In v2026.1 we introduced support for a more robust and real-life secure authorization for your FHIR endpoints.

This is achieved by using SMART on FHIR v2 fine-grained scopes.

Focus - Not SMART in general, rather, the fine-grained scopes; Hands-on easy sample

Introduction

Earlier this year, I set about creating kit to introduce young techy folk at a Health Tech hackathon to using InterSystems IRIS for health, particularly focusing on using FHIR and vector search.

I wanted to publish this to the developer community because the tutorials included in the kit make a great introduction to using FHIR and to building a basic RAG system in IRIS.

JSON

JSON (JavaScript Object Notation) is a lightweight, text-based format designed for structured data interchange. It represents data objects consisting of key–value pairs and arrays, and it is entirely language-independent.

You’ve seen how tools like Lovable are shaking up web development. People are spinning up entire apps just by talking to an AI, almost like pair‑programming on steroids.

Now imagine bringing that same “vibe coding” experience into healthcare. know, it sounds crazy. Healthcare is complex, full of regulations, and usually gives us a headache just thinking about the interoperability rules.

That’s exactly the space where withLove lives: an AI‑Native, Low‑Code platform built entirely on InterSystems IRIS for Health.

10:47 AM — Jose Garcia's creatinine test results arrive at the hospital FHIR server. 2.1 mg/dL — a 35% increase from last month.

What happens next?

• Most systems: ❌ The result sits in a queue until a clinician reviews it manually — hours or days later.
• This system: 👍 An AI agent evaluates the trend, consults clinical guidelines, and generates evidence-based recommendations — in seconds, automatically.

No chatbot. No manual prompts. No black-box reasoning.

This is event-driven clinical decision support with full explainability:

✅ Triggered automatically by FHIR events ✅ Multi-agent reasoning (context, guidelines, recommendations) ✅ Complete audit trail in SQL (every decision, every evidence source) ✅ FHIR-native outputs (DiagnosticReport published to server)

Built with:

• InterSystems IRIS for Health — Orchestration, FHIR, persistence, vector search
• CrewAI — Multi-agent framework for structured reasoning

You'll learn: 🖋️ How to orchestrate agentic AI workflows within production-grade interoperability systems — and why explainability matters more than accuracy alone.

What is a FHIR Profile?

A FHIR profile is a collection of rules and constraints used to customize and refine a base Fast Healthcare Interoperability Resources (FHIR) resource. Profiling is a vital process that adapts the base FHIR resource standard to satisfy the unique requirements of a specific use case, geographic region, medical institution, or clinical workflow.

While the base FHIR specification provides generic, flexible definitions for resources (such as Patient, Observation, or Medication), profiles transform these generic resources into more precise ones. This ensures consistent and interoperable data exchange tailored for a particular community or implementation.

FHIR is designed to cover various healthcare scenarios globally. Profiles allow implementers to adapt this general platform without losing the benefits of standardization.

Hi, now I would like to continuous on the topic that we talk about previously

Using Postman for testing the OAuth2.0 of the InterSystems FHIR repository - Part1

Question 1: Where is my client_id and client_secret come form?

Short answer: Authentication Server.

If you don't have an Authentication Server, you may set up one as following

Provide the hostname (the host must support Https), at least 1 grand type (we choose client credential here), and SSL/TSL configuration

Input the scopes (here we input user/*.read and user/*.

Sometimes it is more convenient, more efficient, and more secure, to limit FHIR Searches per pre-defined "Lists" of Resources.

Since v2025.1 we support several List-related features in our FHIR Server.

I will highlight these here, and provide some samples.

Hi all, it's me again for sharing what I am studying recently.😓

Recently, I am studying how to setup OAuth2 authentication for the InterSystems FHIR repository. And I found the following articles are very good and easy to follow.😁

SMART on FHIR EHR Launch with IRIS for Health

Building an FHIR Repository + OAuth2 Authorization Server/Resource Server Configuration on IRIS for Health Part 2

For me, as a user who do not have much knowledge about OAuth2.0. I think it quite difficult to understand how to setup the whole OAuth2.0 environment before knowing how's it look like (what is it?

InterSystems API Manager (IAM) is a core component of the InterSystems IRIS Data Platform, offering centralized API management with a strong emphasis on security. IAM simplifies the entire API lifecycle, from creation to retirement, and provides a developer portal for easy API discovery and integration. Access control features allow administrators to define precise permissions, and IAM seamlessly integrates with the IRIS Data Platform, enhancing data management and integration capabilities.

Features of IAM include:

• API Gateway: Centralized API management and security hub.

You send an HTTP request and get back an HTTP error but with an HTML error page which you didn't expect... what's happening?... 🤔

Specifically for example, perhaps you tried to READ a FHIR Resource (e.g. /Patient/123) and you get back a 404 error page, even though with other Patient IDs, you get back the Resource payload, so "the page" definitely does exist... why should you be getting a 404 error page? 🙄

Also in previous versions you could define your FHIR Server to accept requests via OAuth 2.0 (e.g. for a SMART on FHIR client) but nowadays with v2024.3, which was released a while ago, there is a new feature, that enables doing this more easily - the OAuth FHIR Client QuickStart.

An extension “extends” or enhances a FHIR resource or a data element in a custom way. The extension can be added to the root of a resource, such as “Patient.ethnicity” in US Core profile, and they can be added to individual elements such as HumanName, Address or Identifier.

Did you know that you can also add an extension to a primitive data type?

Primitives usually store a single item and are the most basic element in FHIR. For example: "Keren", false, 1234, 12/08/2024 etc.

