>_ What is Aidbox?

FHIR Server and Database

FHIR server demo video

Build healthcare solutions from CDRs to EHRs using FHIR, PostgreSQL, and our SDK. Free for development. Scale to terabytes with a flat monthly fee of $1,900

Use Aidbox for effective development of interoperable apps that can be plugged into the connected healthcare ecosystem. Focus on business logic, we'll guide you through any FHIR implementation challenges.

Design FHIR-first systems
  • Use a domain-driven data model as your foundation
  • Be interoperable by design
  • Get expert advice and help from community
Manage FHIR data in PostgreSQL ❤️️
  • Store data transparently in PostgreSQL as JSONB
  • Query, join and aggregate any resource by any element
  • Implement transactional operations, reports and migrations
Work with FHIR data efficiently
  • Build with comprehensive APIs and SDK
  • React on changes with Subscription & Changes APIs
  • Start from template projects with your tech stack
Secure FHIR data
  • Manage users in the Aidbox Auth or external IDPs
  • Configure fine-grained access with RBAC and ABAC
  • Track all activities related to ePHI with Audit Log on BALP

#! Aidbox / Server Overview

Build FHIR-first apps

Aidbox is a metadata-driven server where everything is represented as data/resources that can be customized and always remain under your control.
Using Aidbox server provides you with:

  • Mature and extensible modules
  • Major FHIR versions support
  • HIPAA safeguards
  • Proven architecture frameworks
  • Custom resources if FHIR is not enough
  • Consistent performance at any scale
  • Open source tooling on top of Aidbox
FHIR Server features scheme
Sample projects

Get started with ready-to-use templates

Beda EMR

AI-driven, patient-centered, open source frontend for Electronic Medical Records.

Designed to provide an exceptional clinical experience for both practitioners and patients.

Sample project ->
IPS FHIR IG Implementation

A pre-configured server instance with the $summary operation as defined by IPS. This setup covers essential details like allergies, medications, past surgeries, and other key aspects of medical history.

Aidbox Notify via Custom Resources

A demonstration of custom resources using a minimalist JavaScript example project that implements a typical notification workflow: requesting a notification, locking it for dispatch, and then sending it (placeholder).

Aidbox Form Builder

Pluggable Form Builder for Digital Health.

Design and embed intelligent forms with an excellent UX, and capture data in a well-structured FHIR format for reporting and analysis

Aidbox Online Tools

Free tools for developers and IT professionals

Aidbox Form Builder

Create, debug, and share Questionnaires for free with the Aidbox Public Form Builder. Start from scratch or pick from 3000+ ready-to-use forms.

ViewDefinition Builder

Convert FHIR data stored in JSON format into a tabular, flat layout for easy data analysis. Fully compliant with HL7 Spec and SQL-on-FHIR IG.

CCDA / FHIR Converter

Convert C-CDA to FHIR and back effortlessly, quickly, and securely. No sample on hand? Check out our ready-to-use options.

#! Aidbox / Server Features

Move faster with Aidbox FHIR server

Storage

FHIR storage based on PostgreSQL with JSONB

FHIR

Integration with object storages, support for signed URLs

Unique

Custom Resources

Unique

APIs

HL7 FHIR REST (all versions)

FHIR

GraphQL / Reactive API & Subscriptions

Unique

SQL API / SQL on FHIR

Unique

Bulk APIs for import/export

Unique

Custom Operations

Unique

Security & Access Control

Built-in Auth server with OAuth 2.0, OpenID Connect, SMART App Launch

Unique

Access Control based on Access Policies (JSON Schema/SQL/Matcho DSL)

Unique

User/Client management (SCIM/roles)

Unique

Audit Log

HIPAA

Terminology

FHIR terminology API and storage

FHIR

Importers for ICD-10, SNOMED, RxNorm, LOINC, and US NPI

FHIR

Custom CodeSystems and ValueSets

Unique

Infrastructure

HIPAA eligible infrastructure (technical safeguards)

HIPAA

Automated Aidbox server deployment based on Kubernetes (K8s) for AWS, GCP, Azure, and on-premises

Unique

Backup management and replicas

Unique

Explore how other companies use Aidbox

BestNotes is a successful behavioral health EHR company from Idaho that serves 2,000 practices.

