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HL7 Interface Development and FHIR Integration, Including SMART on FHIR Apps That Run Inside the EHR

QSS Technosoft builds the interfaces that get one healthcare system talking to another: HL7 v2 feeds on Mirth Connect, Iguana and Rhapsody, FHIR R4 APIs and facades, SMART on FHIR apps that launch inside Epic, Oracle Health and athenahealth, and the connections to labs, imaging, pharmacy, payers and national networks. It is where most healthcare projects lose time, and it is what we do most.

HL7 v2 · FHIR R4 · SMART on FHIR · IHE | 16+ years in healthcare · 20+ EHR, EMR and HIS integrations | CMMI Level 3 · ISO 27001 · ISO 9001

Trusted by hospitals, labs, healthtech companies and exchanges
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Healthcare data still moves mostly over HL7 v2, while everything new is being built on FHIR, and most hospitals will need both for years. Our interoperability practice is built for that reality: dedicated HL7, Mirth Connect and Iguana teams for the feeds that keep a hospital running, FHIR engineers for the APIs and SMART on FHIR apps that modern products and the Cures Act require, and 16+ years of doing it inside real health systems. We know which HL7 FHIR integration tools healthcare organisations actually need for a given job, and we say so in the first meeting.

What you're up against, and what changes when you work with us

Interface projects rarely fail on the standard. They fail on the vendor’s dialect of it, on the feed nobody monitors, on the app that needs to live inside the EHR and doesn’t. Here is where we see organisations get stuck, and how our HL7 and FHIR work is built to get them unstuck.

What you're up againstHow we solve itYou gain
Every vendor speaks a different HL7Message profiling, mapping and transformation on Mirth Connect, Iguana or Rhapsody, with a conformance test for every partner before go-live.Feeds that parse the first time and keep parsing
Your app has to run inside the EHR, not beside itSMART on FHIR app development: EHR launch, OAuth 2.0 authorisation, FHIR R4 read/write, certified for Epic, Oracle Health and athenahealth app programmes.Clinician adoption without a second login
The EHR only offers FHIR, but your systems only speak v2HL7 v2 to FHIR transformation and FHIR facades over legacy systems, so both worlds connect through one layer.Modern APIs without replacing what works
Interfaces fail silently until a clinician noticesMonitoring, alerting and replay for every channel, with dashboards your team can read and an on-call model that covers nights.Problems caught before the ward does
Cures Act, USCDI and TEFCA deadlines keep movingPatient-access APIs, Bulk FHIR, USCDI data classes and TEFCA/QHIN readiness built into the platform, not bolted on.Compliance that stays current
Integration skills are scarce and expensiveDedicated interface analysts and FHIR engineers who already know Mirth, Iguana, Epic Bridges and the EHR vendors’ quirks, ramped in weeks.Capacity that understands the constraints

HL7 Interface and FHIR Integration Services: What We Build

Six kinds of interoperability work, one team. Whether you need one ADT feed, a full interface-engine implementation, a SMART on FHIR product or connectivity to a national network, we build it on standards and on the HL7 FHIR integration tools healthcare IT teams already run.

The feeds that keep a hospital running: admissions, orders, results, scheduling and documents, built on an interface engine so each new partner is configuration, not a project.

  • ADT, ORM/OMG, ORU, SIU, MDM, DFT, MFN and custom message types
  • Message profiling, mapping, transformation and acknowledgement handling
  • MLLP, TCP/IP, SFTP, HTTPS and web-service transports
  • Legacy system interfaces where no modern API exists

Design, build and run of the engine layer on Mirth Connect, Iguana, Rhapsody or Cloverleaf, including migration between engines and managed operations.

  • Engine selection, architecture, high availability and disaster recovery
  • Channel development, reusable templates and code-set management
  • Migration from legacy engines (Corepoint, eGate, BizTalk) to Mirth, Iguana or Rhapsody
  • 24/7 monitoring, alerting, replay and managed support (see Mirth Connect and Iguana pages)

FHIR R4 APIs, servers and facades that expose clinical data to modern applications, payers and patients, whether the source system speaks FHIR or not.

