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Comparison of HL7 vs FHIR in 2024 | Which One to Choose

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    Posted in HL7

    Last Updated | January 24, 2024

    What Is The Basic Difference Between HL7 VS FHIR?

    Are you looking for the difference between HL7 vs FHIR? Read the guide to get the correct answer and critically understand what is the difference between HL7 and FHIR. HL7 is a set of international data-sharing standards that are meant to enhance healthcare interoperability.

    HL7 is a clinical messaging format that supports the secure exchange of documents and healthcare messaging between healthcare organizations. HL7 uses ASCII text-based messages to communicate between different systems, such as patient management systems, healthcare information systems, EMRs, laboratory information systems, and billing systems.

    On the other hand, the Fast Healthcare Interoperability Resources (FHIR) standard was released in 2014, as an alternative to HL7 v2, as an open standard that enables new apps and legacy systems to more easily exchange data than in the past. This move hopes to improve interoperability and enhance the efficiency of communication.

    Based on RESTful principles, FHIR aims to accelerate the implementation of HL7 and enhance interaction between legacy healthcare systems, as well as allow users to gain access to medical data from various devices.

    HL7 VS FHIR Standards

    HL7 and its members provide a framework that defines the exchange, integration, sharing and retrieval of electronic health information. HL7 standards define a process for how information is packaged and communicated from one party to another, as well as the language which is to be used, and the correct structure and data types required for seamless integration between systems.

    HL7 standards support clinical practice and the management, delivery, and evaluation of health services. Some common primary HL7 standards include Clinical Document Architecture (CDA®) Products, context management specifications, HL7 Version 2 Product Suite, and HL7 Version 3 Product Suite, while messaging and document standards for clinical specialties and groups include Arden Syntax, HL7/ANSI standards, HL7 Consumer Mobile Health Application Functional Framework, HL7 EHR-S Functional Requirements, and hundreds of others.

    FHIR® is also an interoperability standard of HL7 intended to facilitate the exchange of healthcare information between healthcare providers, patients, caregivers, payers, researchers, and anyone else involved in the healthcare ecosystem. You can also call it the HL7 latest version.

    FHIR contains two sections; a content model in the form of ‘resources’, and a specification for the exchange of these resources via RESTful interfaces as well as messaging and Documents.

    FHIR is known to help researchers with the exchange of information, and its two sectors collectively ensure better resource management. However, how the FHIR system is developed can impact the information exchange between the researchers.

    For this reason, you must choose the vendor that conducts in-depth UX research in healthcare to ensure the information exchange is secure, optimized, and error-free.

    Some common FHIR standards include HL7 Fast Healthcare Interoperability Resources Specification, HL7 FHIR® IG: Payer Coverage Decision Exchange, HL7 FHIR® Implementation Guides on Bulk Data, bidirectional services, C-CDA on FHIR, clinical decision support for immunization, coverage requirements discovery, consumer-facing real-time pharmacy benefit check, electronic case reporting, healthcare-associated infection reports, payer coverage decision exchange, consumer-directed payer data exchange, structured and unstructured data capture, unsolicited notifications, and data exchange for quality measures.

    To summarize hl7 cda vs fhi, A patient’s whole medical history can be organized using the CDA/CCD (Clinical Document Architecture) technique in an XML document. Whereas, FHIR includes numerous CDA components because both of these standards were created by HL7, yet they are divided into smaller, easier-to-manage parts. However, in the debate of hl7 and fhir, adopting FHIR is required for providers that want to follow industry standards.

    HL7 VS FHIR Protocols

    Health Level Seven (HL7) is one of the HL7 examples facilitates the sharing of vital information between different healthcare systems. It is the seventh OSI layer protocol that defines the format and the content of the messages that must be used by applications when exchanging data with one another. Here are the different HL7 Protocols:

    Event Driven Protocol

    Any real-world event that triggers the need for information exchange between applications, such as when the patient is admitted to or discharged from a facility or when an order needs to be placed at the pharmacy, defines an event-level protocol. Every time an application registers a real-world event, it needs to communicate this with other systems where such information is vital.

    Application to Application Protocol

    This protocol relates to communication between two independent applications, instead of between client-server type applications. What is important here is the message that is being exchanged between applications, and not the role of each application.

    OSI Level 7 Protocol

    This protocol pertains to the exact format and content of the data exchanged between the applications and not the mode of transmission between systems. HL7 has no connection with the transmission mode between applications. In most cases, a TCP/IP connection is established to deliver a message.

