How to Choose the Right HL7 Integration Company

Key Takeaways

• For selecting a good HL7 integration company, look for one that has handled real healthcare projects and understands how HL7 integration works in practice. 
• Make sure the team has worked with the EHR or EMR systems you plan to connect with your platform. 
• Go through their past projects to see how they solved integration problems for other healthcare businesses.
• Ask about their testing and security process and find out how they will support you after the system goes live. 
• Learn how companies like Idea Usher can help with HL7 integration and connect healthcare systems for smoother, more reliable data exchange.

To choose the right HL7 integration company, look for a team that has real experience with HL7, FHIR as well as EHR systems. It is also important to check their past healthcare projects. A good company should help you from planning the integration to testing and launch. This will make it easier to build an integration that works well now and can grow with your platform. 

Choosing an HL7 integration company can be tricky when you have to consider your healthcare systems, data flow, security needs, and future requirements. Idea Usher has worked on HL7 solutions for different healthcare businesses using technologies such as HL7 FHIR and interface engines. In this blog, we’ll explain what to look for in an integration partner and how to choose one that fits your project. 

Why Are Healthcare Businesses Investing More in HL7 Integration?

Healthcare businesses are investing in HL7 integration because disconnected systems can slow down workflows and make patient information harder to access. Integration helps hospitals, labs, EHRs, and healthcare applications exchange data without relying on repeated manual work. The demand is also growing as interoperability becomes a larger technology investment. According to Future Market Insights, the HL7 FHIR compliance market was valued at $2.3 billion and is projected to reach $2.6 billion and then $8.6 billion, growing at a 12.7% CAGR.

Source: Future Market Insights

Reducing System Gaps

Healthcare data often sits across EHRs, laboratories, pharmacies, imaging systems, and other platforms. HL7 helps these systems exchange information in a structured way instead of forcing staff to move data manually. This can reduce duplicate entry and make it easier for different teams to work from the same patient information.

For example, AllianceChicago used HL7 FHIR in its Aligning Housing and Healthcare project to connect healthcare and social-service providers. This helped coordinate services for people experiencing homelessness.

Improving Patient Data Access

HL7 integration allows patient information to move between systems where it is needed. This is especially useful when patients receive care from multiple providers and their records are spread across different platforms. HL7’s International Patient Access initiative uses FHIR to support secure patient access to health information. It reports adoption across 29 countries, showing the growing use of FHIR for cross-system access.

Cohere Health is another example. Its Cohere Connect platform uses HL7 FHIR-based APIs to support prior authorization workflows directly from provider EMRs. The product was introduced to help health plans address interoperability requirements while reducing provider workload and speeding up the authorization process. 

Supporting Connected Care

HL7 integration can help healthcare teams receive clinical information faster and use it within existing workflows. Lab results, orders, patient records, and other data can move between systems without requiring staff to repeatedly request or enter the same information. This can support more connected care while reducing administrative delays.

The business value extends beyond data exchange. Interweave, an NHS-owned FHIR platform, now supports six Integrated Care Systems and uses FHIR as the foundation for sharing health and social-care data. Its use cases include reducing administrative work, improving information flow, and helping clinicians access relevant patient information during care.

Before Choosing a Company, Define What You Need to Integrate

Before choosing an HL7 integration company, first define which systems you need to connect and what data they need to exchange. Your choice will depend on the EHRs or healthcare systems involved, the type of patient data, and how that data needs to move. You should also decide whether you need HL7 v2, FHIR, or both, and whether the integration needs real-time or batch processing. 

Which Systems Need to Connect?

List every system that needs to exchange data. This may include EHRs, EMRs, labs, PACS, pharmacies, billing platforms, patient apps, or health information exchanges. More systems usually mean more mapping, testing, authentication, and monitoring. A single EHR connection can cost around $10K–$25K, while multi-EHR environments can reach $80K–$150K+.

What Patient Data Needs to Move?

Define exactly what the systems need to exchange. This may include demographics, encounters, allergies, medications, lab results, clinical notes, orders, claims, or appointments. The type and volume of data will also affect mapping, testing, and overall integration cost.

