Key takeaways
- HL7 v2, FHIR and X12 are different standards, and an analyst strong in one can be new to another.
- Analysts, interface engineers and testers need different skills, so decide which one the project needs most.
- Interview questions should test real message work, like reading a raw message and tracing an error.
- A good requisition names the standard, the interface engine, the systems on each side and the project phase.
Why an interface requisition needs more detail
"We need an HL7 person" is one of the most common requisitions in healthcare IT, and one of the least specific. Healthcare data moves through several standards and many different tools. A consultant who has built lab interfaces for years can still be fairly new to FHIR APIs or claims files. So when the profile is not clear, vendors send the wrong people and the client spends weeks interviewing.
Getting the profile right before sourcing saves that time. Below is how we think about these roles when a hospital, a health tech company or a prime vendor sends us a requisition.
The standards behind the work
HL7 v2
Still the workhorse inside hospitals. Admissions, orders, results, scheduling and charges move between the EHR and other systems as HL7 v2 messages, such as ADT, ORM, ORU, SIU and DFT. The work is mapping fields, handling Z segments and local rules, and fixing messages that fail at two in the morning.
FHIR
The newer API based standard. It is used for patient access, payer data exchange, apps that plug into the EHR and many interoperability programs. FHIR work looks more like modern web development: REST APIs, JSON, resources and profiles, and security with OAuth and SMART on FHIR.
X12 EDI
The language of claims and payments. 837 claims, 835 remittances, 270 and 271 eligibility, 276 and 277 claim status. This work sits close to the revenue cycle, so the analyst needs to understand billing as well as file formats.
Some people are strong in all three. Most are strong in one or two. That is normal, and it is better to know it up front.
Analyst, engineer or tester?
Inside each standard there are different kinds of roles, and they need different people.
- Interface analysts gather requirements, write the specification and mapping documents, and work with the clinical or billing teams to confirm what the data should look like.
- Interface engineers build and support the interfaces in an engine like Rhapsody, Mirth, Cloverleaf or InterSystems, and write the scripts and transformations.
- Integration testers plan and run end to end tests, compare messages before and after a change, and support go live.
Many requisitions ask for one person who does everything. Sometimes that person exists, but it narrows the pool a lot. Its usually better to decide which skill the project needs most and screen for that.
The engine and the EHR matter
Experience with the specific interface engine shortens the ramp up time. So does knowing the EHR on either side, whether that is Epic, Oracle Health, MEDITECH, athenahealth or another system. Some clients also ask for vendor certification on their EHR.
That said, a strong engineer can move between engines faster than people think. If the pool is small, ask whether engine experience is a must have or a nice to have. The answer can open up many more good profiles.
Questions worth asking in the interview
General questions about healthcare IT will not tell you much. Ask about hands on work.
- Here is a raw ADT message. Walk us through what it says about the patient and the visit.
- A lab result is reaching the EHR but showing on the wrong patient. Where do you start?
- Which interface engines have you built in yourself, and what did you build?
- How have you handled custom Z segments or local code sets?
- For FHIR roles: which resources have you worked with, and how was the API secured?
- For X12 roles: how do you trace a rejected 837 back to its cause?
Listen for specific steps and real problems. Someone who has supported interfaces in production will talk about failed messages and late night fixes as easily as about the build.
Do not skip HIPAA and access
Interface work means seeing real patient data in messages and logs. Make sure the consultant has current HIPAA training, understands minimum necessary access, and knows not to copy messages with patient details into email or personal notes. At iCareTechno we confirm this before a consultant starts, but it is worth asking in interview too.
How to write the requisition
A clear requisition gets better submittals faster. Include these items:
- Standard. HL7 v2, FHIR, X12 or a mix.
- Interface engine. Rhapsody, Mirth, Cloverleaf, InterSystems or other.
- Systems. The EHR and the systems on the other side, such as lab, imaging, billing or a payer.
- Role type. Analyst, engineer or tester.
- Project phase. New implementation, EHR conversion, upgrade or ongoing support.
We place healthcare IT and integration consultants for hospitals, health tech companies and prime vendors. You can read more on our healthcare IT and RCM page.
HL7 and FHIR are registered trademarks of Health Level Seven International. Other product names belong to their owners. This article is independent and not endorsed by any of them.
Frequently asked questions
What does an HL7 interface analyst do?
An HL7 interface analyst gathers requirements, writes mapping specifications and works with clinical or billing teams so data moves correctly between the EHR and other systems. Interface engineers then build the interfaces in an integration engine.
What is the difference between HL7 v2 and FHIR?
HL7 v2 is a message based standard used inside hospitals for admissions, orders and results. FHIR is a newer API based standard that uses REST and JSON, often for patient access, apps and data exchange between organizations.
What should an interface job requisition include?
Name the standard, the interface engine, the systems on each side, the role type and the project phase. This helps vendors send the right profiles the first time.
Need an interface analyst or engineer?
Tell us the standard, the engine and the systems involved. We reply within one business day with a clear plan for the search.
Israr Kazmi
Israr Kazmi is the founder of iCareTechno, the IT staffing, recruitment and consulting division of iCareBilling LLC in Chicago. He writes about hiring, vendor relationships and careers in IT.
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