FHIRQL Gateway

FHIRQL Gateway is a Rust-first, portable SQL-like query and execution runtime for FHIR REST APIs.

Canonical JSON plans under examples/plans are the stable execution contract. User-facing .fhirql text is parsed into those canonical plans before validation, planning, and execution. The benchmark materials under examples/benchmark and tests/fixtures/performance are regression fixtures and acceptance coverage, not a separate runtime.

The supported canonical plan shape is documented in docs/CANONICAL_PLAN.md.

Development

Format:

cargo fmt --all
cargo fmt --all -- --check

Lint:

cargo clippy --workspace --all-targets -- -D warnings

Test:

cargo test --workspace

Optional IRIS-backed FHIR integration tests live under integration_tests/iris. They use Python only to orchestrate either an existing IRIS FHIR endpoint or a testcontainers-iris container; execution still goes through the Rust CLI.

python3 -m venv .venv-iris
. .venv-iris/bin/activate
python -m pip install -r integration_tests/iris/requirements.txt
FHIRQL_RUN_IRIS_INTEGRATION=1 python -m pytest integration_tests/iris

CLI Demo

Validate a canonical JSON FHIRQL plan:

cargo run -p fhirql-cli -- validate examples/plans/worsening_hba1c.json

Execute against embedded mock FHIR fixtures:

cargo run -p fhirql-cli -- execute examples/plans/worsening_hba1c.json --mock

Parse a FHIRQL text query into the canonical JSON plan shape:

cargo run -p fhirql-cli -- parse examples/benchmark/queries/01_patient_timeline.fhirql

Execute a FHIRQL text query through the same backend options:

cargo run -p fhirql-cli -- execute-text examples/benchmark/queries/02_worsening_hba1c_on_insulin.fhirql --mock --today 2026-05-23

For deterministic runs with a fixed runtime date:

cargo run -p fhirql-cli -- execute examples/plans/worsening_hba1c.json --mock --today 2026-05-23

The mock backend uses the shared synthetic fixture pack in fhirql-test-data/tests/fixtures/fhir.

The larger 10k benchmark pack is copied into tests/fixtures/performance with benchmark text queries, canonical example plans, and expected results under examples/benchmark.

Run the accepted benchmark scenarios directly through the CLI:

cargo run -p fhirql-cli -- benchmark all

Or run one scenario with the short query id:

cargo run -p fhirql-cli -- benchmark ckd_egfr_decline --today 2026-05-23

Supported benchmark ids are 01_patient_timeline, 02_worsening_hba1c_on_insulin, 03_asthma_night_symptoms_semantic, 04_uncontrolled_hypertension_despite_medication, 05_ckd_egfr_decline, 06_abnormal_hba1c_no_followup, 07_anticoagulant_nsaid_overlap, 08_copd_recurrent_exacerbations, and 09_chf_weight_gain. Short names such as patient_timeline, abnormal_hba1c_no_followup, and chf_weight_gain are accepted too.

Execute against a standard FHIR R4 REST server:

cargo run -p fhirql-cli -- execute examples/plans/worsening_hba1c.json --fhir-base-url http://localhost:8080/fhir/r4

For local IRIS development with Basic Auth:

cargo run -p fhirql-cli -- execute examples/plans/worsening_hba1c.json \
  --fhir-base-url http://localhost:8080/fhir/r4 \
  --basic-user _system \
  --basic-password SYS

Inspect backend capabilities:

cargo run -p fhirql-cli -- capabilities \
  --fhir-base-url http://localhost:8080/fhir/r4 \
  --basic-user _system \
  --basic-password SYS

For a compact FHIRQL-oriented capability view:

cargo run -p fhirql-cli -- capabilities --summary \
  --fhir-base-url http://localhost:8080/fhir/r4 \
  --basic-user _system \
  --basic-password SYS

Load the shared synthetic fixtures into a local FHIR server:

cargo run -p fhirql-cli -- load-fixtures \
  fhirql-test-data/tests/fixtures/fhir/all-resources-transaction-bundle.json \
  --fhir-base-url http://localhost:8080/fhir/r4 \
  --basic-user _system \
  --basic-password SYS

You can also provide the REST backend through environment variables:

FHIR_BASE_URL=http://localhost:8080/fhir/r4 cargo run -p fhirql-cli -- execute examples/plans/worsening_hba1c.json

FHIR_BASE_URL=http://localhost:8080/fhir/r4 \
FHIR_BASIC_USER=_system \
FHIR_BASIC_PASSWORD=SYS \
cargo run -p fhirql-cli -- execute examples/plans/worsening_hba1c.json

Docker Image

Build the local image:

docker build -t fhirql-gateway:local .

