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The proper sharing of data of healthcare information and interchangeability play an essential role in the healthcare industry. With an increased transferring and exchanging of personal health information across systems in an organization or between multiple organizations, there is a real concern over who has access to this information and how much protection is provided to personal data.

As a healthcare start-up, you have probably come across the terms “HL7” and “HIPAA” and would like to know if they are two completely individual concepts or do they work together. Below we discuss the difference between HL7 and HIPAA in the healthcare industry.

What Is HL7?

Health Level Seven (HL7) is an internationally recognized set of messaging standards that defines how healthcare information is received, exchanged, or managed between different software applications that are used by healthcare organizations.

Primary Standards

  • Version 2.x/3 Messaging standard
  • Continuity of Care Document
  • HL7 Version 2 Product site
  • Clinical Context Object Workgroup
  • Clinical Document Architecture (CDA)
  • Structures product labeling

Why Is HL7 Used In the Healthcare Industry?

Why Is HL7 Used In the Healthcare Industry

HL7 plays an essential role in the healthcare industry as it enables proper data sharing and interchangeability. It ensures smooth data integration between all disparate data sources and systems. HL& is most commonly used by private clinics, hospitals, health software providers, pharmaceutical companies, and other patient and medical facilities.

Integration with other systems

The main goal of HL7 is to create and support a universal protocol so that any healthcare organization, with the necessary permission, can retrieve and access healthcare data from other healthcare applications or software systems.

Workflow automation

HL7 messaging standards structure and shares information in a clear and efficient way, ensuring that the information exchange process in healthcare organizations is simplified.

Collaboration

Healthcare systems are able to store and exchange healthcare data, both domestically and internationally, increasing the opportunity for global collaboration. All healthcare organizations worldwide have unified guidelines, which enables them to cooperate more efficiently and faster.  

What are the benefits of using an HL7 interface?

Improved clinical efficiency 

HL7 enables smoother and faster information exchange, which allows medical professionals to have access to up-to-date data, improving patient care.

Elimination of administration errors 

Through HL7, medical professionals now have access to relevant data from many different sources and can make sure that all information is relevant and synchronized. This reduces the need for manually requesting and filling out information. HL7 thus saves time and ensures that there is increased accuracy.

Opportunities for new technology 

HL7 software and protocols provide multiple options for healthcare organizations to experiment with software solutions, enabling the flexibility of tech solutions for healthcare organizations.

What Is HIPAA?

The Health Insurance Portability and Accountability Act of 1996, or HIPAA, is legislation that was passed in the United States that provides data privacy and security provisions for the safeguarding of patient or other medical information. The law has become more prominent over the years due to multiple health data breaches that have been caused by ransomware attacks and cyber attacks on health providers and insurers.

The primary goals of HIPAA are to (i) limit the use of protected health information and (ii) penalize those (organizations, individuals) that do not comply with the confidentiality regulations.

The five main components of HIPAA

  1. Title I: HIPAA Health Insurance Reform 
  1. Title II: HIPAA Administrative Simplification- HIPAA compliance
  • National Provider Identifier
  • Transactions and Code Sets Standards
  • HIPAA Privacy Rule
  • HIPAA Security Rule
  • HIPAA Enforcement Rule

3. Title III: HIPAA Tax-Related Health Provisions

4. Title IV: Application and Enforcement of Group Health Plan Requirements

5. Title V: Revenue Offsets.

HIPAA Privacy Rule

HIPAA is the first established national standard in the United States that protects patients’ personal information or protected health information. The privacy rule guarantees that patients have the right to receive their protected health information when requested from a healthcare provider that is covered by HIPAA.

HIPAA covered entities

Only covered Entities and their BAs are subject to HIPAA.

  • Health plans
  • Healthcare providers
  • Healthcare clearinghouses
  • Business associates

Information Protected under HIPAA

HIPAA protects any information that has identifiers that could be used to connect a specific patient to healthcare information (e.g., social security number, name, email address, street address, cell phone number, etc.). The information sources protected include any forms such as paper, digital, or oral that can spread or give access to the identifying information.

Information that is not protected includes employment records, education information, and other records that have been characterized in the Family Educational Rights and Privacy Act (FERPA) and de-identified data.

Is HL7 Part Of HIPAA?

HL7 is not part of HIPAA, but the messaging standard (HL7) and HIPAA (privacy law) do overlap in the healthcare industry.

HL7 and HIPAA messages can overlap in the healthcare business when HL7 is used in some specific HIPAA EDI-X12 transactions. This can be seen; for example, when a patient is admitted to the hospital, the PAS (Patient Administration System) records the patient and patient administration details. Depending on the patient’s needs, other hospital departments and systems (e.g., the pathology lab information systems or the pharmacy systems) are expected to need information about the patient that has just been admitted. The PAS sends an HL7 message with the patient data to the relevant hospital systems.

At a later point, the hospital sends a claim for payment to another organization (i.e., an insurance company), and the hospital and insurance company will exchange HIPAA EDI-X12 messages. One or more of these HIPAA EDI-X12 messages will contain an embedded HL7 message with further patient information.

Conclusion

HL7 is a messaging standard that defines how healthcare data can be exchanged and transferred, whilst HIPAA is a federal law passed to protect an individual’s healthcare information. This rise in installations of HL7 and increased healthcare interoperability has increased the need for updated laws like HIPAA to safeguard medical information.

If you and your healthcare start-up would like to find out more about how HL7 and HIPAA benefit the healthcare industry, We invite you to read more about HL7 and HIPAA on our blog or service page to see how we can help you.

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