What challenges do FHIR implementers face when working with asynchronous interactions for CRUD operations? How can alternative patterns, such as queue-based protocols, improve server-to-server data replication? What are the practical limitations of the FHIR Asynchronous Request Pattern in real-world scenarios?
In this webinar, Josh Mandel, Chief Architect at Microsoft Healthcare, and Nikolai Ryzhikov, CTO at Health Samurai, discuss these critical questions. They explore advanced interaction patterns, share best practices, and provide insights into optimizing data workflows for healthcare systems of all size
Naive REST interactions with a FHIR server may not fit more complex scenarios. We plan to discuss possible alternative patterns and protocols. During the meetup want to do a deep dive into FHIR implementers’ experiences and discuss how they are currently employing async and queue patterns in their real-world projects.
FHIR’s current Asynchronous Request Pattern defines a request pattern designed for interactions that take a long time to perform and produce large volumes of dataThe general interaction pattern is:1. Kick off a request2. Receive a “status” endpoint3. Poll the status endpoint until the request has completed4. Upon successful completion, receive a Bulk Data Manifest with links to FHIR NDJSON files (* these are suitable for large, unordered piles of data)Why doesn’t this work for CRUD interactions and many operations? Bulk Data Manifests are designed to support bulk $export scenarios or other interactions that produce big piles of FHIR resources that clients need to copy wholesale.
Josh C. Mandel, MD is a physician and software developer working to fuel an ecosystem of health apps with access to clinical and research data. As Chief Architect for Microsoft Healthcare, Chief Architect for SMART Health IT, and Lecturer at the Harvard Medical School Department of Biomedical Informatics, Josh works closely with the standards development community to lay groundwork for frictionless data access, authorization, analytics, and app integration. Josh leads development of the SMART on FHIR specification (the basis for US Patient Access API capabilities that certified EHRs must support) and the SMART Health Cards specification (used by pharmacies, public health departments, and healthcare providers to issue verifiable records of vaccination status).
CRUDSS (search, subscriptions) REST protocol works well client-server interactions where the server is the source of truth and client lifetime is short: get data from server, do something (render, modify), write back to server.It does not work so good for server to server interactions, where we want to replicate data between servers reliably. Queue-based protocols and messaging paradigm works better for this circumstances.
Nikolai is a CTO at Health Samurai and technical leader of the Aidbox FHIR Platform with more than 15 years of experience in healthcare IT. Since 2012, it has been actively contributing to the FHIR standard and popular open-source projects like Fhirbase and FHIR.js. Author of the FHIR-first development approach and regular speaker of FHIR events.
Aidbox is a developer-friendly FHIR platform where everything remains under your control. Build your enterprise-grade digital healthcare apps and systems using a habitual tech stack and suitable cloud infrastructure: Google, Azure, AWS, or on-premises.
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