FHIR vs HL7: Choosing the Best Healthcare Data Exchange Standard

9 min read


The HL7 organization has developed two interoperability standards for healthcare data management: HL7 Version 2 (V2) and the Fast Healthcare Interoperability Resources (FHIR) standard. While both HIPAA-compliant standards aim to facilitate the exchange of healthcare information, they have significant differences in terms of technology, flexibility, and adoption. Understanding these key differences is crucial for healthcare organizations looking to implement an effective data exchange standard. 

Against the backdrop of this need, the Healthcare Information Exchange Market, estimated at USD 1.97 billion in 2024 and expected to reach USD 3.44 billion by 2029, emphasizes the increasing importance of streamlined and scalable healthcare data management solutions.

Key Takeaways:

  • HL7 V2 and FHIR are two interoperability standards for healthcare data management.
  • HL7 V2 is the older legacy standard, while FHIR is a more modern and flexible alternative.
  • HL7 V2 lacks precise message modeling and requires custom coding for interoperability.
  • FHIR leverages RESTful web services and open web technologies, making it easier to integrate and exchange clinical data.
  • FHIR offers multiple options for health data exchange, including messaging, documents, and a RESTful API approach.
  • The adoption of FHIR also offers advantages such as simplified information sharing, improved collaboration, and enhanced patient engagement.

HL7 Version 2 – The Legacy Standard

HL7 Version 2 (V2) is the legacy standard in healthcare data exchange that has been widely adopted by healthcare organizations. This healthcare standard provides a messaging framework for seamless communication between different healthcare systems, including electronic medical record (EMR) systems, billing systems, and laboratory information systems. Despite its widespread use, V2 has certain limitations that hinder its flexibility and scalability.

The Benefits and Limitations of HL7 V2

HL7 V2 has been instrumental in facilitating the exchange of healthcare data among various systems within the healthcare ecosystem. Its adoption has enabled healthcare organizations to share vital patient information securely and efficiently. However, V2 lacks a precise message model, which means that each implementation often requires custom coding, resulting in higher development and maintenance costs. Additionally, V2 does not support modern web technologies, making it more challenging to integrate with emerging systems and technologies.

The Need for a Modern Data Exchange Standard

As the healthcare industry evolves and embraces advancements in technology, there is a growing demand for a more modern and interoperable data exchange between systems. The limitations of HL7 V2 have prompted the development of the Fast Healthcare Interoperability Resources (FHIR) standard.

HL7 V2 vs HL7 FHIR – a comparison:


HL7 V2



Custom messaging format

RESTful web services


Requires custom coding

Easier integration using modern web technologies


Limited flexibility

Highly flexible and customizable


Challenging to scale

Scalable and adaptable

While V2 has served as a reliable standard for healthcare data exchange capabilities over the years, the emergence of HL7 FHIR presents a more advanced and adaptable solution for interoperability.

Fast Healthcare Interoperability Resources (FHIR) – The Modern Standard

Introduced in 2014, the Fast Healthcare Interoperability Resources (FHIR) standard presents a modern and flexible alternative to HL7 V2. 

With FHIR, developers can easily exchange data and integrate multiple systems, thanks to the use of widely adopted web technologies such as XML, JSON, and RDF data formats. This versatility allows healthcare organizations to choose the method that best suits their specific requirements.

Key Features of FHIR:

  • Modern and flexible standard
  • Uses RESTful web services and open web technologies
  • Supports XML, JSON, and RDF data formats
  • Multiple options for data exchange
  • Easier integration and interoperability between systems
  • Defines resources for efficient data access and update

The FHIR standard introduces the concept of resources, which represent meaningful pieces of healthcare data. Resources enable easy access and update of specific data elements, providing a granular and efficient approach to healthcare information exchange.


HL7 V2

Modern and flexible

Legacy standard

Supports RESTful web services and open web technologies

Requires custom coding

Multiple options for data exchange

Primarily messaging-based

Defines resources for efficient data access and update

Lacks a precise message model

Advantages of FHIR Adoption

Adopting FHIR offers several advantages for healthcare organizations. The Fast Healthcare Interoperability Resources (FHIR) standard simplifies information sharing and collaboration among healthcare teams, enabling faster decision-making and improved patient care. By implementing FHIR, healthcare organizations can experience the following benefits:

Simplified Healthcare Data Exchange

FHIR provides a standardized approach to healthcare data exchange, making it easier for different systems and applications to communicate and share information. With its modern architecture and RESTful API approach, FHIR offers a more efficient and streamlined solution for exchanging data among systems. This simplifies the process of accessing and utilizing patient information, leading to improved care coordination and outcomes.

