I. Healthcare in the Future


In 2030, a patient will enter a clinic to have his regular check-up. Upon entering the clinic, the receptionist nurse will bring out her phone and ask the patient for a copy of his ID for the ID number. The nurse will just scan the ID using an application she downloaded online for free. She will then put the patient's ID number in a web portal to obtain vital health data. She will see that the patient is wearing Apple Watch, and she will request if she can transfer the heart beat data, and sleeping record from the watch to her application.

The patient will wait at the Lobby until called. Once called, the Doctor, using her own mobile app, costing 2$ will receive the patient's records from the receptionists. It now includes the Apple Watch data. She will also view the patient's past medical history by querying it from an online record repository. This will also contain records from other facilities.

After the check-up, the patient will be asked by the receptionist to log in to a payment app. Since the patient has his own health insurance, the patient will just share his ID to the payment app and it will automatically make a claim to the insurance provider.

This is the future of digital health. There will be no enterprise Electronic Medical Records (EMRs) or a single monolithic Electronic Health Record (EHR) or Hospital Information System (HIS). Facilities will be using small apps made by startups for each of the workflows. There will be an admission app, a consultation app, and a monitoring app. Data from wearables such as Fitbit or Apple Watch will be available to health providers. Piece-wise health data will be collected and this cannot be done using existing standards such as HL7V2 or HL7 CDA. This requires the use of APIs and the sharing of data from a server. It is envisioned that these workflows would flourish with the adaption of HL7 FHIR.

II. Introduction to HL7 Standards

HL7 V2, V3, CDA, and FHIR are the health data exchange standards that were released by the Health Level 7 (HL7) International group.

The Health Level 7 (HL7) International group released HL7 V2, V3, CDA, and FHIR health data exchange standards. As health data exchange standards, these are used widely by EHRs/EMRs around the world today. Each of the above-mentioned standards was developed using a different framework and mindset.

II.1. V2

Health Level Seven Version 2 (V2) is a purely messaging standard that allows the exchange of clinical data between systems. It is designed to support a central patient care system as well as a more distributed environment where data resides in departmental systems. (source: HL7 V2 Briefer)