  • FHIR R4 server and facade implementation (HAPI FHIR, Azure/AWS/Google FHIR services)
  • HL7 v2 to FHIR and C-CDA to FHIR transformation
  • Patient-access, provider-access and payer-to-payer APIs (Cures Act, CMS rules)
  • Bulk FHIR ($export) for analytics and population health

Applications that launch inside the EHR, use its login and read and write through FHIR APIs: the fastest route to clinician adoption for a new capability.

  • EHR launch and standalone launch, OAuth 2.0 and OpenID Connect authorisation
  • Epic, Oracle Health (Cerner) and athenahealth app programme certification support
  • Clinical decision support, imaging and monitoring views, documentation tools, patient-facing apps
  • CDS Hooks for in-workflow alerts and suggestions

The connections a health system needs, on the standards each partner uses, through one interface layer.

  • Epic, Oracle Health (Cerner), Meditech, Allscripts (Veradigm), athenahealth, OpenEMR
  • LIS, RIS/PACS (HL7 and DICOM), pharmacy (NCPDP), devices and RPM platforms
  • Payer and clearinghouse connectivity (X12 270/271, 837/835) and prior-authorisation APIs
  • HIE, Carequality, CommonWell, eHealth Exchange and TEFCA QHIN connectivity

The tools around the interfaces: validation, simulation, monitoring and the dashboards that tell you a feed is healthy before a clinician tells you it isn’t.

  • HL7 and FHIR message validation, conformance testing and partner simulation
  • Custom HL7 viewers, parsers and anonymisers for interface analysts
  • Interface monitoring dashboards, alerting and automated replay
  • Test data generation and de-identified message sets for regression testing

Why Healthcare Organisations Choose QSS for HL7 and FHIR Integration

Interoperability is not a feature of our healthcare practice; it is the practice. Every EHR, imaging, telehealth and RPM project we deliver runs on the same HL7, FHIR and SMART on FHIR backbone, which is why our interface analysts have seen the vendor dialects, the failed feeds and the app-programme certifications before they reach your project.

Dedicated engine practices

Named teams for Mirth Connect and Iguana, with production experience on Rhapsody and Cloverleaf, and dedicated pages for each. 20+ EHR, EMR and HIS integrations delivered (HIE).

Both standards, one layer

HL7 v2 for the systems that still run on it, FHIR R4 for anything new, and transformation between them so a hospital does not have to choose.

SMART on FHIR from launch to certification

EHR launch, OAuth 2.0, FHIR read/write and CDS Hooks, with support through the Epic, Oracle Health and athenahealth app programmes (EHR/EMR development).

Compliance and regulation built in

HIPAA, HITECH, Cures Act API rules, USCDI, TEFCA readiness, 42 CFR Part 2 consent handling, and ATNA-style audit on every channel.

Interfaces we run, not just build

Monitoring, alerting, replay and 24/7 support as a managed service, so the feeds keep flowing after go-live.

Mature, flexible delivery

Fixed-scope interface sets, a dedicated interoperability team or build-operate-transfer, under CMMI Level 3 and ISO 27001, with 4.9/5 on Clutch.

Capabilities we can build into your integration layer

Every integration layer is scoped to its systems and partners, but these are the building blocks we draw on most often. Select the ones that matter and we’ll map them to your architecture in the discovery call.