They wanted to modernize their EHR and build a cloud-based, multi-tenant SaaS EHR with a modern web UI and enhanced functionality. To make it future-proof, they decided to go with FHIR on the backend and looked for a FHIR-based backend that would provide enough flexibility to develop a full-blown EHR. They discovered Aidbox and loved it for its support of custom resources, SQL API, and easy multi-tenancy.

BestNotes builts the next generation of their EHR on top of Aidbox as its sole backend and are now migrating their clients to the new solution

Full story

Play video

‍PatientsKnowBest is a PHR (Personal Health Record) technology vendor for the NHS that serves 15 million users, which is more than a quarter of the United Kingdom population.

It is the first PHR to be integrated with the UK NHS network. They rebuilt their technology with a FHIR-native approach and not only used Aidbox for the backend but also built their patient portal UI using Aidbox Forms.

Every non-FHIR data source receives its dedicated server for data normalization. Normalized data is then aggregated to a global regional server, which harmonizes data from several FHIR servers into a clean longitudinal medical record.

Full story

>_ Run Server Locally

Run the FHIR server locally

FHIR server demo video
curl -JO https://aidbox.app/runme && docker compose up
Copy

>_ Aidbox / Server Infrastructure

Server infrastructure
HIPAA eligible cloud Aidbox server infrastructure is built on Kubernetes with solutions for backup, monitoring and logging that can be deployed to public clouds or on-premises.
Aidbox Server + Google Cloud Platform

Standard HIPAA eligible infrastructure is deployed to Google Kubernetes Engine and integrated with the following Google Cloud Services. Requirements for standard installation: 2-3 nodes 8 vCPUs/16GB RAM/500GB.

Aidbox + Amazon Web Services

Standard HIPAA Eligible Infrastructure is deployed into and integrated with Amazon Elastic Kubernetes Service  and integrated with Amazon Web Services. Requirements for standard installation: 2-3 nodes 8 vCPUs/16GB RAM/500GB.
Get Aidbox on AWS Marketplace

Amazon Web Services and Aidbox Scheme

Aidbox + Microsoft Azure

Standard HIPAA Eligible Infrastructure is deployed into and integrated with Azure Kubernetes Service and integrated with: load balancer, storage, DNS, and container registry. Requirements for standard installation: 2-3 nodes 8 vCPUs/16GB RAM/500GB.

Microsoft Azure and Aidbox Scheme

Aidbox + On-Premises

Standard HIPAA Eligible Infrastructure is deployed into Kubernetes and integrated with the load balancer, storage, local DNS server, container registry and Minio. Requirements for standard installation: 2-3 nodes 8 vCPUs/16GB RAM/500GB.

Aidbox On-premise Scheme

$_ Aidbox / Pricing

Choose your Box

It's super easy. Book a demo or get your trial license.

Aidbox Pricing Logo

Ready for production

Production License

  • Aidbox Check icon
    Flat fee per instance
  • Aidbox Check icon
    No usage based fees
  • Aidbox Check icon
    Pay upfront and get 10% off
Book A DEMO
Aidbox Pricing Logo

Ready for production

Development License

  • Aidbox Check icon
    No additional payments
  • Aidbox Check icon
    DB max size 5GB
  • Aidbox Check icon
    No PHI data
GET A LICENSE
Multibox Pricing Logo
  • Aidbox Check icon
    Lower overall costs
  • Aidbox Check icon
    Optimize hardware resource utilization
  • Aidbox Check icon
    Improve ease of maintenance

Use multitenant version of Aidbox to create FHIR-based clouds or separate environments with isolated data and APIs for every client.

SOUNDS INTERESTING? TALK TO US
Aidbox FHIR Platform: Unified FHIR Server and Database for high-performance healthcare applications
Introduction to Aidbox
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Aidbox is a FHIR-first platform combining a FHIR server and a purpose-built FHIR database under one system. Built on PostgreSQL with custom extensions, Aidbox delivers:

· High-throughput ingestion (up to 20,000+ resources/second)
· Low-latency search across millions of FHIR records
· Fast data export for analytics, migrations, or external system integrations
· Full control over indexing and data structure, letting you tailor performance optimizations and workflows to your exact needs

Unlike many solutions that abstract away the backend, Aidbox lets you access and manipulate your data directly — you can build custom business logic, implement advanced workflows, or tie into existing systems on your terms.