Enhanced Collaboration and Decision-Making

By adopting FHIR, healthcare organizations can facilitate seamless collaboration among healthcare teams. FHIR allows for the exchange of comprehensive and accurate patient data in real time, enabling clinicians to make informed decisions promptly. This contributes to better patient outcomes and a more coordinated approach to healthcare delivery.

Improved Efficiency and Scalability

FHIR’s modern architecture and RESTful API approach improve efficiency and scalability in healthcare data management. FHIR employs a flexible framework for integrating and connecting various healthcare systems and applications, eliminating the need for complex custom coding. This reduces development time and costs while ensuring interoperability across different platforms and devices.

Support for Insurance Use Cases

Insurance companies can leverage FHIR to supplement claims data with clinical information for better risk assessment and cost control. FHIR enables the exchange of relevant patient data between healthcare providers and insurers, allowing for more accurate assessments of medical conditions and associated costs. This enables insurance companies to make data-driven decisions, resulting in improved risk management and better pricing strategies.

Patient Engagement and Empowerment

FHIR facilitates patient engagement by enabling easy access to medical information through healthcare software development such as user-friendly mobile apps and web portals. Patients can securely access their health records, share information with healthcare providers, and actively participate in their own care. FHIR empowers patients by giving them more control and involvement in their healthcare journey, ultimately leading to better patient satisfaction and outcomes.

Advantages of FHIR Adoption

Simplified healthcare data exchange

Enhanced collaboration and decision-making

Improved efficiency and scalability

Support for insurance use cases

Patient engagement and empowerment


In conclusion, healthcare data exchange standards play a vital role in achieving interoperability in the healthcare industry. When comparing HL7 V2 and FHIR, it is evident that the implementation of FHIR offers significant advantages over its legacy counterpart.

HL7 V2, although widely adopted, lacks the flexibility and scalability that FHIR provides. With V2, organizations often need to invest in custom coding to achieve interoperability, resulting in increased complexity and time-consuming implementations.

On the other hand, FHIR leverages modern technologies such as RESTful web services and open data formats, making it easier to integrate systems and exchange healthcare information. The adoption of FHIR simplifies data exchange, improves collaboration among healthcare teams, and enhances patient engagement.

As the healthcare industry continues to strive for seamless data interoperability, FHIR emerges as the preferred choice for healthcare organizations. Its modern architecture, ease of implementation, and numerous benefits position FHIR as the future of healthcare data exchange standards.


Who developed HL7 and FHIR standards?

HL7 standards were developed by Health Level Seven International, while FHIR was also developed under the auspices of HL7, aiming to address the industry’s need for a more modern and agile healthcare data exchange standard.

What are the key differences between HL7 and FHIR standards?

The main difference between FHIR and HL7 (Health Level Seven) is that HL7 is a set of messaging standards for exchanging medical and administrative data, while FHIR is a modern standard for exchanging healthcare information electronically. FHIR focuses on modern web standards, RESTful principles, and resource-oriented architecture, while traditional HL7 standards have more legacy messaging formats and structures.

How does HL7 v2 differ from FHIR?

HL7 v2 is a legacy standard for healthcare data exchange, while FHIR is a modern and more flexible standard designed to meet current industry needs for data exchange, integration, and interoperability.

Is FHIR better than HL7?

FHIR is often considered better than HL7 v2 due to its modern design, use of contemporary web standards, and flexibility in managing healthcare data and resources.

Can FHIR be used alongside HL7 v3 or CDA?

Yes, FHIR can be used in conjunction with HL7 v3 and HL7 CDA standards, providing compatibility and supporting seamless data exchange between different systems and technologies.

How does FHIR implementation differ from traditional HL7 standards?

FHIR’s implementation differs from traditional HL7 standards by offering a more modern approach to data exchange, utilizing RESTful APIs, and providing a simplified and streamlined framework for interoperability. If your organization lacks in-house expertise in HL7 implementations, working with a healthcare software outsourcing company might be a good option.

What is SMART on FHIR?

SMART on FHIR is a healthcare application platform that uses FHIR as the underlying standard for securely and efficiently exchanging healthcare data and enabling third-party application integration with electronic health record systems.

How does FHIR support data sharing in healthcare?

FHIR supports data sharing in healthcare by providing a standardized and interoperable framework for exchanging clinical and administrative data, enabling efficient communication between different healthcare systems and applications.

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