Editing Health Level 7 (section)

==Other standards and methods==

===Fast Healthcare Interoperability Resources (FHIR)===
{{main|Fast Healthcare Interoperability Resources}}{{Update section|date=April 2024|reason=FHIR has matured significantly and is now at version 5 of the specification.}}
Fast Healthcare Interoperability Resources is a modern interoperability specification from [[Health Level Seven International|HL7 International]] designed to be easier to implement, more open, and more extensible than HL7 versions 2.x or 3.x. It leverages a modern web-based suite of API technology, including a [[HTTP]]-based [[RESTful]]  protocol, [[HTML]] and [[Cascading Style Sheets]] for user interface integration, a choice of [[JSON]] or [[XML]] for data representation, [[OAuth]] for authorization and [[Atom (web standard)|Atom]] for query results.<ref name="forbes">{{cite news
 | url=https://www.forbes.com/sites/danmunro/2014/03/30/setting-healthcare-interop-on-fire/
 | title=Setting Healthcare Interop On Fire
 | work=[[Forbes]]
 | author=Dan Munro
 | date=2014-03-30
 | access-date=2014-11-22 }}
</ref> The main purpose of the FHIR standard is to ensure interoperability between different computer systems. It defines the data format and protocol for exchanging medical information, regardless of how it is stored in these systems.<ref>{{cite journal
|last1=Kryszyn |first1=Jacek
|last2=Smolik |first2=Waldemar T. 
|last3=Wanta |first3=Damian 
|last4=Midura |first4=Mateusz
|last5=Wróblewski |first5=Przemysław
|journal=International Journal of Electronics and Telecommunications
|title=Comparison of OpenEHR and HL7 FHIR Standards
|url=https://journals.pan.pl/dlibra/publication/144330/edition/126538/content
|date=2023 |volume=69 |issue=1 |pages=47–52
|doi=10.24425/ijet.2023.144330
|access-date=2024-01-08}}</ref>

===Services Aware Interoperability Framework===
{{main|HL7 Services Aware Interoperability Framework}}

The HL7 Services-Aware Enterprise Architecture Framework (SAIF) provides consistency between all HL7 artifacts, and enables a standardized approach to Enterprise Architecture (EA) development and implementation, and a way to measure the consistency.

SAIF is a way of thinking about producing specifications that explicitly describe the governance, conformance, compliance, and behavioral semantics that are needed to achieve computable semantic working interoperability. The intended information transmission technology might use a messaging, document exchange, or service approach.

SAIF is the framework that is required to rationalize interoperability of other standards. SAIF is an architecture for achieving interoperability, but it is not a whole-solution design for enterprise architecture management.

=== Arden syntax ===
{{main|Arden syntax}}
The [[Arden syntax]] is a language for encoding medical knowledge. [[Health Level Seven International|HL7 International]] adopted and oversees the standard beginning with Arden syntax 2.0. These [[Medical logic module|Medical Logic Modules]] ([[Medical logic module|MLM]]s) are used in the clinical setting as they can contain sufficient knowledge to make single medical decisions.{{Citation needed|date=August 2007}}  They can produce alerts, diagnoses, and interpretations along with quality assurance function and administrative support.  An [[Medical logic module|MLM]] must run on a computer that meets the minimum system requirements and has the correct program installed.  Then, the MLM can give advice for when and where it is needed.

===Clinical Quality Language===
'''Clinical Quality Language''' (CQL) is a [[ANSI]] certified<ref>{{Cite web|url=https://cql.hl7.org/|title=Clinical Quality Language (CQL)|website=cql.hl7.org}}</ref> clinically focused high-level expression language standard curated by Health Level 7.<ref>{{Cite web|url=https://cql.hl7.org/01-introduction.html|title=1. Introduction|website=cql.hl7.org}}</ref> It is designated for clinical knowledge sharing in the domains of electronic clinical quality measurement and [[Clinical decision support system|clinical decision support]].<ref>{{Cite web|url=https://ecqi.healthit.gov/cql|title=CQL - Clinical Quality Language &#124; eCQI Resource Center|website=ecqi.healthit.gov}}</ref>