Health Samurai has implemented and supported dozens of high-load systems in production — spanning hospitals, labs, startups, healthcare software solution providers, and major payers — confirming the platform's performance and reliability.

What makes Aidbox different
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1. FHIR-Native Database
Aidbox doesn’t just provide a FHIR API; it includes a FHIR-optimized database built on PostgreSQL with custom extensions. By combining the API and database in one platform, Aidbox ensures low latency, fewer moving parts, and less overhead than solutions that rely on multiple external services.

2. High-Performance Data Processing
Aidbox easily handles thousands of operations per second, even when working with millions of resources. This includes fast reads and writes, so you can load patient data, run analytics, or power clinical apps without delay.

3. Flexible Infrastructure
Because Aidbox is distributed as a lightweight Docker container that only needs PostgreSQL, you avoid the hassle of complex multi-service setups. It’s deployable on-premises, in the cloud, or in hybrid environments, all while reducing maintenance and potential points of failure.

4. Customizable Indexing & Data Model
Aidbox’s PostgreSQL foundation means you can define your own indexing strategies, modify search behavior, and shape the data model to match your specific project needs, rather than working around a one-size-fits-all approach.

Performance Highlights
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1. High-volume data ingestion
We tested Aidbox with 23 million and then 100 million resources via the /fhir/$import endpoint.

Single Import (23M Resources)
    ~4.3 GB zipped (~17.9 GB unzipped)
    Completed in ~65 minutes
    ~6,000 resources/second

Concurrent Import (100M Resources)
    4 concurrent requests, 10 parallel workers each
    ~180 GB in the database post-import
    ~20,000+ resources/second peak throughput

2. Fast bulk export
When exporting 100 million resources via /fhir/$export:

202.8 GB of data
1 hour 47 minutes total time
15,500 resources/second (32.3 MB/s)

3. High-concurrency CRUD operations
Even under 300 parallel threads, Aidbox achieves:

Create: Up to 2,800 RPS (Observations)
Read: Up to 3,500 RPS (Patients)
Update: ~1,900 RPS (Encounters)
Delete: Over 3,900 RPS (ExplanationOfBenefit)

4. Efficient transactions for mid-sized loads
Testing FHIR transactions (bundles of 10, 50, 100, 300 resources) showed:

~3,500 resources/second throughput
Optimal concurrency at 1–2 threads per CPU core

5. Optimized search with indexing at scale
Search performance was validated across resources like Patient, Encounter, Claim, and Observation, with up to
5 million records:

Patient Search: ~2,081 RPS (search by name & sort by family)
Encounter Search: ~3,125 RPS (by patient & date)
Observation Search: ~2,042 RPS (by patient & date)

Flexible deployment
Runs as a lightweight Docker container with a PostgreSQL backend
No need for external search engines, queues, or middleware
Works seamlessly in cloud, on-premises, or hybrid environments

Ideal For
Healthtech teams building scalable digital health products
Payers and providers that need fast, real-time access to clinical data
Organizations working with real-time EHR feeds or running analytics on FHIR data

Conclusion
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Aidbox offers speed, control, and reliability in one streamlined package. The result is a solution that can scale from tens of millions to billions of FHIR resources, delivering:Outstanding performance on minimal hardware
Even an 8 vCPU, 8 GB RAM setup can yield results 10x faster than popular open-source FHIR servers.

1. Streamlined operations
Aidbox’s containerized distribution requires only PostgreSQL, minimizing deployment and maintenance.

2. Reliability under heavy load
High concurrency and large transaction bundles don’t hamper Aidbox’s responsiveness or stability.

3. Scalable Bulk Import & Export
Process large FHIR datasets—from millions to billions—end-to-end, quickly and without added complexity.

If you’re looking for a powerful, FHIR-compliant platform that simplifies infrastructure, accelerates performance, and keeps data fully accessible, Aidbox is ready to meet your needs.

User Community

Join our chat to share your expertise and get help from community.

Documentation

We're working hard to provide you with easy-to-use docs with reference guides and tutorials. Check it out here

Extended FAQ

#! Aidbox / Go

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