The image contains the fhirql, fhirql-mcp, and fhirql-pgwire binaries. Its default entrypoint is PGWire, bound to 0.0.0.0:55432 for container use:

docker run --rm -p 55432:55432 fhirql-gateway:local

Append PGWire flags directly. For example, run against the packaged benchmark JSON fixtures:

docker run --rm -p 55432:55432 fhirql-gateway:local --benchmark-fixtures

Or point PGWire at a live FHIR REST endpoint:

docker run --rm -p 55432:55432 \
  -e FHIR_BASE_URL=http://host.docker.internal:8080/fhir/r4 \
  fhirql-gateway:local \
  --auth cleartext \
  --user fhirql \
  --password fhirql

Other tools are available by overriding the entrypoint:

docker run --rm --entrypoint fhirql fhirql-gateway:local --help
docker run --rm -i --entrypoint fhirql-mcp fhirql-gateway:local --mock

PGWire / DBeaver Demo

The PGWire gateway is a limited DBeaver-compatible FHIRQL surface. It supports safe PostgreSQL metadata probes plus native FHIRQL ... text parsing for the canonical FHIRQL subset. It is not a full PostgreSQL server or a general SQL engine.

Start it:

cargo run -p fhirql-pgwire -- --port 55432
psql -h localhost -p 55432 -d fhirql

To run the benchmark .fhirql examples locally through DBeaver or psql, start PGWire with the benchmark fixtures:

cargo run -p fhirql-pgwire -- --port 55432 --benchmark-fixtures

You can also point at any compatible local fixture directory:

cargo run -p fhirql-pgwire -- --port 55432 --fixture-dir tests/fixtures/performance/json

Then run:

SELECT version();

FHIRQL
FROM Patient p
WHERE EXISTS Condition diabetes
  ON diabetes.subject = p
  WHERE diabetes.code IN @diabetes
RETURN patient, evidence
LIMIT 10;

Supported native text includes the benchmark/demo shapes for:

• patient timeline
• condition cohort
• HbA1c, eGFR, and weight trends
• semantic DocumentReference match
• latest observation cohort
• observation care gap
• encounter count cohort
• medication overlap

Benchmark query text such as 01_patient_timeline.fhirql through 09_chf_weight_gain.fhirql is parsed to canonical Rust plans before execution. PGWire requires the FHIRQL prefix, including for SQL-style text such as FHIRQL SELECT patient FROM Patient p WHERE p.id = 'Patient/p-00001'. Canonical JSON plans remain the stable runtime contract.

The DBeaver result columns are:

• patient_id
• patient_display
• result_json
• evidence_json
• row_index
• status
• warnings_json
• metadata_json

For DBeaver, use cleartext password authentication:

cargo run -p fhirql-pgwire -- --port 55432 --auth cleartext --user fhirql --password fhirql

To execute native FHIRQL from DBeaver against a live FHIR REST server, start PGWire with a REST backend:

cargo run -p fhirql-pgwire -- \
  --port 55432 \
  --auth cleartext \
  --user fhirql \
  --password fhirql \
  --fhir-base-url http://localhost:8080/fhir/r4 \
  --fhir-basic-user _system \
  --fhir-basic-password SYS

DBeaver connection settings:

• Host: localhost
• Port: 55432
• Database: fhirql
• Username: fhirql
• Password: fhirql
• Driver: PostgreSQL

MCP Demo

The MCP server is a thin tools-only adapter over the Rust-owned canonical plan API. Backend details are fixed at server startup; MCP tool calls cannot supply arbitrary FHIR URLs or credentials.

Run against deterministic mock fixtures:

cargo run -p fhirql-mcp -- --mock --today 2026-05-23

Run against a standard FHIR REST backend:

cargo run -p fhirql-mcp -- \
  --fhir-base-url http://localhost:8080/fhir/r4 \
  --basic-user _system \
  --basic-password SYS \
  --today 2026-05-23

Exposed MCP tools:

• fhirql_validate_plan
• fhirql_compile_plan
• fhirql_execute_plan
• fhirql_backend_capabilities
• fhirql_explain_result