A Guide to Healthcare Data Interoperability In 2026
How Custom Software Enables Interoperability & FHIR Integration
What is Healthcare Interoperability?
Digital healthcare systems have an abundance of moving parts, with data processed across Electronic Health Records (EHRs), telemedicine apps, and patient platforms. These various platforms needa way to communicate with one another seamlessly and securely, in a highly regulated environment, to ensure the best outcomes for patients, practitioners, and providers. This is where ‘interoperability’ comes in.
Healthcare interoperability aims to enable the sharing, use, and storage of patient data across different systems, regardless of their features or formats. Interoperability can be challenging due to the complexity of the healthcare ecosystem, yet it is crucial for efficient operations and secure data exchange.
The Role of FHIR Standards
Utilizing standards across systems provides a means for effective data exchange. One such standard is HL7 (Health Level 7), for exchanging patient data. The most recent evolution of HL7 is FHIR (Fast Healthcare Interoperability Resources) — pronounced “fire” — which organizes data into small, reusable units called “resources,”. These data might be medications, appointments, or lab results, and with FHIR, can be more easily shared between systems through modern APIs. FHIR represents a shift from complex, rigid data exchange to flexible, API-driven interoperability. For healthcare providers and software companies alike, it offers speed, scalability, and standardization - all while increasing innovation potential.
APIs and Integration Engines
APIs (Application Programming Interfaces) and integration engines are core components of healthcare interoperability, enabling the standardized exchange of data across diverse systems. APIs allow applications to communicate in real time by sending and retrieving specific data on demand, rather than relying solely on batch-based data transfers. In modern healthcare architectures, APIs are typically aligned with standards such as HL7 and FHIR, and use secure transport protocols.
FHIR-based APIs, in particular, have become the preferred approach for interoperability, as they are built on widely adopted web technologies such as REST, JSON, and HTTP. This makes them scalable, developer-friendly, and suitable for cloud-based and mobile applications. Integration engines continue to play an important role by translating, routing, and transforming data between legacy systems (such as HL7 v2 messaging) and newer FHIR-enabled platforms, allowing healthcare organizations to modernize their infrastructure without fully replacing existing systems.
While FHIR APIs are becoming the standard for modern interoperability, many healthcare organizations still rely on integration engines such as Mirth® Connect by NextGen Healthcare to connect legacy systems. These tools help translate and route data between older HL7-based infrastructures and newer API-driven platforms.
Why Interoperability is a Challenge in Healthcare
Prior to the adoption of common national (U.S.) interoperability standards, certain legacy systems hampered cross-platform sharing, as they each had unique ways of entering and storing data. Healthcare systems have relied on HL7 standards for decades to exchange patient information, but the newer FHIR standard builds on HL7 by using modern web technologies such as REST APIs, making healthcare integrations faster and more flexible.
Despite FHIR’s success, there are still a number of limitations when it comes to achieving interoperability in healthcare:
Data Quality and Standardization
Variations in data formats can cause problems. While standardized platforms have become more widespread, data formats are far from universal.
Privacy and Cybersecurity
Protecting healthcare data can be a major challenge because of the handling of PHI (Protected Health Information) and other sensitive information. Compliance regulations such as HIPAA are in place to ensure data security, and any solution must meet these requirements.
Integration
Integrating/adopting new data exchange systems can pose financial challenges due to the need for specialized developers, member training, and ongoing maintenance.
How Custom Software Enables Interoperability
Custom healthcare software development enables interoperability by connecting disconnected systems, standardizing data exchange, and building scalable, API-driven solutions tailored to real-world healthcare environments. Solutions in interoperability are never one-size-fits-all. Healthcare providers often rely on custom integrations - custom development ensures that nothing is lost in translation during data exchange, and that the resulting systems meet the needs of the users. Interface engines, such as Mirth® Connect by NextGen Healthcare, allow for multiple custom interfaces to run simultaneously while preserving a single connection point for software applications (to the interface engine).
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