliver the expected benefits with their involvement and understanding. In this respect, HL7 is more like a philosophy than a technology. It is a vision of healthcare in which different systems and devices work together to create a coherent and efficient care network. Above all, we can achieve better patient outcomes through collaboration and information sharing.