A simple way to scope it is:

Patient data → Message/resource → Destination → Action

FHIR uses modular Resources for patient information. Its data model has grown from 49 Resources to 145, showing how much information modern FHIR integrations can support. 

Do You Need HL7 v2 or FHIR?

HL7 v2 remains useful for existing hospital and laboratory systems. FHIR is better suited to API-based applications and newer interoperability workflows. ONC reports that 9 in 10 hospitals enabled patient access through APIs, while 7 in 10 used standards-based APIs such as FHIR. It also found that 73% of digital health companies use standards-based APIs for EHR integration. 

A hybrid architecture can use HL7 v2 for older systems and FHIR for newer applications.

Will Data Move One Way?

Decide whether your product only reads data or also writes data back to the EHR. Read-only integrations are generally simpler because they do not modify the source system. Current benchmarks put read-only FHIR around $15K–$30K, bidirectional FHIR around $30K–$60K, and bidirectional HL7 v2 around $25K–$45K. 

ONC also distinguishes between applications that read EHR data and those that write information back. This should be defined before requesting vendor proposals. SonderMind provides a useful example. Its partnership with Atlas Systems uses PRIME Provider Payer Connect to automate provider-payer data exchange and deliver near-real-time updates across its network. 

Do You Need Real-Time Data?

Decide how quickly information needs to reach the receiving system. Real-time exchange fits orders, results, alerts, and some authorization workflows, while batch processing works for reports and periodic synchronization. FHIR also supports Bulk Data for transferring large datasets from a FHIR server to another application. 

Real-time integrations can cost more because they need stronger monitoring, retry logic, and availability. Basic one-way HL7 v2 work is estimated at $10K–$20K, while bidirectional environments can reach $25K–$45K+.  

Careviso is another example. Its seeQer price-transparency tool completed a real-time exchange of Good Faith Estimates and Advanced Explanations of Benefits through the HL7 FHIR Da Vinci framework.

What Sets Experienced HL7 Integration Companies Apart?

An experienced HL7 integration company understands both healthcare systems and software development. The difference is knowing how EHRs work in production, how clinical data is mapped, how failed messages are recovered, and how healthcare data is secured. These skills help prevent problems that may only appear after launch.

They Have Production HL7 Experience

A company with real HL7 experience should be able to explain how its integrations work after launch. Look for experience with message processing, interface monitoring, error handling, testing, and production support rather than only theoretical knowledge of HL7. They should also understand how to troubleshoot issues when real clinical data does not move as expected. 

They Understand HL7 Data

HL7 integration involves more than moving messages between systems. The team should understand ADT, ORM, ORU, and SIU messages, along with segments, fields, acknowledgments, and custom Z-segments.

They Have Real EHR Experience

EHRs can differ in their APIs, HL7 interfaces, authentication, testing environments, and vendor requirements. An experienced team should know how to work with both modern FHIR APIs and older HL7 connections. They should also be familiar with the approval and testing steps required before an integration goes live.

They Know Healthcare Data Mapping

Data mapping is not just about moving data from one system to another. Different healthcare systems may store the same patient information in different ways. The integration team needs to understand what the data means and make sure it reaches the right place. Good mapping helps prevent errors and keeps the information useful for the people who need it. 

A strong mapping process covers:

• Source and destination fields
• Required values
• Clinical terminology
• Data transformations
• Validation rules
• Missing information

They Can Handle Interface Failures

Production integrations can encounter downtime, rejected messages, timeouts, and unexpected data. The team should therefore build acknowledgments, retries, logging, alerts, error queues, and reconciliation into the integration. ONC reports that the average number of electronic methods hospitals use to obtain external information increased from 2 in 2019 to 3.4 in 2025, showing the growing complexity of interoperability environments. 

They Understand Healthcare Security

Healthcare integrations handle sensitive patient information, so security needs to be taken seriously from the start. The system should make sure only the right people and applications can access the data. It should also protect information while it moves between systems and keep a record of important access and changes. 

