Microsoft FHIR Server for Azure extends to SQL

This weblog publish was co-authored by Doug Seven, Senior Director, Microsoft Well being Engineering and Michael Hansen, Senior Program Supervisor, Microsoft Well being Engineering.

For the reason that launch of the open supply FHIR Server for Azure on GitHub final November, we’ve been humbled by the tremendously optimistic response and surge in the usage of FHIR within the healthcare group. There was nice curiosity in Microsoft increasing capabilities within the FHIR service, and right now we’re happy to announce that the open supply FHIR Server for Azure now helps each Azure Cosmos DB and SQL backed persistence suppliers. With the SQL persistence supplier, builders will be capable to carry out complicated search queries that be part of data throughout a number of FHIR useful resource varieties and leverage transactions.

Why we’re including SQL to the FHIR Server for Azure

The FHIR service depends on a knowledge persistence supplier for storing and looking FHIR assets. The preliminary launch of the FHIR service included a knowledge persistence supplier based mostly on Azure Cosmos DB, which is a globally distributed, multi-model database for any scale. Azure Cosmos DB is good for healthcare situations the place customers want arbitrary scale and low latency. As our developer group continues to broaden healthcare functions with FHIR, new use instances and options of the FHIR specification have emerged which are a pure match for a relational database similar to SQL Server. For instance, SQL can allow search queries that might correspond to a database be part of (chained searches, _include, _revinclude) and allow atomic transactions the place your complete set of modifications succeed or fail as a single entity.

Many healthcare organizations are already conscious of the advantages of SQL for managing relational knowledge. Combining the ability of SQL with knowledge within the native FHIR format offers new choices and functions to speed up the usage of FHIR. To get began, the latter half of this weblog publish offers you a straightforward to make use of demonstration on deploy the SQL based mostly FHIR service and work together with the API.

Introducing FHIR R4

In December 2018, HL7 introduced FHIR v4.0.0 (aka FHIR R4). This launch is important as a result of numerous essentially the most mature useful resource definitions grew to become normative, which means they are going to be backwards suitable in future releases. We’re happy to announce assist for FHIR R4 within the open supply FHIR Server for Azure. Accessible instantly in open supply, this permits builders to configure their FHIR server to make use of the newest iteration of the FHIR specification with belief that the 13 mostly used assets, together with Affected person, Statement, and StructureDefinition, are “locked” and anticipated to stay constant in future iterations of the specification.

Getting began in FHIR

Beginning with FHIR is straightforward. Each the open supply FHIR Server for Azure and the Azure API for FHIR managed service assist you to provision a FHIR service in just some minutes. The FHIR Server for Azure repository consists of an Azure Useful resource Supervisor template for deploying the FHIR server with a SQL persistence supplier.


To deploy this template in Azure use this deployment hyperlink, which can open a customized template deployment kind.

Azure Resource Manager template for deploying the FHIR server wirh a SQL persistence provider

At a minimal, you have to present a useful resource group, service identify, and SQL service administrator password. If no safety particulars (authority and viewers) are offered, the occasion might be provisioned with no safety. For particulars on provisioning with safety enabled, see the FHIR Server deployment directions.


After deployment, use a instrument like Postman to check the FHIR service. First test the aptitude assertion from the /metadata endpoint.

Check the capability statement from the /metadata endpoint in Postman

Subsequent, insert a affected person with a POST to /Affected person.

Insert a patient with a POST to /Patient

Lastly, check that you may search sufferers.

Search for patients in Postman

FHIR in your group

Whether or not you selected to leverage Azure Cosmos DB or the SQL persistence supplier, there are numerous decisions by way of database schema and indexing. The open supply FHIR Server for Azure showcases a design alternative that can cowl a broad set of use instances and allows you to optimize as wanted in your particular use case. We encourage you to discover the supply code, deploy the SQL configuration of the server, and supply us with suggestions!

We’re thrilled to see the business embracing FHIR! This week our crew is on the HL7 FHIR DevDays, hosted on the Microsoft campus in Redmond, Washington. When you’re attending DevDays and are excited about studying extra in regards to the design consideration, please attend the session entitled “Constructing a SQL persistence supplier for a FHIR server” or cease by the Microsoft coding desk!

FHIR® is the registered trademark of HL7 and is used with the permission of HL7.

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