Challenge
Legacy system integration without vendor documentation
Agnotic approach
Custom parsers, reverse-engineered segment mappings, and partner-assisted validation.
HL7 v2 Integration
HL7 v2 integration services
Connect hospitals, labs, pharmacies, EHRs, and billing systems with HL7 v2 messaging (ADT, ORU, ORM, SIU, MDM) through Mirth, Rhapsody, or Azure interface engines, with a clean path to FHIR when you're ready.
HL7 v2Mirth / RhapsodyHL7 → FHIRInterface Engine
Trusted by global innovators
What are HL7 integration services?
HL7 integration services build and run the HL7 v2 interfaces that move admissions, orders, results and scheduling messages between EHRs, labs, imaging and billing systems. Agnotic Technologies designs these interfaces for hospitals and health tech teams: message mapping, interface engine channels, MLLP transport with acknowledgments, monitoring, and HL7 to FHIR mapping where modern apps need it.
HL7 v2 (Health Level Seven, version 2) is the message-based standard behind many production clinical events: admissions and transfers, lab and radiology results, orders, scheduling and documents. It remains one of HL7's most widely adopted standards, especially in hospitals, so most integrations still speak it.
The work is in the interface engine: non-conformant messages, segment mapping across systems that bend the standard, MLLP acknowledgements and retries, and an audit trail. We build on Mirth, Rhapsody or Azure Health Data Services and add an HL7 to FHIR path where needed.
What HL7 is
HL7 remains the backbone of clinical messaging
HL7 (Health Level Seven) is a global standard for exchanging healthcare information between hospitals, labs, EHRs, pharmacies, and billing systems. HL7 v2, the message-based version, remains in widespread production use despite FHIR's rise.
We implement HL7 v2 interfaces, HL7 ↔ FHIR transformation pipelines, and interface engines that manage message flow across heterogeneous health systems. Your modern stack doesn't have to abandon HL7 to move forward.
How does an HL7 v2 interface fit together?
A blueprint for HL7 v2 messaging across your systems: interface engine, MLLP transport, segment mapping, HL7 → FHIR transformation, and the audit and monitoring layers production needs.
Common failure modes
Where do HL7 v2 interfaces fail?
Challenge
Point-to-point spaghetti across a hospital
Agnotic approach
Interface engine consolidation, replacing per-system bespoke integrations with a managed interface layer.
Challenge
Data inconsistency between sending systems
Agnotic approach
Canonical data model, terminology services, and reconciliation workflows for ambiguous inputs.
Challenge
Compliance and audit expectations
Agnotic approach
Message-level audit logging, HIPAA-aware PHI handling, and retention policy enforcement.
Challenge
Workflow inefficiencies from message-based delays
Agnotic approach
Event-driven enhancements, FHIR subscriptions or Kafka layer, for workflows that need near-real-time response.
What does HL7 v2 interface development cover?
HL7 v2 interface development covers the message types, the interface engine, transport and monitoring. We name the exact message types and engine up front, because that determines what's buildable, and how reliably.
ADT, ORM & ORU messaging
ADT (admit/discharge/transfer), ORM (orders), and ORU (results) feeds (plus SIU scheduling, MDM documents, DFT financials, and VXU immunizations) parsed, mapped, and acknowledged reliably.
Interface engine development
Custom channels and transformers on Mirth Connect, Rhapsody, or Azure Health Data Services, matched to your message volume and ops model rather than a default.
Reliable MLLP transport
Low-latency MLLP over TCP/IP with acknowledgement handling, retry logic, and store-and-forward so no clinical message is silently dropped.
HL7 v2 ↔ FHIR transformation
Bidirectional HL7 v2 ↔ FHIR R4 mapping for hybrid deployments and staged migration off legacy feeds.
CDA / CCD & DICOM alongside
Clinical Document Architecture (CDA/CCD/C32) exchange and DICOM/PACS imaging workflows where orders and results span both HL7 and imaging.
Audit & observability
Message-level audit logging, PHI-aware log scrubbing, interface health dashboards, and failed-message alerting for operational and compliance confidence.
