Case Study - e7Charts HL7 Integration with State & Lab Systems

Overview

e7 Health, a preventative healthcare company with national reach, needed to modernize its systems for more efficient lab reporting and communication with external medical platforms. With a significant portion of its services involving vaccinations, STD screenings, and employee testing, the organization required robust interoperability—especially HL7 (Health Level Seven) support.

Web3Box was brought in to lead the development of HL7-based interfaces for two critical functions:

• Vaccine and lab result integration with Illinois I-CARE (Immunization Registry)
• Bi-directional result exchange with third-party labs such as CPL and CynergyMRO

Our work enabled e7Charts to automatically receive, process, and report medical results with minimal human intervention, while meeting state and lab-specific standards.

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The Challenge

Before integration, e7 Health’s clinical data flow relied heavily on manual entry, PDF exchanges, and inconsistent result delivery. This caused delays in:

• Lab result availability
• Vaccine record reporting to I-CARE
• Internal processing and recordkeeping

Additional challenges included:

• Ensuring HL7 messages met lab-specific formatting for test codes like Chlamydia (3771) and Gonorrhea (3772)
• Maintaining accurate specimen source fields (e.g., "pharyngeal" vs. "nasopharyngeal")
• Testing across staging and live environments without disrupting operations
• Handling scheduled downtime (e.g., I-CARE maintenance windows) and batching messages accordingly

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Our Solution

Web3Box designed a modular HL7 interface layer within the e7Charts system, covering both order submission and result ingestion workflows.

Key Solutions Delivered:

• HL7 ORM Message Configuration:
  Enhanced outbound orders with correct OBX segments, ensuring AOE (Ask at Order Entry) data such as specimen source was included for critical test codes.

• Incoming Result Automation:
  Built a listener system to receive HL7 lab results from CynergyMRO and CPL. Implemented custom endpoints to receive updates, verify record match, and insert results into patient history.

• I-CARE Integration:
  Developed an HL7 vaccine submission process that aligned with the I-CARE registry protocol, batching messages when offline and retrying after maintenance windows.

• Realtime Notifications:
  Enabled webhook callbacks so that the e7 system could respond to real-time lab result updates from third parties, reducing latency in record availability.

• Validation & Error Handling:
  Ran several rounds of test data submissions and validations across various test cases (single vs. multiple tests, missing OBX segments, malformed HL7s)

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Technology Stack

• HL7 (ORM^O01 / ORU^R01)
• PHP (Laravel)
• Custom Webhook APIs
• Staging + Production sync environments
• Integration with I-CARE and CynergyMRO/CPL systems

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Results

• Reduced turnaround time for lab result delivery by over 50%
• Streamlined HL7 compliance for multi-lab support
• Eliminated dozens of hours of manual processing each week
• Enabled e7 Health to scale nationwide testing efforts without compromising data flow reliability

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Why Web3Box

e7 Health chose Web3Box not only for our technical capabilities but also our collaborative approach. From interpreting obscure HL7 documentation to working directly with lab partners and state IT teams, our team ensured every message, format, and validation step aligned with operational needs.