What is the difference between FHIR and HL7 v2?
HL7 v2 is a message-based standard that pushes events such as admissions, orders, and results between systems over interface engines. FHIR is a resource-based standard that exposes data through RESTful APIs so applications can request exactly what they need. Most organizations run both: HL7 v2 continues to carry high-volume clinical event traffic while FHIR supports apps, partner APIs, and regulatory requirements.
- HL7 v2 strengths: mature, event-driven, high throughput, deeply embedded in existing clinical operations.
- FHIR strengths: API access, granular queries, app launch through SMART on FHIR, and regulatory alignment.
- The decision depends on workflow, latency, partner capability, and who will operate the integration.
- Migration is usually incremental, with FHIR added alongside existing v2 interfaces rather than replacing them.