Where it runs
Where are HL7 v2 interfaces used?
Hospital system integration
Core EHR-to-ancillary system messaging across inpatient and ambulatory operations.
Lab & diagnostics
Order and result flow between labs, imaging centres, and ordering clinicians.
Billing & claims
Financial transaction messaging from clinical events to billing systems.
Telehealth connectivity
Bridging telehealth platforms into hospital HL7 infrastructure.
Patient data synchronisation
Cross-system patient demographic and clinical data sync.
HIE participation
Regional and national health information exchange connectivity.
Message types
Which HL7 v2 message types do we build?
The core message types in production healthcare, and what they actually do.
| Code | Name | Typical use |
|---|---|---|
| ADT | Admit, Discharge, Transfer | Patient movement events: admissions, discharges, transfers, updates to demographics and insurance. |
| ORU | Observation Result Unsolicited | Lab, radiology, and diagnostic results sent from ancillary systems to EHRs and ordering clinicians. |
| ORM | Order Message | Orders for labs, imaging, medications, and procedures placed by providers. |
| SIU | Scheduling Information Unsolicited | Appointment creation, rescheduling, cancellation, and status updates across systems. |
| MDM | Medical Document Management | Document events: transcription, clinical notes, and document status changes. |
| DFT | Detailed Financial Transaction | Charges, billing events, and financial adjustments flowing to billing and claims systems. |
| RAS / RGV | Medication admin / dispense | Pharmacy message types for medication administration, dispensing, and tracking. |
| VXU | Unsolicited Vaccination Record Update | Immunisation data exchange with IIS (immunisation information systems) and public health registries. |
HL7 v2 alongside FHIR
Many hospital systems still exchange admissions, orders and results over HL7 v2, so modern FHIR builds often need both. We build interfaces that bridge the two.
5+
Message types in routine production
3+
Interface engines supported
ACK
Every message acknowledged or alerted
Compliance-First Healthcare App Development Services Backed by Global Standards
15-Minute Scoping Call01
HIPAA
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, strict access controls, and traceable audit logs.
02
GDPR
General Data Protection Regulation
Implement lawful consent flows, data minimization, retention controls, and secure processing for sensitive health data.
03
FHIR
Fast Healthcare Interoperability Resources
Enable standardized health data exchange across apps, care teams, and systems through standards-based FHIR APIs.
04
HL7
Health Level Seven International
Support enterprise-grade interoperability with HL7-based integrations for records, events, and clinical messaging workflows.
05
HITRUST
Health Information Trust Alliance
Align security programs to healthcare-specific control and risk management practices trusted by providers and ecosystem partners.
06
HITECH
Health Information Technology for Economic and Clinical Health Act
Design with breach notification readiness, digital record safeguards, and operational controls that support regulated care programs.
07
SaMD
FDA Software as a Medical Device
Plan software quality, traceability, and documentation pathways for products that may require SaMD review and submission.
08
MDR (EU)
Medical Device Regulation (European Union)
Prepare EU market-ready processes for risk classification, evidence tracking, and lifecycle governance under MDR expectations.
09
SAMHSA
Substance Abuse and Mental Health Services Administration
Apply confidentiality controls and consent-aware sharing models for behavioral and mental health data experiences.
Compliance & standards
Which standards do our HL7 interfaces follow?
HL7FHIRHIPAAHITECHMLLP
Our Process
How do we deliver an HL7 v2 interface?
Interface design, mapping, and cutover run as parallel tracks so message flow reaches production reliably.
1.
Discovery & Scope
We map source and target systems, the message types and volumes involved, latency needs, and the interface engine that fits before any build.
Message-first
2.
Interface Design & Sandbox
Channel design, transformer logic, and acknowledgement flow stood up on the chosen engine and validated against sample messages.
Engine-ready
3.
Build & Test
Segment and field mapping with terminology alignment, HL7 → FHIR transformation where needed, and synthetic plus partner-assisted UAT.
Validated
4.