    Exchange Protocol

    This protocol delineates how data exchange between applications will be made. How this data is stored or processed by different applications isn’t of any importance here. Even though the database structure needs to coincide with HL7 message definitions, this is not compulsory.

    Standard Protocol

    Before a message can be exchanged between two applications, a proprietary, non-standard link needs to be created. However, all your link-building efforts can go down the drain when you are trying to connect to a third-party system. However HL7 standard protocol lets you reuse your initial development effort.


    DICOM and HL7 FHIR are complementary Standards in healthcare. While both HL7 vs FHIR provide the information model for health information, DICOM offers capabilities for storing, transmitting, and processing medical images. You can think of HL7 as a transaction-based protocol, which is driven by real-world events that necessitate the need for communication. As a result of these triggers or events, information systems share information with each other. On the other hand, DICOM is a much more client-oriented protocol. For example, when we talk about DICOM, imaging equipment sends requests to an MWL server to receive a work list.

    HL7 V2 VS FHIR

    Even though FHIR supports messaging (similar to HL7 V2), it also supports multiple options for facilitating data exchange among systems. But between hl7v2 vs fhir, FHIR is more advantageous because it provides more flexibility. The main difference between HL7 vs FHIR lies in the fact that, unlike HL7 v2, FHIR employs RESTful web services and open web technologies, such as JSON and RDF data formats. Since most developers are acquainted with these technologies, they experience a less steep learning curve than previous standards. Not to mention, The RESTful API approach replaces point-to-point interfaces with one-to-many interfaces, thereby making it much easier to exchange data and minimize the time to onboard new data exchange partners. Another major benefit of the RESTful approach is that increases interoperability between not just electronic health record (EHR) systems, but myriad other devices and systems, such as mobile apps, mobile devices, and wearables. Folio3 Custom Medical Software Development Company offers Folio3 EHR/EMR integration solutions that support HL7 implementation by integrating third-party technologies and wearable devices to create smarter experiences for both doctors and patients.

    Another difference between HL7 v2 and FHIR is that the former still depends on document exchange for health information exchange and data interoperability. Providers using HL7 v2 typically choose a set of data to transmit and then generate a message enveloping that data. HL7 v2 still uses the Consolidated Clinical Document format that contains a great deal of critical information, just like the static data in a PDF, it becomes quite laborious to extract the information and make it usable in any other format. This type of document exchange limits the provider from digging deep into the context of the data received.  Further in our debate of fhir vs hl7 v2, data-level change is quite critical in many applications, which is why FHIR leverages standardized application programming interface (API) standards to transcend data reconciliation challenges. Using FHIR, Applications can be plugged into a basic EHR operating system and information can then be fed into the provider workflow automatically.

    Somewhat akin to segments in HL7 v2 messages, FHIR stores and exchanges meaningful pieces of data known as “resources”. Each resource contains metadata, text, or bundled collections of information that form clinical documents. The best thing about the concept of resources is that each resource has a unique identifying tag, which helps devices and applications access required data without complicated data exchange processes.

    Why Is FHIR Better Than HL7?

    The whole idea behind the development of FHIR is to create a basic set of resources that, individually or in combination, can solve real-world clinical and administrative problems at a fraction of the price of existing FHIR alternatives. Like segments in an HL7 v2, each FHIR resource can be sliced into types and groups, wherein each type has a unique field structure, with either composite or primitive values. These fields are either optional or compulsory, and the resources are based on XML, Atom, JSON, HTTP, and OAuth. Although a single resource may suffice for a given use case, more often than not, resources are combined and tailored to meet use case-specific requirements.

    Another reason why FHIR is better than HL7 is that it offers numerous options for exchanging data among systems. In addition to supporting the messaging format of HL7, the FHIR system leverages the RESTful API approach. This allows FHIR to improve interoperability among a wide array of systems and devices beyond electronic health record (EHR) systems.

    FHIR is also promising to improve information sharing, simplify implementation, and offer better support for mobile apps. One area where FHIR especially stands out is its ability to support vital use cases that benefit providers, payers, and patients. FHIR will also facilitate patient data sharing between clinicians to provide coordinated care to patients and enhance critical decision-making. Insurance companies can use FHIR to supplement claims data with clinical data to verify details and improve outcomes. This would also solve a lot of false insurance claims and cut down on costs. As for patients, FHIR will allow patient-led care and allow users to become more involved in their healthcare and access medical information on the go through consumer-friendly apps, on the devices of their choice.

    Current interoperability efforts, such as HL7, only operate with a single aim, which is to move data back and forth and remove data reconciliation obstacles. On the other hand, the goal of FHIR is to coordinate care plans across the boundaries of systems, with the help of mobile devices and easily accessible apps. By incorporating apps that can be plugged into the basic EHR operating system and feed information directly into the provider workflow, FHIR aims to remove many of the issues associated with document exchange.

