Native HL7 and FHIR R4 integration
for hospital systems

Connect your PACS with the hospital HIS, RIS, and laboratory. Bidirectional HL7 v2.x messaging via MLLP and a native FHIR R4 server for modern integration with any system.

HL7 v2.x: standard clinical messaging

HL7 v2.x is the most widely deployed messaging standard for communication between hospital systems. Despite its age, it remains the dominant protocol in the majority of HIS and RIS systems installed in hospitals worldwide.

Medisfera implements a bidirectional MLLP gateway (Minimal Lower Layer Protocol) that listens on port 2575 and processes incoming HL7 messages, automatically updating the DICOM worklist, study status, and patient demographic data.

Supported message types

ADT^A01/A08

Patient admission and update

ORM^O01

Imaging order (study request)

ORU^R01

Study result / report

SIU^S12/S13

Scheduling and appointment

ACK

Acknowledgement (AA, AE, AR)

ORM^O01 Cancel

Order cancellation

Example: ORM^O01 (Imaging order)

MSH|^~\&|HIS|HOSPITAL_A|MEDISFERA|PACS|20250315120000||ORM^O01|MSG001|P|2.5
PID|1||1234567890^^^HIS||GARCIA^PEDRO^M||19751022|M|||C/ MAYOR 1^MADRID^^28001
PV1|1|O|RADIOLOGY||||12345^DR LOPEZ^ANA|
ORC|NW|ORD-2025-001|||SC||||20250315120000|||12345^DR LOPEZ^ANA
OBR|1|ORD-2025-001||72193^TC ABDOMEN SIN CONTRASTE^LN|||20250315|||||||||||
|12345^DR LOPEZ^ANA||||||CT|||^^MEDISFERA_MWL^MEDISFERA|||SC

Example: ORU^R01 (Study result)

MSH|^~\&|MEDISFERA|PACS|HIS|HOSPITAL_A|20250315145530||ORU^R01|RPT001|P|2.5
PID|1||1234567890^^^HIS||GARCIA^PEDRO^M||19751022|M
OBR|1|ORD-2025-001||72193^TC ABDOMEN SIN CONTRASTE^LN|||20250315|
|||||||||12345^DR LOPEZ^ANA||||CT|20250315145530||F
OBX|1|TX|59380-7^Impresión diagnóstica^LN||Estudio sin hallazgos
significativos. No se evidencian alteraciones focales.||||||F

FHIR R4: the next generation of interoperability

FHIR R4 (Fast Healthcare Interoperability Resources) is the HL7 standard for REST and JSON/XML-based healthcare interoperability. Designed for the web era, it lets you integrate healthcare systems as easily as a conventional REST API.

Medisfera implements a full FHIR R4 server with support for the most relevant resources in medical imaging, exposing both clinical information and DICOM studies through a modern, documented API.

Patient read, search, create, update

Patient management with bidirectional synchronisation with the PACS

Appointment read, search, create

Appointment scheduling linked to the DICOM worklist

ImagingStudy read, search

Exposes DICOM studies as FHIR resources with WADO-RS endpoints

ServiceRequest read, search, create

Medical imaging requests (equivalent to ORM in HL7 v2)

Example: ImagingStudy FHIR R4

{
  "resourceType": "ImagingStudy",
  "id": "study-20250315-001",
  "status": "available",
  "subject": {
    "reference": "Patient/1234567890"
  },
  "started": "2025-03-15T12:05:00+01:00",
  "numberOfSeries": 3,
  "numberOfInstances": 512,
  "modality": [{"code": "CT"}],
  "identifier": [{
    "system": "urn:dicom:uid",
    "value": "urn:oid:1.2.3.4.5.6.7"
  }],
  "series": [{
    "uid": "1.2.3.4.5.6.8",
    "modality": {"code": "CT"},
    "numberOfInstances": 512,
    "endpoint": [{
      "reference": "Endpoint/wado-rs"
    }]
  }]
}

CapabilityStatement available at:

GET /fhir/R4/metadata

Integration with HIS/RIS systems

Medisfera is designed to integrate seamlessly with the most common hospital information systems across Europe and beyond.

Agfa Orbis / Impax

HIS / RIS

HL7 SIU/ORM/ORU, DICOMWeb

Certified integration. Bidirectional worklist.

iSOFT

HIS

HL7 ADT/ORM, FHIR R4

Patient and order synchronisation.

SAP IS-H

HIS

HL7 ADT/ORM via Mirth Connect

Mirth Connect as integration middleware.

Qualycare / Nexus

RIS

HL7 SIU/ORM, DICOMWeb WADO-RS

Worklist integration and image retrieval.

OpenMRS

Open source HIS

FHIR R4

Native FHIR R4 integration for NGO and public environments.

Any HL7 system

Generic

HL7 v2.5/2.6/2.7 MLLP

Configurable adapters for custom message formats.

Your HIS/RIS not on this list?

If your system has an HL7 v2.x or FHIR interface, we can integrate it. We use Mirth Connect as an integration engine for complex adaptations.

Check compatibility for your system

Real-world use cases

Hospital with HIS + PACS

The physician creates an imaging request in the HIS
The HIS sends an ORM^O01 to Medisfera's HL7 gateway
Medisfera automatically creates the item in the DICOM worklist
The modality queries the MWL and auto-populates patient data
After acquisition, MPPS notifies Medisfera of completion
The report is sent back to the HIS via ORU^R01

Private clinic with mobile app

The radiologist accesses the study from the web viewer (OHIF)
A third-party mobile app queries ImagingStudy via FHIR R4
The patient can access their images using a SMART on FHIR token
The telemedicine app retrieves images directly via WADO-RS
Reports are synchronised with the patient portal via FHIR

We integrate your PACS with your HIS in days, not months

Our team has extensive experience integrating Medisfera with the major hospital information systems on the market. Tell us about your setup.

Discuss my integration case

Native HL7 and FHIR R4 integration for hospital systems