HL7 v2 messaging

ADT, ORM, ORU, SIU, MDM, DFT and custom message types

Message mapping & transformation

Profiles, mappings and code-set translation per partner

FHIR R4 APIs

Resource-level read/write with search, versioning and subscriptions

FHIR facade

Modern APIs over legacy systems without replacing them

FHIR server

HAPI FHIR or cloud FHIR services as a clinical data store

SMART on FHIR launch

EHR-embedded apps with OAuth 2.0 and OpenID Connect

CDS Hooks

In-workflow alerts and suggestions from external services

Bulk FHIR export

Population-scale data extraction for analytics

v2-to-FHIR transformation

Bridge legacy feeds into FHIR resources

C-CDA & document exchange

Summary documents for transitions of care

X12 EDI

Eligibility, claims and remittance transactions

NCPDP SCRIPT

E-prescribing connectivity

DICOM & imaging feeds

Orders, results and image links between RIS, PACS and EHR

Device & RPM feeds

Vitals from monitors and wearables into the record

Interface engine channels

Mirth, Iguana, Rhapsody, Cloverleaf development

High availability

Clustered engines, failover and disaster recovery

Monitoring & alerting

Channel health, queue depth and error dashboards

Automated replay

Recover failed messages without manual re-sends

Conformance testing

Partner simulation and validation before go-live

HL7 viewer & anonymiser

Analyst tooling for inspection and de-identified test data

Terminology services

SNOMED CT, LOINC, RxNorm, ICD-10 mapping

National network connectivity

Carequality, CommonWell, eHealth Exchange, TEFCA QHIN

Consent enforcement

42 CFR Part 2 and opt-in/opt-out rules at exchange time

Audit & security

ATNA-style audit, TLS, certificate management, RBAC

AI-assisted integration, with interface analysts in control

Interface work is full of repetitive, error-prone tasks: reading a vendor’s spec, drafting a mapping, spotting the feed that changed. We use AI where it saves an analyst hours and catches problems earlier, and we keep a person in control of every mapping that touches patient data.

AI capabilityWhat it doesIn practice
Mapping and transformation assistanceModels read vendor specifications and sample messages and draft field mappings and transformation code for analyst review.A new lab partner’s ORU spec becomes a draft Mirth channel in hours, not days.
Anomaly and drift detectionMachine learning on message traffic flags malformed messages, terminology drift and unusual volumes before they reach clinicians.A lab that starts sending results under a new local code is caught within minutes.
Unstructured-to-structured extractionNLP extracts structured data from C-CDA narrative, PDFs and free text into FHIR resources, with source links.Discharge summaries arriving as PDF populate Condition and Medication resources for review.
Terminology mappingAI-assisted mapping of local codes to SNOMED CT, LOINC and RxNorm with confidence scores and stewardship queues.Ninety percent of a hospital’s local lab codes are mapped automatically; the rest are queued for a human.

HL7 and FHIR integration for every part of healthcare

A hospital, a lab and a healthtech startup need different interfaces, different standards and different tools. We build for the organisation you are and the partners you exchange with.

Hospitals & Health Systems

Enable seamless communication between EHRs, labs, radiology, and pharmacy systems through secure HL7 integration.

Clinical Laboratories

Automate lab order and result exchange with healthcare providers using standards like HL7 v2 and FHIR.

Health Insurance Providers

Facilitate claims data exchange, eligibility checks, and pre-authorization workflows through reliable HL7 connectivity.

Telemedicine Platforms

Integrate real-time patient data from EHRs, labs, and devices to enhance virtual care delivery.

Medical Device Manufacturers

Ensure medical devices can securely transmit patient data to hospital systems using HL7 or FHIR protocols.

Pharmaceutical & Life Sciences

Streamline clinical trial data integration, lab reporting, and patient monitoring using healthcare data standards.

Public Health Organizations

Enable timely public health reporting, immunization tracking, and population health analytics via HL7-compliant systems.

Not sure which fits?

Tell us the setting you run and the people the work is for, and we’ll map the right approach in the discovery call.

Consult Our Experts

Use cases we build for

Healthtech products needing EHR access

SMART on FHIR apps and FHIR integrations that get a product into Epic, Oracle Health and athenahealth.

Interface engine migration

Moving from Corepoint, eGate or BizTalk to Mirth, Iguana or Rhapsody without dropping a feed.

Cures Act and CMS API compliance

Patient-access, provider-access and payer-to-payer FHIR APIs.

TEFCA and national network onboarding

QHIN, Carequality and CommonWell connectivity on top of your engine.

Lab and imaging connectivity

Orders and results between LIS, RIS/PACS and the EHR (see HIE and DICOM/PACS pages).

RPM and device integration

Vitals from home devices into the chart (see Remote Patient Monitoring).

Payer and RCM integration

Eligibility, claims and prior authorisation over X12 and FHIR (see RCM).

Managed interface operations

Monitoring, on-call and support for interfaces you already run.

Empowering Healthcare Interoperability with HL7 Integration

We implemented a scalable HL7 integration solution for a multi-facility healthcare network, enabling seamless data exchange across EHR, LIS, and HIS systems. The project enhanced real-time interoperability, improved clinical efficiency, and ensured regulatory compliance across all systems.