    Last but not least in our guide on FHIR vs hl7, FHIR has a strong focus on implementation and offers fast easy implementation. With multiple available implementation libraries, developers can kick-start development without any delay.


    You can use the FHIR Converter to convert legacy data (currently HL7 v2 messages) into FHIR bundles. Converting legacy data to FHIR expands the use cases for health data and enables interoperability. Folio3 Medical app development services make it a breeze to convert HL7 v2 messages into FHIR bundles.

    HL7 V3 Vs FHIR

    Here are some basic FHIR vs HL7 v3 differences to find a base for your understanding to differentiate between FHIR and HL7 v3.

    Rigorous types and XML-based communications electronic healthcare paradigm is what HL7 v3 is attempting to establish. The RIM (Reference Information representation) idea, which denotes a static representation of medical data, is introduced in the HL7 V3 standard. It offers data kinds, messages, and terminologies. 

    The open-source model is utilized by the standard that is implementers-focused, FHIR. It is accessible for study and application, in contrast to earlier healthcare norms. The community’s interest has substantially increased, and developers are involved in standard development, and testing thanks to the standard’s accessibility.It should be highlighted that smooth data interchange and integration within the sector are being made possible in both hl7 v3 vs fhir, which are redefining healthcare interoperability.

    How To Convert HL7 To XML

    It is quite easy to convert HL7 to XML. It is helpful to bear in mind that there are two objects generated when a message is received while performing this adjustment. The first is the “Source,” and the second is the “Message.” Both items initially resemble one another perfectly and include a replica of the message sent. 

    There are two methods for finishing this project. As seen below, it could be simpler to map each field in the HL7 message independently for straightforward XML files.

    Converting the message object from an HL7 message type to XML is the first step.

    message = qie.createXMLMessage(“”, ‘UTF-8’);

    Next, map the source HL7 Nodes to the XML XPATH in step two. 

    The patient ID is copied to the XML patient identifier node path in the following sample line of code.

    message.setNode(“/Patient/identifier/@value”, source.getNode(“PID-3”));

    In the final step, you must assess the template and produce the XML message. The template is first obtained and then passed to the qie.evaluateTemplate method. The data from a particular message is used to replace the HL7 Node Tags in this method. The new XML message is then used to generate the message object. 


    HL7 FHIR vs CDA. What’s the best one to choose?

    In essence, Clinical Document Architecture is limited to “clinical” use cases or data that deals with patients and their health conditions. This model doesn’t facilitate the exchange of content that doesn’t have any clinical relevance, such as financial information. On the other hand, HL7 FHIR documents have no limitation on their content and can have data about other aspects of healthcare, such as billing and insurance.

    Similarly, in CDA, the “content” of the document is expressed using a complex model, which gives implementers the flexibility to express a clinical concept in any degree of granularity. This model poses many challenges, for instance, when it comes to representing a person’s allergies or surgery. Templates are required to support interoperability. Another issue that arises with CDA is that common clinical concepts are modeled differently in different circumstances. FHIR bids adieu to all these problems since all clinical (and non-clinical) content in a message is handled by referencing existing resource definitions. This gives implementers a lot of flexibility when representing common structures.

    Is FHIR an HL7? 

    FHIR is a draft data standard developed and nurtured by HL7 International. FHIR combines the best features of HL7’s various versions while relying on the latest and most up-to-date web standards to solve challenges in interoperability. Folio3 hl7 integration solutions ensure the integration and interoperability of electronic health information.

    Are FHIR vs HL7 message types different too?

    Yes, fair vs HL7 message types are different as well. While HL7 only supports XML, FHIR makes use of RESTful web services and open web technologies including XML, JSON, and RDF.

    message = qie.createXMLMessage(qie.evaluateTemplate(qie.getVariable(‘HL7toXML Template’)), ‘UTF-8’);

    How do you configure authorization/access control in the FHIR store (HL7, Fhir, Hapi, and development)?

    An FHIR system will need some kind of security sub-system that administers users, user authentication, and user authorization. In Role-Based Access Control (RBAC), a user needs permissions for every object they wish to access. Permissions are grouped into roles, wherein each role characterizes the functions a user can perform. If a user’s role is granted permission to access an object, they can readily access it. FHIR supports this form of access control since FHIR Resources are object types and events such as Create, Read, Update, Delete, and Execute are operations on those objects. You can contact a healthcare app development solution provider to configure access control on your behalf.

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