Every healthcare format, translated — in days, not quarters.
Health1st translates HL7 v2, FHIR, C-CDA, X12 and NCPDP in both directions — with AI agents that draft the mappings, normalize the codes and validate against US Core, so your team reviews instead of hand-building. Your HL7 backlog is measured in months. Ours in days.
- HL7 v2.x ↔ FHIR R4/R4B/R5 at the core — round-trip fidelity
- US Core, Da Vinci & IPS conformance, with exportable reports
- Built for CMS-0057-F: four FHIR APIs due January 1, 2027
- Deploy in cloud, VPC or on-prem — you control the data
MSH|^~\&|EPIC|HOSP|H1ST|DST|202601..||ADT^A01|
PID|1||MRN12345^^^HOSP^MR||DOE^JOHN^A||
19701225|M|||123 MAIN ST^^AUSTIN^TX
PV1|1|I|ICU^101^A|||...admit...
DG1|1|I10|E11.9^Type 2 diabetes mellitusAgent
{ "resourceType": "Patient",
"identifier": [{ "value": "MRN12345" }],
"name": [{ "family": "Doe",
"given": ["John","A"] }],
"gender": "male",
"birthDate": "1970-12-25" }
{ "resourceType": "Condition",
"code": { "coding": [{
"system": "…/icd-10-cm",
"code": "E11.9" }] } }In short
Must expose FHIR. Still runs HL7 v2.
That single gap — created by the Cures Act and sharpened by CMS-0057-F — is where interface teams drown. Every point-to-point interface is hand-built, brittle, and measured in weeks.
A backlog measured in months
Each new interface is a manual mapping-and-testing project. Scarce, expensive HL7 analysts become the bottleneck for every integration.
A hard 2027 deadline
CMS-0057-F forces impacted payers to stand up four FHIR APIs by January 1, 2027 — and as of October 2025, roughly 43% of payers had not started.
Incumbent engines cost a fortune
Legacy engines run from six figures to $10M+/year at mega scale, and stay consultant-heavy long after the contract is signed.
Clinical errors are unacceptable
A mis-mapped diagnosis or dose is a patient-safety event, not a bug ticket. Speed can't come at the cost of accuracy or auditability.
Ingest → AI-map → validate → deliver
One pipeline runs every transformation. AI agents draft and normalize; your team reviews; the engine validates and delivers with full audit.
- 1
Ingest
Accept any source — HL7 v2 over MLLP, FHIR REST, C-CDA XML, X12 EDI, NCPDP, flat files or a custom API. Real-time, batch or streaming, with guaranteed delivery and replay.
- 2
AI-map
The Mapping and Terminology agents draft field- and segment-level mappings, normalize codes (ICD-10, SNOMED, LOINC, RxNorm↔NDC), and explain every decision in plain English for human review.
- 3
Validate
The Validation agent checks output against US Core, Da Vinci and IPS profiles — cardinality, bindings, must-support — and produces the conformance report procurement and auditors ask for.
- 4
Deliver
The Transformation and Orchestration agents serialize, route and reliably deliver the result — a FHIR bundle, an X12 278, an NCPDP SCRIPT message — with round-trip fidelity and full audit.
MSH|^~\&|EPIC|HOSP|H1ST|DST|202601..||ADT^A01|
PID|1||MRN12345^^^HOSP^MR||DOE^JOHN^A||
19701225|M|||123 MAIN ST^^AUSTIN^TX
PV1|1|I|ICU^101^A|||...admit...
DG1|1|I10|E11.9^Type 2 diabetes mellitusAgent
{ "resourceType": "Patient",
"identifier": [{ "value": "MRN12345" }],
"name": [{ "family": "Doe",
"given": ["John","A"] }],
"gender": "male",
"birthDate": "1970-12-25" }
{ "resourceType": "Condition",
"code": { "coding": [{
"system": "…/icd-10-cm",
"code": "E11.9" }] } }A live example: an inbound HL7 v2.5.1 ADT^A01 admission maps segment-by-segment into a validated FHIR R4 bundle — PID → Patient, PV1 → Encounter, DG1 (ICD-10 E11.9, Type 2 diabetes) → Condition — and back again.
The protocol & format matrix
Bidirectional support across the clinical, payer/administrative and pharmacy domains — plus the terminology systems that make a mapping actually correct.