Healthcare

EMAR – Electronic Medication Administration Records App

Digitizes medication tracking and real-time clinical documentation. Reduces errors in prescriptions and improves staff efficiency in patient care.

Kotlin · Node.js · HL7 · HIPAA-Compliant APIs

  • ✓Reduced manual documentation time for medical staff
  • ✓Digitized prescription and medication dispensing with real-time updates
  • ✓Secured patient record tracking with full compliance to EHR standards
Read the full story →

Healthcare

Notify – Healthcare Communication App

A next-gen nurse call mobile application that enables caregivers to respond instantly to emergency alerts from patients. Streamlines communication for faster assistance and better patient safety.

React Native · Firebase · HL7 · Bluetooth Low Energy (BLE)

  • ✓Real-time nurse–patient communication through mobile alerts
  • ✓Improved emergency response time in senior care facilities
  • ✓Fully integrated with HL7-based hospital systems
Read the full story →

Healthcare

HIPAA-Compliant Cloud Storage App

A digital document management solution that allows senior living centers to upload, store, and share medical documents securely via cloud, replacing outdated paper-based workflows.

Angular · AWS S3 · HL7 · HIPAA-Compliant APIs

  • ✓Eliminated physical documentation, mailing, and faxing processes
  • ✓Enabled secure document uploads with E-signature support
  • ✓Reduced administrative overhead while ensuring compliance
Read the full story →
No obligation

What you get from a 30-minute discovery call

Thirty minutes with a healthcare solutions architect, not a salesperson. You leave with a clear, practical plan.

Book a Discovery Call
  • An interface map: which systems, which message types, which standards, which engine
  • A view on FHIR facade vs FHIR server vs direct EHR APIs for your case
  • Whether your app needs SMART on FHIR, and what the EHR app programme will require
  • Compliance considerations: Cures Act APIs, USCDI, TEFCA, consent
  • A ballpark cost range, timeline and recommended phase-one scope

How we work with you

We follow a structured, collaborative approach to build and run interfaces that parse the first time and keep parsing.

Discovery and interface inventory
We map your systems, partners, message types, volumes and current engine, and agree the outcomes: feeds in scope, uptime, latency, compliance deadlines.
Architecture and standards design
Engine choice, channel architecture, FHIR facade or server, SMART on FHIR launch model, high availability and the standards each partner will use.
Specification and mapping
Message profiles, field mappings, code sets and acknowledgement rules agreed with each partner and documented as interface specifications.
Build and conformance testing
Channel and API development in sprints; partner simulation, conformance and load testing against real endpoints early.
Go-live and cut-over
Phased activation by partner or feed, parallel running where needed, hypercare with on-call coverage.
Operate and expand
24/7 monitoring, alerting, replay and support; new partners added as configuration; regulatory updates applied as they arrive.

Our Engagement Models

Choose the engagement model that fits how integration sits in your roadmap — a fixed-scope interface set, a dedicated team, or managed interface operations.

Fixed-scope interface set

  • Defined feeds, FHIR scope or one app
  • Fixed price, milestone-based delivery
  • Clear go-live date
  • Best for a set launch

Dedicated interoperability team

  • Named interface analysts & FHIR engineers
  • QA included
  • Works as an extension of yours
  • Best for continuous integration

Managed interface operations

  • Monitoring, on-call and support
  • Kept current with vendor changes
  • Build capacity on call
  • Best for feeds you already run

Compliance and security, engineered in

Interfaces carry protected health information between organisations that don’t share a security team. We design every integration to the regulations and API rules that apply, and we can show you how, control by control.

HIPAAHITECHONCPIPEDAPHIPANCPDP42 CFR Part 2GDPRHL7FHIRIHEISO 27001

TLS 1.2+ on every MLLP, HTTPS and API connection, mutual TLS where partners support it, certificate lifecycle management.

OAuth 2.0 and OpenID Connect for FHIR and SMART on FHIR, with scopes limited to the resources each app needs.

Patient-access, provider-access and payer-to-payer APIs built to the ONC and CMS specifications, with USCDI data classes.

