HL7 / FHIR
HL7 / FHIR
Health Level 7 & Fast Healthcare Interoperability Resources
1. Overview of HL7/FHIR, the Healthcare Interoperability Standard for Securely Exchanging Clinical Data Between Medical Systems
flowchart LR
A["Fragmented, non-standard<br/>EMRs per institution —<br/>hard to interconnect data"] --"HL7 FHIR —<br/>a RESTful API standard"--> B["Resource-based<br/>standardization of health data"] --"Interoperability<br/>achieved"--> C["An integrated<br/>digital healthcare platform"]
style A fill:#FFEBEE,stroke:#D32F2F,color:#000
style B fill:#E3F2FD,stroke:#1976D2,color:#000
style C fill:#E8F5E9,stroke:#388E3C,color:#000
Definition: HL7 (Health Level 7) is the international standards body for healthcare information exchange. Its most recent standard, FHIR (Fast Healthcare Interoperability Resources), is a RESTful-API-based, resource-level standard for exchanging health data — a framework that enables secure, consistent sharing of patient information and clinical data between hospital information systems.
Characteristics: (RESTful API-based) Exchanges health data in JSON/XML over standard web methods, far easier to implement than legacy HL7 v2/v3. (Resource-centric) Defines around 80 standard resources such as Patient, Observation, and MedicationRequest. (Regulatory mandate) FHIR support is legally mandated under US ONC (Office of the National Coordinator for Health IT) and CMS rules; Korea’s health ministry is pursuing similar requirements.
Evolution of HL7 Standard Versions
| Version | Characteristics | Key Use |
|---|---|---|
| HL7 v2 | Pipe-delimited message format, established in 1987 | Still widely used to connect domestic hospital HIS/LIS systems |
| HL7 v3 | XML-based; complex structure made adoption difficult | Limited use |
| FHIR R4 | REST/JSON/API-based; the current mainstream standard | The baseline standard for global digital healthcare platforms |
| FHIR R5 | Stronger subscription model, improved smart-app integration | Planned for next-generation medical AI/PHR platforms |
2. Core Structure of HL7 FHIR
A. FHIR’s Core Components
flowchart TD
subgraph R1[" "]
direction LR
RES["Resource<br/>Patient, Observation,<br/>MedicationRequest, Encounter —<br/>around 80 standard resources"]
API["RESTful API<br/>CRUD-based standard operations —<br/>GET/POST/PUT/DELETE,<br/>JSON/XML formats"]
end
subgraph R2[" "]
direction LR
PRF["Profile<br/>defines country/institution-specific<br/>constraints — Korea FHIR IG,<br/>supports Extensions"]
SEC["Security/authentication<br/>SMART on FHIR —<br/>OAuth 2.0/OpenID Connect,<br/>patient-consent-based access"]
end
style RES fill:#E3F2FD,stroke:#1976D2,color:#000
style API fill:#F3E5F5,stroke:#7B1FA2,color:#000
style PRF fill:#FFF3E0,stroke:#F57C00,color:#000
style SEC fill:#E8F5E9,stroke:#388E3C,color:#000
style R1 fill:none,stroke:none
style R2 fill:none,stroke:none
Key FHIR Resource Categories
| Category | Resources | Description |
|---|---|---|
| Patient information | Patient, RelatedPerson | Patient demographics, guardian information |
| Clinical information | Observation, Condition, Procedure | Test results, diagnosis, treatment history |
| Medication | MedicationRequest, MedicationDispense | Prescription, administration, dispensing information |
| Care records | Encounter, EpisodeOfCare | Visit, admission, and outpatient episodes |
| Diagnostic imaging | ImagingStudy, DiagnosticReport | DICOM linkage, image interpretation |
| Administrative information | Organization, Practitioner, Location | Institution, clinician, and facility information |
B. Digital Healthcare Data Integration and Application
flowchart LR
subgraph SRC["Data Sources"]
direction TB
S1["EMR/HIS<br/>(hospital information systems)"]
S2["LIS/PACS<br/>(lab/imaging systems)"]
S3["PHR/wearables<br/>(personal health records)"]
end
subgraph FHIR_SRV["FHIR Server"]
direction TB
F1["FHIR Repository<br/>standard resource storage"]
F2["FHIR API<br/>RESTful interface"]
end
subgraph APP["Application Services"]
direction TB
A1["AI diagnostic support,<br/>clinical decision-making"]
A2["PHR app —<br/>patient self-access"]
A3["Public health analytics,<br/>epidemiological investigation"]
end
SRC --> FHIR_SRV --> APP
style SRC fill:#E3F2FD,stroke:#1976D2,color:#1E3A5F
style FHIR_SRV fill:#1E3A5F,stroke:#1E3A5F,color:#fff
style APP fill:#E8F5E9,stroke:#388E3C,color:#1B5E20
FHIR Adoption in Korea’s Digital Healthcare Sector
| Area | Application | Related Agency / Regulation |
|---|---|---|
| My Healthway | Platform for individuals to view and use their own health data | Ministry of Health and Welfare, National Health Insurance Service |
| Clinical information exchange | Sharing treatment history between institutions based on patient consent | Medical Service Act, clinical information exchange programs |
| AI medical devices | Training/inference of AI models on FHIR-based clinical data | Ministry of Food and Drug Safety (MFDS) SaMD guidelines |
| Public health | Linking epidemiological data for legally notifiable diseases such as COVID-19 | Korea Disease Control and Prevention Agency (KDCA) |
3. Expected Benefits and Application of HL7/FHIR Adoption
| Category | Key Expected Benefits | Application and Practical Approach |
|---|---|---|
| Interoperability | Standard data exchange between heterogeneous medical systems | Build a FHIR-API-based hub connecting EMR, LIS, and PACS |
| Patient-centeredness | Patients can view and move their own medical records directly | Use personal health data via My Healthway/PHR app integration |
| AI and analytics foundation | Standardized clinical data improves AI model quality | Build a clinical-data pipeline based on FHIR resources |
| Regulatory response | Establishes a foundation for complying with domestic and international digital-health regulations | Build a medical-app security certification framework based on SMART on FHIR |