Clinical quality language is being used for a variety of clinical applications including [[World Health Organization|WHO]] SMART guidelines where it is used for encoding decision logic and performance indicators.<ref>{{Cite web|url=https://www.who.int/tools/CCC/l3-implementation-guide|title=L3 Implementation Guide|website=www.who.int}}</ref> The [[Centers for Medicare & Medicaid Services]] adopted CQL for clinical quality measure specifications since 2019.<ref name="cms" /><ref>[https://www.jointcommission.org/measurement/pioneers-in-quality/pioneers-in-quality-resources/piq-expert-to-expert-series/-/media/22f989e00f4e4492abc04ad2b6049e5d.ashx Pioneers in Quality. Electronic Clinical Quality Measure (eCQM). Clinical Quality Language (CQL) Basics for Hospitals] jointcommission.org</ref>

CQL allows modular and flexible expression of logic and is both human-readable and machine processable.<ref name="cms">[https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/Downloads/Overview-of-Technical-Specifications-for-electronic-Clinical-Quality-Measures-eCQMs.pdf Measures management system] cms.gov Retrieved 3 April 2024</ref>

An implementation of CQL was [[Open-source software|open sourced]] and published by the [[National Committee for Quality Assurance]] in 2023 with the aim of encouraging adoption of the language.<ref>{{Cite web|url=https://www.hcinnovationgroup.com/policy-value-based-care/value-based-care-quality-measurement/news/53060218/ncqa-makes-clinical-quality-language-software-open-source|title=NCQA Makes Clinical Quality Language Software Open Source|first=David|last=Raths|date=May 11, 2023|website=Healthcare Innovation}}</ref>

===MLLP===
A large portion of HL7 messaging is transported by Minimal Lower Layer Protocol (MLLP), also known as Lower Layer Protocol (LLP)<ref>{{cite web|title=LLP - Lower Layer Protocol|url=http://www.interfaceware.com/llp.html|publisher=iNTERFACEWARE}}</ref> or Minimum Layer Protocol (MLP).<ref>{{cite web|title=Minimum Layer Protocol|date=13 January 2020|url=https://www.lyniate.com/knowledge-hub/mlp-minimum-layer-protocol|publisher=LYNIATE}}</ref> For transmitting via TCP/IP, header and trailer characters are added to the message to identify the beginning and ending of the message because TCP/IP is a continuous stream of bytes.<ref name="mllp-spec">{{cite web |last1=Spronk |first1=Rene |title=Transport Specification: MLLP, Release 1 |url=https://www.hl7.org/documentcenter/public/wg/inm/mllp_transport_specification.PDF |website=hl7.org |publisher=Health Level Seven Inc. |access-date=5 September 2022}}</ref> Hybrid Lower Layer Protocol (HLLP) is a variation of MLLP that includes a checksum to help verify message integrity. Amongst other software vendors, MLLP is supported by Microsoft,<ref>{{cite web|title=MLLP Receive and Send Components|url=http://msdn.microsoft.com/en-us/library/ee409260%28BTS.10%29.aspx|publisher=[[MSDN]]}}</ref> Oracle,<ref>{{cite web|title=Oracle Application Server Integration B2B User's Guide, Supported Protocols|url=http://download.oracle.com/docs/cd/B14099_19/integrate.1012/b19370/supp_protos.htm#BACIFDJG|publisher=[[Oracle Corporation|Oracle]]}}</ref> [[Cleo (company)|Cleo]].<ref>{{cite web|title=Which Secure Managed File Transfer Protocol is Right for You?|url=https://www.cleo.com/solutions/compare-protocols/|publisher=[[Cleo (company)|Cleo]]|access-date=2015-01-23|archive-url=https://web.archive.org/web/20150607155326/http://www.cleo.com/solutions/compare-protocols/|archive-date=2015-06-07|url-status=dead}}</ref>

MLLP contains no inherent security or encryption but relies on lower layer protocols such as [[Transport Layer Security]] (TLS) or [[IPsec]] for safeguarding [[Protected health information]] outside of a secure network.

===Functional EHR and PHR specifications===
Functional specifications for an [[electronic health record]].