Security, policy and testing evidence prepared for QHIN participation and national-network onboarding.

42 CFR Part 2 and opt-in/opt-out rules enforced at exchange time; sensitive-data segmentation where required.

ATNA-style audit of every message, query, API call and administrative action, exportable for OCR audits.

HIPAA-eligible environments on AWS, Azure or Google Cloud with Business Associate Agreements; high availability and tested disaster recovery; on-premise where required.

Third-party vulnerability assessments and penetration tests tracked to closure; conformance and load testing before every partner go-live.

The HL7 FHIR integration tools healthcare IT teams ask us about, and where we use them

Tool choice is a large part of an integration decision, and buyers ask about it early. These are the HL7 FHIR integration tools healthcare organisations most often run or evaluate, grouped by what they do and with our view on when each fits.

GroupToolsWhere we use them
Interface enginesMirth Connect (NextGen Connect) · Iguana (iNTERFACEWARE) · Rhapsody (incl. former Corepoint) · Infor Cloverleaf · InterSystems Ensemble/HealthShare · Qvera QIEThe backbone of HL7 v2 integration; Mirth for open-source flexibility, Iguana for rapid channel development, Rhapsody and Cloverleaf in large health systems
FHIR servers and servicesHAPI FHIR · Microsoft Azure Health Data Services · AWS HealthLake · Google Cloud Healthcare API · Firely · Smile CDRClinical data stores, FHIR facades and patient-access APIs
SMART on FHIR and app toolingSMART App Launch libraries (JS, .NET, Java, Python) · CDS Hooks · EHR sandboxes (Epic, Oracle Health, athenahealth)Apps that launch inside the EHR and in-workflow decision support
Validation and testingHL7 Inspector · 7Edit · Inferno (ONC) · Touchstone (AEGIS) · FHIR Validator · Postman · custom conformance suitesPartner conformance, ONC certification testing and regression
Transformation and terminologyFHIR Mapping Language · v2-to-FHIR mappings · SNOMED CT, LOINC, RxNorm terminology servicesBridging legacy feeds into FHIR and normalising codes
Monitoring and operationsEngine dashboards · Grafana and Prometheus · custom channel monitors with alerting and replayKeeping feeds healthy after go-live
Integration platforms (non-healthcare)MuleSoft · Apache Camel · Microsoft BizTalk / Azure Integration Services · Oracle Integration for HealthcareEnterprise integration where a healthcare engine is not the right fit, or for migration from them

What HL7 and FHIR integration costs, and how long it takes

Every integration is scoped to its systems and partners, but buyers deserve a straight answer. These are typical ranges based on our delivery history and current market rates; your discovery call gives you figures specific to your scope.

Single interface or FHIR connectionInterface engine or bidirectional EHR integrationEnterprise interoperability programme
Typical timeline3 – 6 weeks10 – 16 weeks4 – 9 months, phased
Typical investment$8,000 – $18,000$35,000 – $70,000$90,000 – $180,000+
What's includedOne HL7 v2 feed or one read-only FHIR connection: mapping, transformation, testing, go-live, documentationEngine implementation or migration, or a bidirectional integration with one EHR (demographics, clinical data, orders, results) across FHIR and v2; monitoring and hypercareMulti-system integration layer, FHIR facade or server, SMART on FHIR app, national-network or TEFCA connectivity, high-availability architecture, managed operations

Figures are indicative and exclude EHR vendor fees (Epic app programme, Oracle Health API licensing), which are quoted separately — your discovery call gives you a range specific to your scope.

Frequently Asked Questions

Answers about our HL7 and FHIR integration, SMART on FHIR apps, interface engines, the HL7 FHIR integration tools healthcare teams ask about, compliance, timelines and costs.

Health Level Seven (HL7) is a set of international standards for the exchange, integration and retrieval of electronic health information. It ensures communication between healthcare systems such as EHRs, labs, billing and pharmacy software by enabling structured data exchange, which reduces manual entry and errors, speeds decisions, lowers cost and keeps organisations compliant. HL7 v2 remains the workhorse for messaging inside hospitals; HL7 FHIR is the modern API standard for anything new.