Data in transit → Authentication → Access control → Processing → Storage → Audit logging

A general software vendor may understand application security, but healthcare integration requires applying those controls to clinical data exchange and EHR workflows.

They Support Beyond Launch

HL7 integration does not end after the first message reaches the right system. Healthcare systems can change over time, and those changes may affect how the integration works. A good HL7 company should be able to fix these issues and keep the connection working as your business grows. This ongoing support can save you from having to rebuild the integration later. 

At IdeaUsher, we can help businesses with HL7 development, EHR and EMR connectivity, data mapping, FHIR APIs, testing, and ongoing improvements. Our team brings 500,000+ hours of coding experience and includes ex-MAANG and FAANG developers.

Check HL7 and FHIR Integration Depth of the Company

Before hiring an HL7 integration company, check whether they can work with both HL7 and FHIR in real healthcare environments. The team should understand how messages are structured, how FHIR APIs work, and how data moves between different healthcare systems. They should also be able to handle transformations when older HL7 systems need to work with newer FHIR-based applications. 

1. HL7 v2 Interface Development

HL7 v2 remains widely used for hospital and healthcare system messaging. A capable team should know message parsing, segments, fields, validation, acknowledgments, and vendor-specific variations. HL7 terminology includes 159 HL7 v2 message-type concepts, including common workflows such as ADT, ORM, and ORU.

2. FHIR API Integration

FHIR uses modular Resources to represent healthcare information through modern APIs. Developers should understand resources, profiles, authentication, API operations, validation, and vendor-specific requirements. FHIR has grown from 49 Resources to 145, showing the breadth of its data model.

Typical FHIR work includes:

• Patient and Encounter resources
• Observation and DiagnosticReport
• Medication and Allergy data
• OAuth and SMART on FHIR
• Read and write operations

3. HL7-to-FHIR Transformation

Many healthcare products need both HL7 and FHIR. An older healthcare system may still send HL7 v2 while a newer app works with FHIR. The integration needs to convert the data into a format the new system can understand. This makes it easier to connect older systems with modern healthcare applications. 

For example:

ADT → Patient + Encounter

ORU → Observation + DiagnosticReport

Custom fields and terminology can increase the development effort. Individual HL7 v2-to-FHIR interfaces can cost around $10K–$25K, while larger multi-system projects can reach $80K–$150K+.

4. ADT, ORU, ORM Workflows

A good HL7 team should know how each message works in a real healthcare workflow. ADT messages are used when a patient is admitted or discharged. ORM messages carry orders, while ORU messages are used for results. Knowing how these messages work helps the team build integrations that fit the way healthcare systems actually operate. 

Custom mappings, acknowledgments, routing, and transformations can increase costs. A basic interface may cost $10K–$25K, while more complex bidirectional workflows can reach $25K–$60K+.

5. Interface Engine Integration

An interface engine is helpful when several healthcare systems need to work together. It gives the integration one place to manage how data moves between systems. This can make it easier to add new connections and fix problems when something goes wrong. It also helps avoid building a completely separate integration for every system. 

For a growing healthcare product, an integration engine can reduce repeated development work when new systems are added.

Look Beyond HL7: Evaluate EHR Integration Experience

Knowing HL7 does not automatically mean a company can integrate with a major EHR. Enterprise EHRs have their own APIs, authentication, testing environments, and data requirements. Before hiring a partner, check whether they have worked with real EHR environments and understand these requirements.

1. Experience With Epic and Oracle

Epic and Oracle Health both support FHIR APIs, but each has its own integration environment. Epic provides FHIR APIs for its health record, while Oracle Health Millennium supports FHIR R4, EHR APIs, SMART applications, and bulk data access. 

More than 1,000 hospitals and 22,000 clinics using Epic were connected to TEFCA through Epic Nexus.

2. MEDITECH and Other EHRs

A capable integration partner should be able to work across different EHR environments. MEDITECH’s Traverse Exchange connects more than 700 facilities across 41 states and supports data exchange with other connected networks. This matters when a healthcare product needs several EHR integrations because each connection may have different data and testing requirements.

