diff --git a/Controllers/HL7Controller.cs b/Controllers/HL7Controller.cs
new file mode 100644
index 0000000..99c1941
--- /dev/null
+++ b/Controllers/HL7Controller.cs
@@ -0,0 +1,97 @@
+using Microsoft.AspNetCore.Mvc;
+using SimpleLIS.DTO;
+using SimpleLIS.Services;
+using SimpleLIS.Models;
+using AutoMapper;
+using System.Text.Json;
+
+namespace SimpleLIS.Controllers;
+
+[ApiController]
+[Route("api/hl7")]
+public class HL7Controller : ControllerBase
+{
+    private readonly MessageService _messageService;
+    private readonly PatientService _patientService;
+    private readonly IMapper _mapper;
+
+    public HL7Controller(
+        MessageService messageService, 
+        PatientService patientService, 
+        IMapper mapper)
+    {
+        _messageService = messageService;
+        _patientService = patientService;
+        _mapper = mapper;
+    }
+
+[HttpPost("process")]
+public async Task<IActionResult> ProcessHL7Message([FromBody] JsonElement payload)
+{
+    try
+    {
+        // Create Patient
+        var patient = new Patient
+        {
+            HL7PatientId = payload.GetProperty("hl7PatientId").GetString(),
+            LastName = payload.GetProperty("lastName").GetString(),
+            FirstName = payload.GetProperty("firstName").GetString(),
+            DateOfBirth = payload.GetProperty("dateOfBirth").GetDateTime(),
+            Gender = payload.GetProperty("gender").GetString(),
+            Messages = new List<Message>()
+        };
+
+        // Check for existing patient
+        var existingPatient = await _patientService.GetPatientByNameAndDOB(
+            patient.FirstName!, 
+            patient.LastName!, 
+            patient.DateOfBirth
+        );
+
+        patient = existingPatient ?? await _patientService.CreatePatientAsync(patient);
+
+        // Create Message
+        var message = new Message
+        {
+            ControlId = payload.GetProperty("controlId").GetString(),
+            MessageType = payload.GetProperty("messageType").GetString(),
+            SendingApp = payload.GetProperty("sendingApp").GetString(),
+            SendingFacility = payload.GetProperty("sendingFacility").GetString(),
+            ReceivingApp = payload.GetProperty("receivingApp").GetString(),
+            ReceivingFacility = payload.GetProperty("receivingFacility").GetString(),
+            Timestamp = payload.GetProperty("timestamp").GetDateTime(),
+            Version = payload.GetProperty("version").GetString(),
+            PatientId = patient.PatientId,
+            Patient = patient,
+            Observations = new List<Observation>()
+        };
+
+        // Create Observations
+        var observationsArray = payload.GetProperty("observations");
+        foreach (var obsElement in observationsArray.EnumerateArray())
+        {
+            var observation = new Observation
+            {
+                ObservationCode = obsElement.GetProperty("ObservationCode").GetString(),
+                ObservationValue = obsElement.GetProperty("ObservationValue").GetString(),
+                Units = obsElement.GetProperty("Units").GetString(),
+                AbnormalFlag = obsElement.GetProperty("AbnormalFlag").GetString(),
+                ResultStatus = obsElement.GetProperty("ResultStatus").GetString() ?? "F",
+                Message = message
+            };
+            message.Observations.Add(observation);
+        }
+
+        var createdMessage = await _messageService.CreateMessageAsync(message);
+        
+        return Ok(new { 
+            message = _mapper.Map<MessageDTO>(createdMessage),
+            patient = _mapper.Map<PatientDTO>(patient)
+        });
+    }
+    catch (Exception ex)
+    {
+        return BadRequest(new { error = ex.Message + (ex.InnerException?.Message ?? "") });
+    }
+}
+}
diff --git a/Services/PatientService.cs b/Services/PatientService.cs
index 3b0e23a..23df81b 100644
--- a/Services/PatientService.cs
+++ b/Services/PatientService.cs
@@ -52,4 +52,14 @@ public class PatientService
     {
         return await _context.Patients.AnyAsync(p => p.PatientId == id);
     }
+    public async Task<Patient?> GetPatientByNameAndDOB(string firstName, string lastName, DateTime dateOfBirth)
+    {
+        return await _context.Patients
+            .FirstOrDefaultAsync(p => 
+                p.FirstName == firstName && 
+                p.LastName == lastName && 
+                p.DateOfBirth == dateOfBirth);
+    }
+
+
 }
diff --git a/hl7.db-shm b/hl7.db-shm
new file mode 100644
index 0000000..597eee2
Binary files /dev/null and b/hl7.db-shm differ
diff --git a/hl7.db-wal b/hl7.db-wal
new file mode 100644
index 0000000..dbd2e34
Binary files /dev/null and b/hl7.db-wal differ