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FHIR vs HL7: What’s the difference, and why does it matter for your business?

If you’re in the home health business, you may already be very well acquainted with FHIR and HL7, especially in the past year as new standardization rules from CMS have taken effect. For many, though, these remain fuzzy concepts—hard-to-define letters related to EHR and the always intimidating prospect of increased regulatory compliance.

Make no mistake. Understanding the difference between HL7 and FHIR could be critical to your organization in the months and years to come. With that in mind, here’s a brief look at FHIR vs HL7 —what they are, how they’re different, and why it matters for your business.

What’s the difference between HL7 and FHIR?

FHIR vs HL7—what’s the difference, really? The short answer is that FHIR is the name for a specific data standard, which was created by the larger governing body, called HL7.

Let’s take it back a step further. Health Level Seven International (HL7) is a governing body that has set the global standards for health data interoperability since the 1980s. These standards are generally called “HL7” as a shorthand. So, the term refers both to the non-profit regulatory organization and, less formally, with the different sets of standards that it has created.

And there have been several of those over the years. In the time since HL7 has been active, it’s developed a series of systems to standardize healthcare data to better facilitate the exchange of EHR and, thus, enable important actions like research, transition and coordination of care. The most recent of these systems is called Fast Healthcare Interoperability Resources (FHIR).

FHIR is designed for the current era, setting standards for the ways that people communicate today. That includes:

  • Making it easier to securely exchange real-time healthcare information across a variety of different formats and devices, including laptops, tablets and smartphones
  • Facilitating interoperability between legacy healthcare systems
  • Letting third-party developers more readily create useful applications to be integrated into current systems

Because FHIR is now the most prominent standard offered by HL7, the two terms are often used interchangeably. But, just to be clear, they are not the same. HL7 is the organization, and a name that could apply to all of that organization’s standards. FHIR applies only to the most recent of these—the standard that’s now mandated for many payers by CMS.

Why FHIR matters today

New interoperability rules from the U.S. Department of Health and Human Services (HHS) that took effect in 2021 have made the FHIR mandatory for many payers. As a result, many providers operating in home health, hospice and other post-acute settings are also under pressure to get up to date.

Designed to accommodate the technology with which information is now usually exchanged in the United States, the new guidelines do serve a vital role. As MedCity News reported, smartphone apps are now considered “among the primary vehicles through which healthcare organizations such as payers and health systems facilitate patient access” to critical data.

Because it defines how health data can be used across such apps, FHIR is now an urgent order of business in post-acute care. As such, we can expect an immediate impact on specifically certified EHRs operating in the acute and ambulatory space. Aside from a few exceptions, most of these organizations’ EHRs have to be able to support these interfaces via FHIR.

And, unfortunately, yesterday’s version won’t cut it anymore. This is what makes the difference between HL7 and FHIR particularly impactful. Older versions, which could all be (and have been) called HL7, have limitations. They were more transaction-based, or designed only for a snapshot or specific scenario. Using them meant using an inefficient, patchwork system.

Instead of dealing with a huge variety of different files and requests for patient information, FHIR allows for the transfer of critical info as one file that’s split into different components called resources. The idea is to streamline the info and the way it’s shared to improve data access and usability.

It’s more and better knowledge, all conveniently located and readily available. And it’s also easier to bring the right info into the appropriate workflows, which can help shore up inefficiencies in both operations and patient care.

Embracing the opportunities of FHIR

For some, the need to implement FHIR means yet another burdensome layer of compliance. In reality, though, it should be seen as an opportunity.

FHIR will be a key part of innovation going forward, and not just when it comes to provider-to-provider communication and transitions. New companies and software solutions are likely to emerge to provide new services around the possibilities of FHIR. Think of Apple and Amazon and the online pharmacies and other patient-forward services they use.

Patient access is key here. There’s a heightened, immediate interest in the ability to quickly move health data around to support different apps. And the government is regulating these standards in a way that gives organizations a clear path to follow if they want to seize the opportunity for better, more direct patient access.

Within each business, mastering FHIR also means getting an efficient and scalable way to structure the use of EHR for the benefits of operational functions ranging from admissions to transitions. That offers consistency and longevity, too—a means to avoid the inefficiencies of brief contracts or incompatible partners.

Add all this up, and it seems imperative for organizations to get on board with FHIR—stat. Failing to do so means not just the risk of running afoul of CMS compliance rules. It also means missing out on some key opportunities to improve operational efficiencies, and the chance to earn new business and contracts in the challenging years to come.

You can trust MatrixCare to help you take advantage of the opportunities of FHIR vs HL7.


Ryan Stutzman
Ryan Stutzman

Ryan Stutzman is a Senior Business Analyst of Integrations and Interoperability for MatrixCare. Ryan has spent the last four years leveraging health IT standards to improve patient care in post-acute settings and has been complicit in the design and development of more than a dozen integrations since joining the MatrixCare team in 2018. He is passionate about innovation that empowers healthcare providers and support staff to focus on providing the best care to their patients.


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