3. Connecting Clinical Systems

Healthcare products often connect to more than an EHR. Labs, pharmacies, imaging systems, and medical devices may also need to exchange information. The integration team should understand how these systems exchange data and where each piece of information needs to go.

4. Working With Legacy Systems

Many healthcare organizations still use older systems that do not support modern APIs. HL7 or an integration layer can connect these systems with newer applications. A UCLA Medical Center implementation used an HL7/DICOM bridge to connect legacy radiology systems with newer infrastructure. 

This means an integration strategy does not always require replacing older technology. Existing systems can continue working while newer applications are added around them.

5. Integrating Multiple Data Sources

The work becomes more complex when patient information comes from several sources. The integration must keep patient identity and clinical meaning consistent across systems. A study involving 77 German hospitals found that data silos limited information access across institutions. The resulting platform combined EHR and claims data using HL7 FHIR models.

Ask How the Company Handles HL7 Data Mapping and Transformation

A good HL7 integration company should have a clear process for mapping and transforming healthcare data. Different systems may store the same information in different ways. The team should know how to map data, handle missing fields, test transformations, and keep records consistent.

How Are HL7 Fields Mapped?

The first step is matching fields in the HL7 message with the receiving system’s data model. This requires more than matching field names because the same data can be structured differently across systems. One study found that about 80% of data elements for three public health registries were available in FHIR. The remaining data still needed mapping or other solutions.

How Are Different EHR Data Formats Normalized?

Different EHRs may represent the same clinical information in different ways. Normalization converts this data into a consistent structure. A Mayo Clinic EHR study created 30 mapping rules, 62 normalization rules, and 11 FHIR extensions to handle these differences.

How Are Missing or Invalid Fields Handled?

Healthcare data is not always complete. Some fields may be missing or may not have a direct match in the receiving system. A good integration should flag these issues instead of passing incorrect information. A lab data study found information loss involving specimen sources, analytical methods, units, reference ranges, and LOINC codes. Using multiple HL7 versions also increased the complexity.

How Are Data Transformations Tested?

Data transformations should be tested before they reach production. Testing should confirm that the data is mapped correctly and still has the right clinical meaning. Research has also found a strong link between validation and testing tools and better FHIR compliance.

Key checks include:

• Field mapping
• Required data
• Terminology conversion
• FHIR profile rules
• Invalid values
• End-to-end delivery

How Is Data Reconciled Across Systems?

Reconciliation helps keep patient information consistent across connected systems. This becomes especially important when different systems update the same record or data arrives at different times. Studies show that FHIR mapping can combine data from different institutions. Research on lab data also highlights how inconsistent codes and values can lead to information loss.

Find Out What Happens When an HL7 Message Fails

A good HL7 integration should not stop working when a message fails. The system should identify the problem, keep the failed message safe, and try to process it again when appropriate. It should also alert the right team and help them see what went wrong. This helps prevent important patient data from being lost during an integration failure.

1. How Are HL7 Messages Validated?

Messages should be checked before processing. The integration can verify required fields, message structure, data types, and codes before sending data to the receiving system. This helps catch problems early and prevents incorrect data from moving through the workflow. FHIR uses the OperationOutcome resource to report errors, warnings, and validation results. It can also identify where the problem occurred, making troubleshooting easier.

2. How Are Failed Messages Retried?

Not every failure means the message is unusable. A temporary network issue or unavailable EHR can cause a valid message to fail. A reliable integration should hold that message and retry it when the receiving system is available again. Retries should have clear limits and intervals. IdeaUsher can help design retry workflows that fit the connected EHRs and expected message volume.

3. How Are Errors Handled?

Messages that continue to fail should move into an error queue. This keeps them available for investigation instead of losing them or leaving teams unsure about their status. An Oregon statewide syndromic surveillance implementation found that hospitals sending HL7 2.5.1 messages used different interface configurations. Its ingestion process used error-handling filters to identify messages that did not meet accepted standards.

