HL7 and FHIR integration

HL7 v2 and FHIR R4 integration

Exchange patients, orders and signed reports with your HIS, EHR and RIS as HL7 v2 messages, and give modern applications a FHIR R4 API to the same data.

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HL7 v2 · HTTP API · File drop · MLLP · FHIR R4

Standards and connectivity

Supported HL7 messages and FHIR resources

Support differs by message type and direction. Interfaces for your systems and versions are confirmed during scoping.

HL7 v2

Receive ADT, SIU, ORM, OMG, OMI and ORU messages
Acknowledgements (AA/AE/AR) and duplicate-message protection
Send ADT, SIU and ORM messages
Send signed reports as ORU^R01 results

HL7 transports

HL7 over the HTTP API or file drop
HL7 over MLLP
Encrypted transport (TLS) for MLLP links

FHIR R4

API: Patient, Encounter, Appointment, ServiceRequest, Observation, Organization, Location
API: ImagingStudy and Practitioner (read), DiagnosticReport (read and create)
Send FHIR resources to other systems

Illustrative workflow

From an HIS order to a signed report

How one common workflow uses HL7 v2, step by step.

The HIS sends an imaging order as an HL7 v2 message, and MiddleOffice acknowledges it
The order reaches the RIS, MedCARE™ or your own, and appears on the modality through the MWL Service
The study is received with its order attached, stored in MedPACS™ or your PACS, and routed to the reading team
Each handoff is recorded in the study’s status history, with failed deliveries retried
The signed report returns to the HIS as an HL7 ORU^R01 result

Use cases

Where teams use HL7 and FHIR

Legacy HIS/EHR to modern applications

Hospitals · Healthcare SaaS companies

The gap: A new application needs patient and order data held in an older HIS that only speaks HL7 v2.
How MiddleOffice helps: MiddleOffice receives the HL7 v2 messages and exposes the data through a FHIR R4 API the new application can use.

Relies on

HL7 v2 receive
FHIR R4 API
Push FHIR resources to other systems

Healthcare data routing and transformation

Hospital networks · Systems integrators

The gap: Each system expects data in its own form, and failed handoffs go unnoticed.
How MiddleOffice helps: Messages are acknowledged, mapped and delivered with retries, and failures are held with their error for follow-up.

Relies on

HL7 v2 receive and send
Retries and held failed messages
Message search and replay

FAQ

Frequently asked questions

Which HL7 v2 messages are supported?

MiddleOffice receives ADT, SIU, ORM, OMG, OMI and ORU messages and sends ADT, SIU and ORM messages. Signed reports are sent as ORU^R01 results, and incoming messages are acknowledged (AA/AE/AR) with duplicate-message protection.

How can HL7 messages reach MiddleOffice?

Over the HTTP API, by file drop or over MLLP. MLLP links can use encrypted transport (TLS).

Which FHIR R4 resources does the API cover?

Patient, Encounter, Appointment, ServiceRequest, Observation, Organization and Location; ImagingStudy and Practitioner for reading; and DiagnosticReport for reading and creating. FHIR resources can also be sent to other systems.

Do we need to replace our HIS, RIS or PACS?

No. MiddleOffice connects to the systems you already run through standard interfaces. You can keep them, replace one later, or add RadpicsAI products alongside them.

Which vendors and systems have you integrated with?

We do not publish vendor names without permission. Tell us your systems and versions, and we will confirm the interfaces available for each during scoping.

Connect your HIS, EHR or RIS

Tell us your systems, versions and the messages you exchange today, and we will confirm the interfaces for each.