Overview

Fast Healthcare Interoperability Resources (FHIR) is a standardized framework developed by HL7 International to facilitate the exchange of healthcare data in a flexible, developer-friendly, and modern way. It leverages contemporary web technologies to ensure seamless integration and communication across healthcare systems.

Key FHIR Technologies

• RESTful APIs for resource interaction
• JSON and XML for data representation
• OAuth2 for secure authorization and authentication

In today’s healthcare data landscape, FHIR has become the standard for structured clinical data exchange. However, while FHIR excels at interoperability, its JSON format makes analytics challenging—including FHIR QuestionnaireResponse.

Three Steps to Build It

1.

Vibe the Module, Not the Data

While working with the FHIR to OMOP Service, I've seen good FHIR synthetic data being created using commercial LLM's etc, custom tailored for ConditionOnset with the typical amazement on return, but witnessed some questionable trust first hand on a call.  This approach also falls short generating gigantic payloads so I can go back to my interests on the backend and ensure smooth data transition.

You may have noticed that to configure a mirror for InterSystems IRIS for Health™ and HealthShare® Health Connect there is a special requirement. I wanted to go through it step by step in this article.

This assumes you have already configured the second failover member and confirmed a successful failover member status in the mirror monitor:

Step 1: Enable HS_Services user (on backup and primary) 

Step 2: Switch to Namespace HSSYS and go to Interoperability > Configure > Credentials.

What is XML?

XML(eXtensible Markup Language) is a flexible, text-based, andplatform-independentformat used to store and transport data in a well-structured way that is both human- and machine-readable. XML permits users to define custom tags to describe the meaning and organization of their data. For example: <book><title>The Hitchhiker's Guide</title></book>.

An XML document is self-descriptive and structured as a hierarchical tree of elements. Every document has a single root element that encapsulates all other content.

When we create a FHIR repository in IRIS, we have an endpoint to access information, create new resources, etc. But there are some resources in FHIR that probably we wont have in our repository, for example, Binary resource (this resource returns a document, like PDF for example).

I have created an example that when a Binary resource is requested, FHIR endpoint returns a response, like it exists in the repository. 

First of all, we need a Namespace and a FHIR endpoint. After this, we need to configure an Interoperability production that will be connected to the FHIR endpoint.

Hi all,

Let's do some more work about the testing data generation and export the result by REST API.😁

Here, I would like to reuse the datagen.restservice class which built in the pervious article Writing a REST api service for exporting the generated patient data in .csv

This time, we are planning to generate a FHIR bundle include multiple resources for testing the FHIR repository.

Here is some reference for you, if you want to know mare about FHIR The Concept of FHIR: A Healthcare Data Standard Designed for the Future

OK... Let's start😆

1. Create a new utility class datagen.utli.

Real Time FHIR® to OMOP Transformation

This part of the OMOP Journey,  we reflect before attempting to challenge Scylla on how fortunate we are that InterSystems OMOP transform is built on the Bulk FHIR Export as the source payload.  This opens up hands off interoperability with the InterSystems OMOP transform across several FHIR® vendors, this time with the Google Cloud Healthcare API.

Hi all,

It's me again 😁. In the pervious article Writing a REST api service for exporting the generated FHIR bundle in JSON, we actually generated a resource DocumentReference, with the content data encoded in Base64

Question!! Is it possible to write a REST service for decoding it? Because I am very curious what is the message data talking about🤔🤔🤔

OK, Let's start!

1. Create a new utility class datagen.utli.decodefhirjson.cls for decoding the data inside the DocumentReference
 

ClassExtends%RegisteredObject

2. Write a Python function decodebase64docref to 
a. loop through the FHIR bundle
b.

Introduction

In my previous article, I introduced the FHIR Data Explorer, a proof-of-concept application that connects InterSystems IRIS, Python, and Ollama to enable semantic search and visualization over healthcare data in FHIR format, a project currently participating in the InterSystems External Language Contest.

In this follow-up, we’ll see how I integrated Ollama for generating patient history summaries directly from structured FHIR data stored in IRIS, using lightweight local language models (LLMs) such as Llama 3.2:1B or Gemma 2:2B.

The goal was to build a completely local AI pipeline that can extract, format, and narrate patient histories while keeping data private and under full control.

All patient data used in this demo comes from FHIR bundles, which were parsed and loaded into IRIS via the IRIStool module. This approach makes it straightforward to query, transform, and vectorize healthcare data using familiar pandas operations in Python. If you’re curious about how I built this integration, check out my previous article Building a FHIR Vector Repository with InterSystems IRIS and Python through the IRIStool module.

Both IRIStool and FHIR Data Explorer are available on the InterSystems Open Exchange — and part of my contest submissions. If you find them useful, please consider voting for them!

• IRIStool and Data Manager
• FHIR Data Explorer

Introduction

In a previous article, I presented the IRIStool module, which seamlessly integrates the pandas Python library with the IRIS database. Now, I'm explaining how we can use IRIStool to leverage InterSystems IRIS as a foundation for intelligent, semantic search over healthcare data in FHIR format.

This article covers what I did to create the database for another of my projects, the FHIR Data Explorer. Both projects are candidates in the current InterSystems contest, so please vote for them if you find them useful.

You can find them at the Open Exchange:

• IRIStool and Data Manager
• FHIR Data Explorer

In this article we'll cover:

• Connecting to InterSystems IRIS database through Python
• Creating a FHIR-ready database schema
• Importing FHIR data with vector embeddings for semantic search