A useful error queue can show:

• Failed message ID
• Patient or encounter reference
• Failure reason
• Retry attempts
• Processing status
• Failure time

4. How Are Integration Failures Reported?

Finding an error is only useful if the right people know about it. Production integrations should alert teams when messages repeatedly fail, queues grow, or a connected system becomes unavailable. ONC data found that 15% of hospitals reported receiving an error message when sending Direct messages. The same research found that 57% faced difficulty matching or identifying the correct patient between systems.

At IdeaUsher, we can help build monitoring and alerts that give teams visibility into these failures instead of relying only on manual log checks.

5. How Is Data Reconciled?

Retrying a message may not fix every problem. If one system receives a record while another does not, reconciliation helps identify the difference and bring the systems back into sync. It can compare message status, patient records, timestamps, acknowledgments, and transaction IDs. This helps identify missing or duplicated data and confirm whether important messages were eventually processed.

Don’t Treat HIPAA and Security as a Checkbox

HIPAA security should be part of the integration architecture rather than a final compliance step. Ask how the vendor protects PHI, controls access, records activity, secures endpoints, and manages security documentation. A good HL7 partner should explain these controls clearly and show how they apply to your integration.

1. How Is PHI Protected?

Ask how PHI is protected while moving between your EHR, HL7 interface, APIs, and other healthcare systems. The HIPAA Security Rule requires safeguards that protect the confidentiality, integrity, and availability of electronic PHI, including security measures for data transmitted over electronic networks.

The vendor should explain its use of encryption, secure transport, certificates, and integrity controls. HHS also recommends appropriate technical safeguards based on the organization’s risks rather than prescribing one specific technology.

2. Who Can Access PHI?

Not every person or application should have access to integration data. Ask how the vendor controls access based on user roles and responsibilities and limits access to the PHI that is actually needed. The HIPAA Security Rule requires technical access controls and policies that allow only authorized people to access ePHI. It also requires procedures for verifying the identity of anyone requesting access.

3. Are Audit Logs Maintained?

Ask whether the integration records important access and system activity. Logs can help identify who accessed information, when an event occurred, and what happened during an integration failure or security investigation. HIPAA requires audit controls that record and examine activity in systems containing or using ePHI. These records can also help healthcare organizations investigate unauthorized access and operational problems.

4. How Are Endpoints Secured?

Ask how API keys, passwords, certificates, tokens, and integration credentials are stored and protected. These credentials should not be exposed in application code or shared broadly across development and production environments. Also ask how the vendor secures each integration endpoint. 

HHS guidance for cloud environments emphasizes risk analysis, appropriate safeguards, and a Business Associate Agreement when a cloud service creates, receives, maintains, or transmits ePHI on behalf of a covered entity.

5. What Security Documents Are Provided?

Do not rely only on a statement that the integration is “HIPAA compliant.” Ask what security documentation the vendor can provide, including relevant policies, risk assessments, security controls, incident procedures, and the BAA where applicable. HHS explains that HIPAA does not automatically require a cloud service provider to give customers detailed security documentation or permit audits. However, customers can require additional assurances through a BAA, SLA, or other documentation based on their own risk analysis.

Ask These Questions Before Hiring an HL7 Integration Company

Before hiring an HL7 integration company, ask questions that show how the team handles real healthcare environments. Check their HL7 and EHR experience along with testing, security, failures, and ongoing support. Also confirm exactly what is included in the project estimate.

1. Which HL7 Versions Have You Used?

Ask which HL7 versions and message types the team has actually implemented. This can include HL7 v2, FHIR, CDA, ADT, ORM, ORU, SIU, and custom Z-segments. HL7 v2 remains widely used and covers patient administration, clinical data, laboratory orders, and reports.

A strong partner should be able to explain how these messages were mapped, validated, acknowledged, and tested in production. Ask for details about the workflows rather than accepting a simple list of standards.

2. Which EHR Systems Have You Integrated?

EHR experience should be checked separately from general HL7 experience. Ask whether the team has worked with systems such as Epic, Oracle Health, MEDITECH, or other EHRs relevant to your project. This matters because each environment can have different APIs, authentication methods, testing processes, and vendor requirements. 

