HL7 v2 — The Real-Time Backbone
The dominant real-time messaging standard across North American hospitals — pipe-delimited, fast, and supported almost everywhere.
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Understanding HL7 Messaging Standards
HL7 (Health Level Seven) defines how clinical data moves between hospital systems — v2 for real-time messaging, v3 in Canadian provincial programs.
HL7 v3 — XML-Based & RIM-Grounded
An XML-based standard grounded in a Reference Information Model (RIM), used in Canadian provincial drug and public health programs.
In Plain Language
Older but widely used standards for exchanging clinical and administrative messages between hospital systems.
What HL7 Integration Covers — Inbound and Outbound, v2 and v3
We integrate HL7 for digital health products, care management platforms, and payers that exchange real-time clinical data with hospital infrastructure.
Parse inbound HL7 v2 messages into structured data and generate conformant outbound messages hospitals accept without error.
Build and consume HL7 v3 CDA payloads for Canadian provincial programs — DIN queries, lab submissions, and public health reporting.
Two-way exchange with hospital systems — receive clinical events (ADT, results, orders) and send back acknowledgements and updates.
Connect to the engines that route HL7 messages — Rhapsody, Mirth Connect, Ensemble, and Cloverleaf — within existing infrastructure.
Translate between HL7 v2 versions (2.3–2.7), between v2 and v3, and between HL7 and FHIR — without losing clinical meaning.
Map clinical codes between vocabularies — LOINC, RxNorm, ICD-9 to ICD-10 — so translated data stays clinically accurate.
Why HL7 Is Still Essential in North American Healthcare
Hospitals have decades invested in HL7 workflows and interface engines — v2 is not going away, and integrating with it cleanly is real engineering.
HL7 v2 Is the Practical Gateway to Clinical Data
For any digital health product in hospital settings, HL7 integration is the practical gateway to real-time clinical data.
ADT Feeds Drive Real-Time Patient Tracking
HL7 v2 ADT feeds from hospital EHRs are the standard way to notify care platforms, HIEs, and payers of admissions and discharges.
Every Site Has Local Variations
Real messages differ from the spec — optional fields and custom segments mean an integration built for one site rarely fits another.
Canada Runs on v2 — and v3 Where It Matters
In Canada, HL7 v2 remains the messaging backbone, while v3 runs in provincial drug and public health systems using PHN identifiers.
HL7 Integration — Step by Step
A disciplined sequence from understanding the messages to a validated go-live. Hover or tap a stage to see what it involves.
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Message Inventory
Message Inventory
Identify which HL7 message types you need — ADT, lab results, orders, scheduling — and review samples for local variations.
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Connectivity Setup
Connectivity Setup
Establish the transport layer — most HL7 v2 uses MLLP over TCP/IP; define ports and routing with hospital IT.
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Message Mapping
Message Mapping
Map each HL7 segment and field to your data structures, handle optional fields, and process acknowledgement (ACK) messages.
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Error Handling & Alerting
Error Handling & Alerting
Handle malformed messages and unknown event types, with alerting for failed deliveries, drops, and queue backups.
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Validation & Go-Live
Validation & Go-Live
Test real message samples in staging — confirm ADT events trigger the right actions and results map to the right patients.
Who This Is For
We build HL7 integrations for products and organisations that depend on real-time hospital data.
Digital Health Products
The parsing, generation, and connectivity layer that lets your product speak HL7 — labs, orders, pharmacy.
Care Management Platforms & HIEs
HL7 v2 ADT feeds connected to your platform, triggering actions on every admission and discharge.
Payers & Health Plans
HL7 interfaces bringing hospital patient-event notifications into utilisation and care coordination.
Hospitals & Health Systems
New interfaces within your Rhapsody, Mirth, or Cloverleaf environment — no re-architecting clinical systems.
Message Types, Transport & Standards — The Building Blocks of HL7 Integration
We work across the full HL7 stack — message types, transport, interface engines, and terminologies.
Message Types
Clinical & Administrative Events
HL7 v2 types driving real-time admissions, results, and orders.
Transport
MLLP & Acknowledgements
Persistent socket transport for HL7 v2, with framing and ACKs.
Interface Engines
Hospital Routing Infrastructure
Hospital HL7 routing engines — we work within them, not around.
Versions
HL7 Versions We Implement
Every HL7 v2 version still in production, plus v3 and CDA.
Terminology
Code Systems & Mapping
Terminology mapping that keeps translated codes clinically accurate.
Canada
Canadian Provincial Programs
HL7 v3 and identifier conventions for Canadian provincial systems.
The HL7 Stack We Build On
Interface engines, transport, and terminology chosen for the hospital systems you connect to.
R
Rhapsody
M
Mirth Connect
E
Ensemble (InterSystems)
C
Cloverleaf
H
HL7 v2.3 – 2.7
H
HL7 v3
C
CDA / C-CDA
H
HL7 FHIR
D
DICOM
M
MLLP over TCP/IP
A
ACK / NACK
M
Message Queues
S
SFTP / File Drop
A
ADT
O
ORU (Results)
O
ORM / OMG (Orders)
M
MDM (Documents)
S
SIU (Scheduling)
L
LOINC
R
RxNorm
I
ICD-9 / ICD-10
S
SNOMED-CT
A
AWS GovCloud
A
Azure Health Data Services
D
Docker / Kubernetes
M
Monitoring & Alerting
Hospital Data Speaks HL7. Your Integration Should Too.
v2 and v3, inbound and outbound, across the interface engines hospitals run. Book a consultation and we will scope a production-ready HL7 implementation.
Book an HL7 Consult
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Frequently Asked Questions
[ 1 ]
What is MLLP and why is it used for HL7 v2?
MLLP (Minimal Lower Layer Protocol) is the standard transport for HL7 v2, wrapping each message with start and end characters over TCP/IP for persistent socket connections. Most hospital interface engines use it by default.
[ 2 ]
What is an ADT message and why does it matter?
ADT (Admit, Discharge, Transfer) messages notify connected systems when a patient's status changes — A01 admitted, A03 discharged, A08 demographic update. ADT feeds are the foundation of real-time patient tracking.
[ 3 ]
How is HL7 v2 different from FHIR?
HL7 v2 is an event-driven messaging format for real-time clinical transactions inside hospitals; FHIR is a resource-based API standard for web data exchange. Many systems use both — v2 internally, FHIR for external API access.
[ 4 ]
Does Canada use different HL7 standards than the U.S.?
The core HL7 v2 spec is the same internationally. But Canadian implementations use provincial patient identifiers (PHNs) and HL7 v3 in specific provincial systems (drug information, public health) where U.S. systems stayed on v2.
Global presence
