The key differences between a v2.x and v3 message are as follows:
v2.x was primarily meant for clinical communications - medical orders, patient registration etc. whereas v3.x has additional features for use by informaticists and for government reporting requirements.
v2.x was a custom format (barebones text - all coded and separated by a pipe with headers and multiple segments etc.) whereas an HL7 v3.0 message is an XML format - very verbose and detailed.
v2.x was primarily meant for clinical communications - medical orders, patient registration etc. whereas v3.x has additional features for use by informaticists and for government reporting requirements.
v2.x was a custom format (barebones text - all coded and separated by a pipe with headers and multiple segments etc.) whereas an HL7 v3.0 message is an XML format - very verbose and detailed.