3. Can You Show Healthcare Case Studies?

Ask for case studies that show what the company actually delivered. Look for the systems connected, standards used, data exchanged, challenges, and production results. This helps you judge whether their experience matches your project. HL7 publishes case studies involving Children’s Hospital of Philadelphia, MERE Medical, and Primary Record. These cover areas such as lab testing, chronic pain management, cancer detection, platelet transfusions, and medication reconciliation.

4. How Do You Handle HL7 Failures?

Ask what happens when an HL7 message fails. A production integration should have validation, retries, error queues, alerts, and reconciliation instead of simply recording an error. At IdeaUsher, we can design failure-handling workflows with message tracking, retry logic, monitoring, and reconciliation to keep integrations easier to manage.

5. How Do You Test Before Production?

Ask how the integration is tested before real patient data is exchanged. Testing should cover message structure, mapping, invalid data, acknowledgments, authentication, errors, and end-to-end workflows. ONC supports conformance tools such as Inferno for standardized FHIR API testing. These tools cover areas including SMART App Launch, US Core, resource searches, profile validation, and Bulk Data Access.

6. Who Owns Integration After Go-Live?

Ask who will be responsible once the integration is live. Healthcare systems change, interfaces need updates, and new workflows may require additional mapping or testing. Your contract should make it clear whether the development team handles fixes, monitoring, upgrades, and future interface changes. 

7. What Security Measures Are Included?

Ask how patient data will be protected during exchange. Important areas include encryption, authentication, authorization, access controls, audit trails, and input validation. HL7 FHIR guidance recommends TLS for production exchange and OAuth for web-based authentication. IBM research also found that healthcare data breaches averaged $7.42 million.

8. What Does Support Include?

Ask whether support covers monitoring, bug fixes, EHR changes, interface updates, security patches, and troubleshooting. Also confirm whether support is included in the project cost or billed separately. AHRQ-reviewed research found that annual EHR operating and maintenance costs could reach 12% to 20% of initial costs, showing why post-launch support should be discussed early.

9. What Is Included In The Estimate?

Ask for a detailed estimate rather than accepting one total development figure. It should show what is included for discovery, HL7 mapping, EHR connectivity, development, testing, deployment, monitoring, security, and support. You should also ask whether vendor fees, additional interfaces, new message types, or future changes are billed separately. 

Contact Idea Usher for HL7 Integration

If you are planning to connect EHRs, EMRs, clinical systems, or healthcare applications, IdeaUsher can help you build the integration around your specific data and workflow requirements. Our team has 500,000+ hours of coding experience and includes ex-MAANG and FAANG developers with experience across complex technology projects. We can support the project from initial planning through development and ongoing improvements.

HL7 and Healthcare Expertise

We help healthcare businesses work with HL7-based data exchange and interoperability requirements. Our team can support message handling, interface development, testing, monitoring, and integration workflows designed for real healthcare environments. We focus on building reliable connections that fit your existing healthcare infrastructure.

EHR and EMR Integration

We can help connect your platform with EHR and EMR systems while handling their different APIs, data structures, authentication methods, and integration requirements. This makes it easier to exchange clinical information across connected systems. Our approach can also accommodate multiple healthcare systems as your integration needs expand.

HL7 and FHIR Development

Whether your project uses HL7 v2, FHIR, or both, we can build the required interfaces and data exchange workflows. We can also help connect legacy HL7 systems with newer FHIR-based applications. This allows your platform to work with both established healthcare systems and modern digital health products.

Healthcare Data Mapping

Different healthcare systems often structure the same information differently. Our team can map, normalize, and transform healthcare data while handling validation and reconciliation requirements to keep information consistent across systems. This helps reduce data mismatches and supports more reliable exchange between connected platforms.

Conclusion

Choosing the right HL7 integration company comes down to more than technical skills. Look for a team with real HL7 and EHR experience, strong data mapping capabilities, reliable error handling, proper security practices, and long-term support. The right partner should also give you a clear estimate based on your systems, workflows, and integration requirements. 

FAQs