| Standard / format | Versions & variants | Domain | Direction |
|---|---|---|---|
| HL7 v2.x | 2.1 – 2.9 · ADT, ORM, ORU, SIU, MDM, DFT, VXU | Clinical / real-time | Bidirectional |
| HL7 FHIR | DSTU2, STU3, R4 (4.0.1), R4B, R5 | Clinical / API | Bidirectional |
| US Core / USCDI | US Core STU 3.1.1+, USCDI data classes | Conformance profile | Profile / validation |
| HL7 CDA / C-CDA | R2.1 — CCD, Discharge, Referral, Progress Note | Clinical documents | Bidirectional |
| X12 EDI | 270/271, 276/277, 278, 834, 835, 837 P/I/D, 820, 999/TA1 | Payer / administrative | Bidirectional (↔ Da Vinci) |
| NCPDP SCRIPT | v2023011 (HTI-4), 10.6 — NewRx, Renewal, Change, CancelRx, RxFill | Pharmacy / e-Rx | Bidirectional |
| NCPDP Telecom / RTPB / F&B | Telecom D.0 · RTPB v13 · Formulary & Benefit | Pharmacy benefit / claims | Bidirectional (↔ CARIN RTPBC) |
| DICOM | Metadata, SR, DICOMweb | Imaging | → FHIR ImagingStudy |
| IHE profiles | XDS.b, MHD, PIX/PDQ, XCA, ATNA | Document / registry exchange | Cross-community |
| Direct / DirectTrust | S/MIME secure messaging | Secure clinical messaging | Provider-to-provider |
| Bulk FHIR (Flat FHIR) | $export · NDJSON · Bulk Data STU 1 | Payer / analytics / population | Export |
| Flat & custom formats | CSV, JSON, XML, delimited, fixed-width, Z-segments, custom APIs | Any / legacy feeds | AI-assisted reverse mapping |
Terminology & code systems (translation + normalization)
Crosswalks such as ICD-10 E11.9 ↔ SNOMED, and RxNorm ↔ NDC (e.g. ATORVASTATIN CALCIUM, NDC 59651-608) are handled by the Terminology agent with a confidence score on every match.
Engine capability, without the consulting tax
Everything a legacy engine does — plus AI mapping, conformance reporting and deployment flexibility that API networks and hyperscaler stores don't give you.
Bidirectional by design
Not a one-way FHIR façade. Every meaningful pairing runs both directions — v2→FHIR for API and patient access, FHIR→v2 to feed the systems that still speak HL7 v2.
AI mapping, human review
Agents propose mappings; your team approves them. Every mapping is versioned with diff and one-click rollback, and every field carries a plain-English explanation.
Conformance you can hand to procurement
Validation against US Core, Da Vinci and IPS profiles produces exportable conformance reports — the artifact buyers require before they integrate.
Real-time, batch & streaming
MLLP feeds, REST APIs, nightly batch and Bulk FHIR $export all run on the same engine, with guaranteed delivery, retry and replay.
Deploy where your data lives
Cloud, single-tenant VPC or on-prem. Control data residency and keep PHI inside your boundary — a control API networks can't offer.
Days, not months
The Onboarding agent learns a partner's format from sample messages and bootstraps the first interfaces — collapsing weeks-long interface builds into days.
Twelve specialists, one orchestrator
Each agent owns a domain — mapping, terminology, validation, prior-auth, pharmacy and more — and operates with human-in-the-loop review and full audit.
Mapping Agent
codename “Cartos”Generates and refines field/schema mappings between any two formats.
Terminology Agent
codename “Lexid”Translates and normalizes codes across clinical & billing code systems.
Transformation Agent
codename “Morphi”Converts every message in both directions — without losing meaning.
Validation Agent
codename “Conforma”Guarantees output conforms to the correct profile / implementation guide.
Prior-Auth Agent
codename “Authra”Runs end-to-end electronic prior authorization.
Pharmacy Agent
codename “Rxena”Owns the drug-industry interoperability surface.
Agent codenames are working names pending trademark & domain clearance. Functional names describe what each agent does.
Explore the platform
Each surface has its own deep dive — from the core translation engine to prior authorization, pharmacy and security.
HL7 v2 ↔ FHIR Engine
The core translation engine: every message type (ADT, ORU, SIU, MDM…) to the right FHIR resource, both directions, with round-trip fidelity.
Learn moreMedical Coding & Terminology
AI code translation across ICD-10, SNOMED CT, LOINC, CPT, RxNorm and NDC — value-set binding and local-code reconciliation with confidence scoring.
Learn morePrior Authorization (CMS-0057-F)
The PARDD API, Da Vinci PAS/CRD/DTR and X12 278 ↔ FHIR — automated documentation assembly for the January 2027 deadline.
Learn morePharmacy & e-Prescribing
NCPDP SCRIPT, EPCS, electronic prior auth, Real-Time Prescription Benefit and RxNorm↔NDC — connecting EHRs, pharmacies, PBMs and pharma.
Learn moreThe AI Agent Fleet
Twelve specialized agents — mapping, terminology, validation, prior-auth, pharmacy and more — coordinated by an orchestrator with human-in-the-loop review.
Learn moreSecurity & Compliance
HIPAA with BAAs today, SOC 2 Type II in progress, HITRUST on the roadmap — AWS HIPAA-eligible infrastructure, SMART on FHIR, RBAC and immutable audit.
Learn moreSecurity & Compliance
Enterprise-grade trust, stated honestly
Protecting PHI is non-negotiable. Here's exactly where our certifications stand — no overclaiming.
Compliant · BAAs available
Audit in progress
On roadmap
Native, by design
AWS HIPAA-eligible infrastructure · Business Associate Agreements (BAAs) · Encryption in transit & at rest · See our security details →
Frequently asked questions
Ready to turn months of interface work into days?
See a live HL7 v2 ↔ FHIR translation on your own message types. No obligation.