The HL7® Survival Guide — Chapter 2: Pros and Cons of Interfacing Capabilities

In Chapter 1 of the HL7® Survival Guide, we covered what it takes to exchange data. To help you make the most suitable choice among interfacing approaches, we’ve laid out the pros and cons of each approach or set of capabilities.





  • Get up and running quickly if you have a few systems only.
  • Small system volume makes it easier to work with
  • Works well and is cost-effective for fewer than five healthcare information/clinical systems as infrastructure investment in minimal and complexity is reduced.
  • Easier to get going quickly when you’re starting from scratch
  • No need for technical resources; vendors can set up interfaces
  • Harder to grow/evolve over time because systems are tightly coupled together and any change to one might impacts all others
  • Doesn’t scale well since there will be N(N-1) interfaces in ecosystem (e.g., 5 systems – 5(5-1) = 20 interfaces)
  • Inflexible – systems must understand other systems’ expected data structure and semantics
  • Limited monitoring capabilities
  • Costs can grow rapidly if you rely on vendor to change or add new interfaces



Interfacing Capabilities

  • Mediates transport protocols between systems
  • Scales elegantly to reduce number of interfaces required (N + 1)
  • Centralizes and facilitates monitoring of message flows and interfaces
  • Systems are loosely coupled, enabling you to add new interfaces and modify existing ones without impacting other systems
  • Provides tools and infrastructure so interface adapts to different HL7® message and data formats
  • Reduces interface costs by using single application capabilities across all applications
  • Reduces dependency on multiple vendors for changes to message format
  • Steep learning curve – need to be well versed in a specific vendor’s technology to develop interfaces
  • Vendor lock in can mean additional costs for integration engine infrastructure, as well as costly interface engine technology conversion that involves large projects impacting several systems



Integration Capabilities

  • Includes workflow management features that enable the interface to respond as clinical workflows evolve and that offer a more flexible migration path for systems and ecosystems
  • Provides a single point for system integration to ensure consistent management
  • Built to scale
  • More complex and expensive than smaller-scale interface engine due to shortage of skilled analysts and need for extensive training
  • Expensive software licenses
  • Need to create a dedicated team (if you don’t already have one)


Vendors of Integration Engines and Technologies

To help you get a jump-start on your research, we’ve listed some of the major interface engine providers below. Each of these providers addresses different needs: while some are best suited to small hospitals, others scale to support multiple locations and stakeholders, such as for an 80-hospital IDN. Still other engine vendors focus on interfacing with EMR solutions (for example, Summit and Iatric are fairly Meditech focused).

Check out the relevant vendors below, and evaluate other players in the market. Use the grid above to figure out the questions you should ask based on your organization’s needs.

  • Cerner Open Engine
  • Cloverleaf
  • Corepoint Health
  • Ensemble
  • Iatric EasyConnect
  • Interfaceware Iguana
  • McKesson Pathways
  • Microsoft BizTalk
  • Mirth Connect / NextGen Connect
  • Oracle Fusion
  • Oracle JCAPS/ICAN/e*Gate/DataGate
  • Rhapsody
  • Siemens OpenLink
  • Summit Exchange

Note: This is a partial list. We welcome your suggestions for other vendors you feel should be added.

Engine Vendor Performance Rankings and Market Share

• For vendor performance rankings, see the KLAS Research website.
• For a current view of the HL7® interface market within healthcare, see the 2018 HL7 Interface Engine Rating survey results published by Core Health Technologies.

Your Feedback Welcome

We’ll be publishing chapters from the HL7® Survival Guide over the upcoming weeks and months. See a topic that needs more detail? Have a different perspective on interfacing and interoperability? Tell us in the comments!

Read More in the HL7® Survival Guide

Chapter 1: How to Integrate and Exchange Healthcare Data
Chapter 2: Pros and Cons of Interfacing Capabilities
Chapter 3: The Heart of the Matter: Data Formats, Workflows, and Meaning
Chapter 4: How to Work with Vendors and Developing Your EHR Strategy
Chapter 5: Vendors, Consultants, and HL7® Interface Specifications
Chapter 6: Interfacing Artifacts: HL7® Conformance Profiles or Interface Specifications
Chapter 7: Interfacing Artifacts: Gap Analysis
Chapter 8: Interfacing Artifacts: Test Scenarios and Test Systems
Chapter 9: Interfacing Artifacts: Message Samples and Test Messages
Chapter 10: Process and Workflow
Chapter 11: Maintenance, Troubleshooting, and Monitoring
Chapter 12: Definitions
Chapter 13: Contributors and Resources

Caristix Workgroup software for integration teams