Health Data Integration Specification Template

HL7 v2 is a messaging standard from the 1990s that uses pipe-delimited text messages (ADT, ORU, ORM). It is point-to-point and requires custom mapping at every site. FHIR (Fast Healthcare Interoperability Resources) is a modern REST API standard using JSON/XML resources. FHIR is more developer-friendly, supports OAuth-based auth, and is mandated by the ONC Cures Act for patient-facing data access. New integrations should default to FHIR unless the health system only supports v2.

End-to-end, expect 3-9 months from initial conversation to production go-live. The breakdown: 1-2 months for business and security review, 1-2 months for sandbox access and development, 1-2 months for testing and certification, and 1-2 months for deployment and validation. The biggest delays are usually organizational (getting the right people to review and approve), not technical.

For broad distribution to multiple Epic customers, yes. App Orchard (now called the Epic App Market) certification is the standard path. For a single-site integration with one health system, you can work directly with that system's integration team using their developer portal. The single-site path is faster but does not scale to multiple customers without repeating the process.

The 21st Century Cures Act (ONC Cures Act) requires certified EHR vendors to implement standardized FHIR APIs for patient data access by 2024. It also prohibits "information blocking," which means EHR vendors and health systems cannot unreasonably restrict data sharing. For you as a health tech PM, this means EHR vendors must provide FHIR API access, and health systems cannot refuse to connect your application without a legitimate reason (security, privacy, or operational concern).

Build a terminology mapping layer. Map incoming codes to your internal canonical model, and maintain mapping tables for ICD-10, SNOMED CT, LOINC, and RxNorm. Use the UMLS (Unified Medical Language System) as a reference for cross-walks between code systems. Accept that some mappings will be imperfect and design your UI to surface unmapped codes for clinical review rather than silently dropping them. ---