HL7 is the not-so-secret superpower of the best CRMs, so if you're not familiar with it, it's worth taking a few minutes to sit down and brush up on the basics.
When you're comparing healthcare CRMs, you'll notice that the most powerful will mention capabilities around real-time data, communicating with clinical systems, and connecting with your EHR to turn all that rich consumer data into brand loyalty and an exceptional consumer experience. That all happens when systems are talking to each other, and those conversations are likely running on an HL7 framework.
What is HL7?
Named after Health Level Seven International, a non-profit standards developing organization, the term “HL7" is used to refer to a framework and standards that facilitate the integration, exchange, retrieval, and sharing of electronic health information. The standards are used extensively around the world to support clinical operations and management of health services, meaning that if your CRM needs to communicate with other health systems, HL7 is the place you want to start.
The standards are continuously evolving, with the latest, FHIR (Fast Health Interoperability Resources, pronounced, “fire"), promising speedier application development and easier exchange of well-defined, highly specific pieces of information between healthcare systems.
You don't need to know exactly how the sausage is made (though if you want to, start here) but understanding where interoperability is headed will add an extra tool in your CRM selection toolbox. That's largely because HL7 sits at the foundation of a lot of the most interesting consumer engagement news in healthcare right now.
Take Apple's recent premier of its health records app. Launching at Cedars-Sinai in LA, Johns Hopkins, and Geisinger Health System, the much-awaited personal health record (PHR) uses FHIR specifications to facilitate consumer record-viewing directly from their iPhones. This connection between the ubiquitous smart device and health data empowers better understanding of the overall health experience by giving consumers the opportunity the view things like immunizations, conditions, medications, and allergies similar to the way they view an EHR through a patient portal.
The Specifications That Matter Most
We've discussed FHIR, but there are actually a few more specifications that fall under the primary (most common) standard category.
CDA® (Clinical Document Architecture) specifies structure and semantics for clinical documents and facilitates exchange between healthcare providers. It can contain any type of clinical document including discharge summaries, pathology reports, imaging reports, and more. It's most commonly used for communication between enterprises (think Health Information Exchanges) and is particularly useful for the re-use of clinical data (i.e., quality monitoring, public health reporting, and patient safety).
This standard is believed to be the most widely implemented healthcare standard in the world and supports a central patient care system. First released in 1987, more than 95 percent of US healthcare organizations use this standard.
This suite of specifications is all about implementation allowing implementers to take advantage of the most effective and up-to-date implementation technologies available. It's designed for universal application, meaning the standards have the broadest possible impact even while they're adaptable to local and regional requirements.
This specification facilitates application integration at the point of use, meaning that it ensures secure and consistent access to patient information from a mix of sources. It allows suppliers to create an experience that feels like a user is accessing a single system when they might actually be using independent applications. Large facilities with multiple uses for clinical information will find this helpful, largely because the option can be used to increase patient safety, address HIPAA requirements, and make applications overall easier to use.
Intro to HL7 Messages
If you're accessing clinical data or pulling information from other systems, your new, loyalty-building CRM is going to be processing a lot of HL7 messages. First, let's take a look at what an HL7 message looks like. You might be surprised to see that you can understand a good part of it.
MSH|^~\&|EPIC|EPICADT|SMS|SMSADT|199912271408|CHARRIS|ADT^A04|1817457|D|2.5| PID||0493575^^^2^ID 1|454721||DOE^JOHN^^^^|DOE^JOHN^^^^|19480203|M||B|254 MYSTREET AVE^^MYTOWN^OH^44123^USA||(216)123-4567|||M|NON|400003403~1129086| NK1||ROE^MARIE^^^^|SPO||(216)123-4567||EC||||||||||||||||||||||||||| PV1||O|168 ~219~C~PMA^^^^^^^^^||||277^ALLEN MYLASTNAME^BONNIE^^^^|||||||||| ||2688684|||||||||||||||||||||||||199912271408||||||002376853
Each message contains segments that are displayed on separate lines of text. Each segment is made up of one or more composites that are also sometimes referred to as “fields." These messages can include lab records, billing info, patient information — almost any information that your CRM can use to compile and construct the optimized consumer insights that are so important to your brand.
Keep in mind that there are over 80 different types of HL7 Messages, and while you don't need to know them all, we do want to cover a few that might be pertinent to your CRM.
ACK: General acknowledgement message. This is sent when a message is received by a destination system.
ADT: Admission, discharge, and transfer. This message is created when a patient moves through any of those states. This particular message type is an integral part of measuring the effects of marketing initiatives relative to new patient acquisition and clinical encounters.
DFT: Financial information related to clinical encounters. This message type is typically used to measure the financial impact of marketing efforts and overall revenue analysis.
BAR: This message signifies an addition to or change to a billing account.
SIU: Schedule information (unsolicited) that is usually patient specific. This message is used to make changes to patient appointments and schedules.
MDM: A hard working message, it handles notes, reports, and even acts as a catchall for data that doesn't map cleanly elsewhere.
Even if you're considering a CRM that doesn't deal in real-time HL7 data, you're going to want to keep an eye on this protocol. What's advanced today will quickly become standard in the industry and even a functional demand of patients who will quickly get used to competitors with more sophisticated and accurate consumer targeting.
If you're looking for some guidance on picking a CRM that keeps you ready for the future of healthcare customer relationships, you'll want to review this white paper to get started.