Go-Live & Monitoring
Phased cutover with message health dashboards, alert routing, and reconciliation workflows for missed or malformed messages.
Observable in production
Interface engine decision
Which HL7 interface engine should you run?
The HL7 interface engine behind your feeds shapes cost, operations and how easily you can map HL7 to FHIR. Here is how Mirth Connect, Rhapsody and Azure Health Data Services compare.
| Dimension | Mirth Connect | Rhapsody | Azure Health Data Services |
|---|---|---|---|
| Licence model | Commercial from version 4.6 (open source up to 4.5.2) | Commercial | Consumption (Azure) |
| Fit | SMB to mid-market | Enterprise, high-volume | Azure-native deployments |
| Learning curve | Moderate | Steep but comprehensive | Familiar for Azure teams |
| Transformation tooling | JavaScript transformers | Powerful mapping tooling | Azure + custom logic |
| HL7 ↔ FHIR | Supported via connectors | Strong native support | Native FHIR integration |
| Ops overhead | Self-managed by default | Vendor support available | Managed service |
We work with all three, and we'll match engine to workload rather than push a default.
Facts and sources
HL7 v2 facts and sources
Each fact below links to its primary source.
HL7 v2 was HL7's first information exchange standard and is one of its most widely adopted, prominent in inpatient settings around the world.
Source: HL7 FHIR R4, Comparison with HL7 v2 messagingHL7 names variation between implementations as one of the biggest challenges in HL7 v2 interoperability: even similar systems handling the same scenario can support different data elements.
Source: HL7 FHIR R4, Comparison with HL7 v2 messagingThe HL7 Version 2 to FHIR implementation guide maps HL7 v2 message segments, data types and vocabulary to FHIR R4 bundles, resources, data types and coding systems.
Source: HL7 International, V2 to FHIR implementation guideThe HIPAA Security Rule requires administrative, physical and technical safeguards for electronic protected health information.
Source: 45 CFR Part 164 Subpart C (eCFR)
Featured case study
Read Case StudyLera Health: compliant health platform
Related proof of standards-based delivery: for Lera Health we built a privacy-first data layer and testing-to-insights workflow end to end, the same reliable, audited data handling a production HL7 interface demands.
Frequently Asked Questions
It depends on how many systems and message types are in scope, how far each sender bends the standard, whether an interface engine is already running, and how quickly each system owner provides specs, connectivity and test messages. We scope against your message types and volumes before giving you a plan.
Cost tracks the number of interfaces and message types, the mapping effort per feed, and whether you need a new interface engine or already run one. HL7 to FHIR mapping, monitoring and support after go-live add to the scope. We share an estimate after scoping.
Yes. HL7 describes v2 as one of its most widely adopted standards, prominent in inpatient settings, and many hospital systems still send admissions, orders and results as v2 messages. New apps often read FHIR APIs while HL7 v2 feeds carry the real-time events, so we build both.
Yes. Since version 4.6, Mirth Connect is sold under a commercial licence, which leads some teams to review their engine. We inventory every channel, rebuild it on the new engine, run old and new in parallel and reconcile message counts before switching the old engine off.
HL7 v2 interfaces usually don't need marketplace certification, but they do require the sending and receiving system owners' cooperation for interface specs, connectivity, and site enablement. We plan those access dependencies in from the start.
Yes. We bridge telehealth and RPM platforms into hospital HL7 infrastructure, turning device and visit data into ORU/ADT messages or transforming it to FHIR, so virtual care stays in sync with the system of record.
Mirth Connect fits most SMB to mid-market builds, Rhapsody fits enterprise high-volume mapping, and Azure Health Data Services fits Azure-native stacks wanting a managed service. We match engine to workload rather than push a default, and support MLLP, SFTP, HTTP/S, and DICOM/PACS alongside where imaging is involved.
Ready to enable smooth healthcare interoperability?
Connect your systems with HL7 and enable efficient, standardised data exchange, with a realistic plan for HL7 → FHIR migration when you're ready.
contact@agnotic.com
Partnerships
contact@agnotic.com