We support all major HL7 standards, including HL7 v2.x for messaging, HL7 v3 and CDA/C-CDA for structured documents, and HL7 FHIR R4 for modern API-based data exchange, including SMART on FHIR and CDS Hooks.

AI assists with mapping and transformation drafting, message validation and anomaly detection, extraction of structured data from documents and free text, and terminology mapping, always with an interface analyst reviewing anything that touches patient data.

Yes. We transform HL7 v2 and C-CDA into FHIR resources, and build FHIR facades over legacy systems, so organisations can adopt FHIR-enabled workflows, apps and third-party integrations while preserving what already works.

HL7 Inspector, 7Edit, Inferno, Touchstone, the FHIR Validator, Postman and custom conformance suites on Mirth Connect and Iguana for schema validation, message simulation and regression testing. Section 12 lists the tools we use and where.

By integrating AI with HL7 and FHIR data, including Bulk FHIR extracts, we enable predictive analytics to identify high-risk patients, track population health trends, personalise care plans and optimise resource use for value-based care models.

HL7 gives disparate systems a common language. An integration layer built on it supports multi-version messaging, bidirectional exchange, real-time synchronisation, parsing and validation, cloud and on-premise systems, and monitoring with audit trails, so data moves across radiology, pharmacy, billing and the EHR without re-keying.

Yes. We build HL7-compliant interfaces that connect legacy systems with modern platforms, with data normalisation, real-time messaging and secure interoperability, and no need to replace existing infrastructure.

All integrations are developed to HIPAA, GDPR and the other regulations that apply, with secure transport, encryption, audit trails, role-based access and, for APIs, OAuth 2.0 and the ONC and CMS specifications.

Absolutely. We build interfaces that connect cloud-based systems such as Epic, Oracle Health (Cerner) and athenahealth with HIE platforms and national networks, ensuring secure data sharing across providers, payers and third-party tools.

Yes. We develop custom dashboards and monitoring tools for HL7 and FHIR interfaces to track message flows, detect anomalies and trigger alerts for failures, with automated replay where safe.

Yes. We provide ongoing support, optimisation and maintenance, including engine version upgrades, performance monitoring, security patches and enhancements, as a managed service if you prefer.

SMART on FHIR is the open standard that lets an application launch inside an EHR such as Epic, Oracle Health or athenahealth, authenticate the user through the EHR’s login using OAuth 2.0, and read and write data through FHIR APIs, all in the clinician’s existing workflow. Yes, we build SMART on FHIR apps, from clinical decision support and imaging views to documentation tools and patient-facing apps, and we support certification through the EHR vendors’ app programmes. It is the fastest route to clinician adoption for a new capability.

It depends on what you are connecting. For HL7 v2 feeds inside a hospital, an interface engine (Mirth Connect, Iguana, Rhapsody or Cloverleaf) is the right tool. For modern APIs, a FHIR server or facade (HAPI FHIR or a cloud FHIR service). For apps that must live inside the EHR, SMART on FHIR libraries and the vendor sandboxes. For testing, Inferno, Touchstone and the FHIR Validator. Section 12 lists the HL7 FHIR integration tools healthcare IT teams ask us about most and where each fits; we help you choose in the discovery call.

Both, in most cases. HL7 v2 still carries the operational messaging inside hospitals (admissions, orders, results) and the systems that produce it will not change soon. FHIR is required for patient access, external exchange, analytics and any new application. We build one integration layer that speaks both and transforms between them, so you are not forced to choose or to replace what works.

Yes. We build the SMART on FHIR launch, the FHIR integration and the security model each vendor requires, and we support the app programme certification process (Epic, Oracle Health, athenahealth). Vendor fees are separate; the engineering and certification evidence are ours to deliver.

Ready to get your systems talking, and your app inside the EHR?

Talk to a healthcare interoperability architect about your feeds, your partners and the EHRs your product must reach.

  • HL7 v2 on Mirth, Iguana and Rhapsody, FHIR R4 APIs and SMART on FHIR apps inside Epic, Oracle Health and athenahealth
  • Cures Act, USCDI and TEFCA readiness engineered in, with monitoring, alerting and replay on every channel
  • No obligation — you leave with an interface map, a view on SMART on FHIR and a cost range
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