Yes, and YES! Not impressed.

This looks an awful lot like ruby. Can someone show me the differences?

HL7 was designed in the 80s, way before XML, JSON, or even the Web existed. Don't be so critical. HL7 2.3 is typically the standard and free version. HL7 3+ is actually written in XML format now.

OMG, someone else that knows HL7!!!

Yes, pr0t0, I've been doing this for over 25 years and I have to agree with you for the most part. However, in my line of experience, I've seen some more variations to this example than the one you gave.

One example is: What is HL7? That's right. Companies with programs that are NOT even familiar with HL7, or an API

Another example is the different forms of medical practice. When we think of medical, we typically think of a clinical/hospital setting. But there are more cases than that: such as screening, per-screeing, preventative medicine, and mental health.

A third issue I've run into is the practice of the clinic itself. In other words, they may or may not follow what the HL7 platform dictates, and that makes API and medical meetings very interesting. You don't want to tell a Masters or Ph.D employee that they might be, "doing it wrong." I've ran into this with immunizations, labs, exams, and screenings so many times I've had to just throw my hands up in the air and let the staff fail in order for them to discover the fore-seen problems I tried to warn about prior.

Personally I'm thankful to have been introduced to HL7 as far back as in the late 90's. It's helped me to not only understand the medical community, but it's helped to shape my programming skills from thinking statically to always thinking dynamically.

I'm not sure where you got that information, but your incorrect. Sending binary data of any type of file is a necessity, and was most certainly included in the HL7 protocol, especially in the most common version, 2.3. Here is an example using version 2.2: How Do I Send a Binary File Inside of an HL7 Message? Most people in the know have been using HL7 2.3 for years, and those wanting to stay on top have ventured to higher versions.