FHIR conformance statement

FHIR stores within the Cloud Healthcare API support a subset of the FHIR STU3 (Fast Healthcare Interoperability Resources, Release 3 - Standard for Trial Use) specification published by HL7 (Health Level 7 International). In general, the server's capability statement indicates parts of the specification that are supported.

Supported functionality in the v1beta1 API includes:

  • Storage and retrieval of all STU3 resources, including support for extension elements. The API accepts, stores, and returns extensions on any data element.
  • All of the methods in the RESTful API, except for:
    • The type-level and system-level history interactions that retrieve history across multiple resources are not supported.
    • The batch/transaction interaction does not support search operations inside the bundle.
  • All of the search functionality, except for:
    • The search parameters Group-characteristic-value, Sequence-coordinate, Location-near, Location-near-distance, Bundle-composition, and Bundle-message are not supported. Search parameters defined on extension elements are not supported.
    • Search parameters that perform phonetic matching are not supported.
    • The search result parameters _contained, _containedType, _summary=count, and _summary=true are not supported.
    • The special search parameter _content searches all fields of the resource that are referred to by search parameters. It excludes fields that are not searchable. It does not support explicit AND (terms are implicitly combined with AND) or brackets.
    • The special search parameters _query and _filter are not supported.
    • The _sort parameter, when used on fields with repeated elements, sorts by the first element; this differs from the specification. All supported search parameters are eligible for _sort, except for the special search parameter _content.

Areas that are not currently supported include:

  • Most extended operations are not implemented.
  • Profiles are not validated or enforced by the server.
  • User-defined search parameters are not supported.

In general, missing or non-standard API functionality at this stage of development should not necessarily be interpreted as a final design decision.

Some areas where the API contains operations outside of the published specification include:

  • The FHIR gRPC API offers an RPC interface for FHIR using the gRPC framework. It is nonstandard, under development, and does not support all FHIR methods.
  • The FHIR store configuration includes an option to notify a user-specified Pub/Sub topic for all changes to resources in the store. This notification mechanism is common across all Cloud Healthcare API stores, and is not intended as a replacement for FHIR Subscription functionality.
  • The FHIR store export operation to Cloud Storage destinations offers only a bulk export of the entire store. It is not an implementation of the FHIR Bulk Data draft specification.
  • The FHIR store import operation is not defined in the specification.
  • The Resource-purge operation that removes historical versions of resources is not defined in the specification. This API could change in the future if the standards process or other FHIR implementations converge on a different API method for this use case.
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