HL7 v2.x messaging and FHIR R4 resources on one Azure-native runtime, deployed into your own Azure subscription. PHI stays inside your cloud boundary, and the version question — R4 today, R6 later — is answered by the mapping layer rather than by rebuilding your interfaces.
In short
Art2link ESB is an Azure-native HL7 and FHIR integration platform that deploys into the customer’s own Azure subscription, so PHI never leaves their cloud boundary. It handles HL7 v2.x messaging and FHIR R4 resources on one runtime, with the v2-to-FHIR mapping held in a versioned layer so an estate can move to FHIR R6 without rebuilding its interfaces. Built by Cerebrum City, integration specialists with two decades of Microsoft BizTalk Server delivery and 500+ enterprise deployments.
Every integration vendor says it supports FHIR. Almost none of them say which release, or what a version change costs you. Here is the honest version.
FHIR R4
4.0.1 · 2019
Production baselineFHIR R5
5.0.0 · 2023
Largely skippedFHIR R6
6.0.0-ballot3 · in ballot
Plan for it, do not wait for itThe promise this makes: your HL7 v2 feeds land on R4 today, and the mapping layer — not your interfaces — absorbs R6 when it arrives.
Version status per Health Samurai’s FHIR R6 readiness analysis and Metriport’s FHIR R4 specification guide.
The translations that carry most production traffic. Each one is a mapping you can inspect, version and roll back — not a black box inside a connector.
| HL7 v2 message | maps to | FHIR R4 resource | What it carries |
|---|---|---|---|
| ADT A01, A04, A08, A31 | Patient · Encounter | Registration, admission, transfer and demographic updates. | |
| ORU^R01 Observation result | Observation · DiagnosticReport | Results delivery from ancillary systems to the record. | |
| ORM / OMP Order message | ServiceRequest · MedicationRequest | Orders for services, procedures and medications. | |
| SIU S12, S14, S15, S26 | Appointment · Schedule | Scheduling, rescheduling and cancellation events. | |
| DFT P03 | ChargeItem · Account | Detailed financial transactions posted to billing. | |
| MDM T02, T06 | DocumentReference | Clinical document notification and content transfer. |
Art2link ESB is single-tenant by construction. It deploys from the Microsoft Marketplace into your own Azure subscription, in the region you nominate, under your own Microsoft Entra ID tenant. There is no vendor-hosted environment holding clinical messages, because there is no vendor-hosted environment at all.
That is the whole deployment argument in three sentences. The long version — the three-model comparison, key ownership, residency and what Cerebrum City can and cannot see — lives on Deployment.
Healthcare integration spans two standards bodies, not one. Art2link carries both sides of that boundary on the same runtime.
The HL7 family: legacy v2 pipe-delimited messaging that still moves most production traffic, and the FHIR resource model that new consumers expect.
The administrative side of healthcare runs on X12, not HL7. Claims, remittance and eligibility move as HIPAA-mandated 5010 transaction sets.
Reference laboratories have a different integration problem to health systems. We wrote each of them their own page rather than one that half-serves both.
Instrument interfaces, discipline-by-discipline vendor coverage, order and result flow from the floor to the ordering EHR, and the operational view a lab CTO actually needs.
HL7 / FHIR for laboratories →The migration question, written for teams whose HL7 interfaces currently run on BizTalk Server: what carries forward, what has to be re-thought, and what the sequencing looks like.
Read the migration analysis →Seven answers, written to be checked rather than admired.
FHIR R4 is the production baseline. R4 (2019) was the first release with normative content and remains the release regulators and certification programmes reference, so it is what Art2link targets for production interfaces. R5 (2023) introduced breaking changes alongside its improvements and has seen limited adoption — most estates skipped it. Art2link supports R5 where a specific counterparty requires it, but does not recommend it as an estate-wide target.
Your interfaces do not change. The HL7 v2 to FHIR translation lives in a versioned mapping layer, held separately from endpoints, transports and routing rules. Moving a consumer from R4 to R6 is a change to that layer, not a rebuild of the estate. R6 is currently in ballot (6.0.0-ballot3); final publication is expected in late 2026, and broad production support is unlikely before late 2027.
Inside your own Azure subscription. Art2link ESB deploys from the Microsoft Marketplace into your Azure tenant, in the region you choose. Message content, mappings and audit records rest inside that boundary rather than in a vendor-hosted multi-tenant environment. The deployment model is documented in full on Deployment.
Yes — that is the normal configuration, not a transitional state. One runtime carries both: existing HL7 v2.x interfaces over MLLP continue unchanged while the same messages are translated to FHIR R4 for consumers that expect them. There is no cutover event, and no requirement to retire v2 in order to start publishing FHIR.
Not for integration. Art2link produces and consumes FHIR R4 resources and translates between HL7 v2 and FHIR at runtime. If your architecture also requires a persistent, queryable FHIR repository of record, Art2link integrates with one rather than replacing it — the platform is the interface engine, not the clinical data store.
Azure Health Data Services provides managed FHIR and DICOM services — the data plane. Art2link is the integration layer above it: HL7 v2 transport and acknowledgements, validation, transformation, routing, error handling, replay and per-message audit across an estate of interfaces. They are complementary, and Art2link runs in the same Azure subscription.
Art2link ships HIPAA-aligned controls: TLS 1.3 in transit, AES-256 at rest, identity through Microsoft Entra ID, role-based access control and immutable audit logging. Because the runtime sits in your own Azure subscription under your own governance, the controls you already operate apply to it. A BAA is available. The full control set is on Security & Governance.
Bring your interface inventory and your FHIR roadmap. You will get a senior integration architect — not an SDR — and a straight answer on what carries forward, within one business day.