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FHIR_CONFIGURATION

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Fadil369 edited this page Jun 9, 2026 · 1 revision

FHIR Configuration Guide

Current Status

Component Status
Infrastructure ✅ Ready
CSP Applications ✅ Created
Endpoint ✅ Port 52773 → IRIS HTTP
Synthetic CapabilityStatement ✅ API Gateway serves /fhir/metadata
IRIS FHIR Module (Community) ⭕ Not installed — synthetic endpoint via API Gateway

Note: The InterSystems IRIS Community Edition does not include HS.FHIR.Config.Root or the full FHIR production classes. The API Gateway on port 58080 serves a synthetic FHIR CapabilityStatement and proxies /fhir/* requests to IRIS.

Accessing FHIR

Via API Gateway (Recommended)

# CapabilityStatement
curl http://localhost:58080/fhir/metadata | jq .

# Resource lookup (returns OperationOutcome if FHIR module not installed)
curl http://localhost:58080/fhir/Patient/101 | jq .

The synthetic CapabilityStatement advertises:

  • Patient, Claim, Coverage, Organization, Practitioner
  • CommunicationRequest, Task, Bundle, DocumentReference
  • RiskAssessment (predictive models)

Via IRIS Direct (port 52773)

curl http://localhost:52773/fhir/r4/metadata
curl http://localhost:52773/fhir/r4/Patient

FHIR Resources Mapped to BRAINSAIT Data

FHIR Resource Source System Description
Patient HNH + Oracle EHRs Patient demographics
Encounter Hospital systems Clinical visits
Condition Clinical diagnoses Medical conditions
MedicationRequest NPHIES Prescriptions
Claim NPHIES Insurance claims
Coverage NPHIES Insurance coverage
CarePlan Clinical pathways Treatment plans
Observation Labs & vitals Lab results, vital signs
DiagnosticReport Imaging & pathology Radiology, lab reports
CommunicationRequest NPHIES Claim communication requests
RiskAssessment Predictive Models Readmission, denial, ED utilization, interaction, no-show

Pulse Agent FHIR Resources

All 19 Pulse agents consume and produce FHIR R4 resources:

Clinical Agents (12)

Agent Primary FHIR Resources
Summary Patient, Encounter, Observation, Composition
Prior Auth Procedure, Claim, ClaimResponse, Coverage
Gaps in Care DiagnosticReport, Observation, CarePlan
Medication Safety MedicationRequest, MedicationDispense, AllergyIntolerance
Care Plan CarePlan, Goal, ActivityDefinition
Clinical Trials ResearchStudy, Group, Evidence
Readmission Risk RiskAssessment, Observation, Encounter
Triage Encounter, Observation, Condition
Imaging Followup ImagingStudy, DiagnosticReport, ServiceRequest
Lab Explainer Observation, DiagnosticReport, Specimen
NL Query Parameters, Bundle
SDOH Referral ServiceRequest, Task, Organization

Predictive Models (5)

Agent Primary FHIR Resource Key Fields
Predict Readmission RiskAssessment prediction[].probabilityDecimal, mitigations[]
Predict PA Denial RiskAssessment prediction[].probabilityDecimal, riskFactors[]
Predict ED Util RiskAssessment predictions[].when.value (7d + 30d)
Predict Interaction RiskAssessment predictions[].medications, predictions[].risk
Predict No-Show RiskAssessment prediction[].probabilityDecimal, interventions[]

Integration Agents (2)

Agent Primary FHIR Resource
Chat Parameters
HF Models Parameters

Query Examples

# FHIR metadata
curl 'http://localhost:58080/fhir/metadata' -H "Accept: application/fhir+json"

# Get patient summary via Pulse
curl "http://localhost:58080/linc/summary?patient=P-5842" | jq .

# Search clinical trials via Pulse
curl "http://localhost:58080/linc/clinical-trials?patient=P-5842" | jq .

# Predictive: readmission risk as RiskAssessment
curl "http://localhost:58080/linc/predict-readmission?patientId=P001" | jq .

# Predictive: drug interactions as RiskAssessment
curl "http://localhost:58080/linc/predict-interaction?patientId=P005&medications=metformin,lisinopril,warfarin,atorvastatin" | jq .

Synthetic CapabilityStatement

The API Gateway serves a synthetic FHIR R4 CapabilityStatement at /fhir/metadata:

{
  "resourceType": "CapabilityStatement",
  "status": "active",
  "fhirVersion": "4.0.1",
  "format": ["application/fhir+json"],
  "rest": [{
    "mode": "server",
    "resource": [
      { "type": "Patient", "interaction": [{"code": "read"}, {"code": "search-type"}] },
      { "type": "Claim", "interaction": [{"code": "read"}, {"code": "search-type"}] },
      { "type": "RiskAssessment", "interaction": [{"code": "read"}] },
      { "type": "Coverage", "interaction": [{"code": "read"}, {"code": "search-type"}] },
      { "type": "Organization", "interaction": [{"code": "read"}, {"code": "search-type"}] },
      { "type": "Practitioner", "interaction": [{"code": "read"}, {"code": "search-type"}] }
    ]
  }]
}

Performance Optimization

When FHIR is fully installed:

  • Cache Strategy: Aggressive, TTL 3600s
  • Connection Pooling: Max 100, Min Idle 10, Acquire 30s
  • Compression: GZIP for responses >1KB

Security

  1. SSL/TLS: Cloudflare edge terminates SSL for public access
  2. Authentication: Bearer token + X-API-Key validation on sensitive paths
  3. Rate Limiting: 100 requests/min per IP (via Python security module)
  4. Audit Logging: All auth failures logged to JSON audit trail
  5. CORS: Restricted origins in production

Reference

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