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#Generative AI (GenAI)

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Generative AI refers to algorithms and models in artificial intelligence that are capable of generating new data or content that is similar to existing data. These models are trained on large datasets and learn to generate new examples that mimic the patterns and characteristics of the original data.

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:

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✅ 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.

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How I Vibecoded a Backend (and Frontend) on InterSystems IRIS

I wanted to try vibecoding a real backend + frontend setup on InterSystems IRIS, ideally using something realistic rather than a toy example. The goal was simple: take an existing, well-known persistent package in IRIS and quickly build a usable UI and API around it — letting AI handle as much of the boilerplate as possible. Here is the result of the experiments.

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Vector search is a retrieval method that converts text, images, audio, and other data into numeric vectors using an AI model, and then searches for items that are semantically close. It enables “semantic similarity search” from free text, which is difficult with keyword search alone.

However, in real use, I encountered cases where results that are “close in meaning” but logically the opposite appeared near the top of the search results.

This is a serious issue in situations where affirmation vs. negation matters. If the system returns the wrong answer, the impact can be significant, so we cannot ignore this problem.

This article does not propose a new algorithm. I wrote it to share a practical way I found useful when semantic search fails due to negation.

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Ever since I started using IRIS, I have wondered if we could create agents on IRIS. It seemed obvious: we have an Interoperability GUI that can trace messages, we have an underlying object database that can store SQL, Vectors and even Base64 images. We currently have a Python SDK that allows us to interface with the platform using Python, but not particularly optimized for developing agentic workflows. This was my attempt to create a Python SDK that can leverage several parts of IRIS to support development of agentic systems.

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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. Its an all inclusive set of tutorials to show in detail how to:

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Introduction

As AI-driven automation becomes an essential part of modern information systems, integrating AI capabilities into existing platforms should be seamless and efficient. The IRIS Agent project showcases how generative AI can work effortlessly with InterSystems IRIS, leveraging its powerful interoperability framework—without the need to learn Python or build separate AI workflows from scratch.

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How to set up RAG for OpenAI agents using IRIS Vector DB in Python

In this article, I’ll walk you through an example of using InterSystems IRIS Vector DB to store embeddings and integrate them with an OpenAI agent.

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Article
· Nov 20, 2025 5m read
OMOP Odyssey - Vibing Synthea Modules for OMOP

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.

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In the previous article, we saw how to build a customer service AI agent with smolagents and InterSystems IRIS, combining SQL, RAG with vector search, and interoperability.

In that case, we used cloud models (OpenAI) for the LLM and embeddings.

This time, we’ll take it one step further: running the same agent, but with local models thanks to Ollama.

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Article
· Sep 13, 2025 4m read
Plug-N-Play on Pattern Match WorkBench

Plug-N-Play on Pattern Match WorkBench

Article to announce pre-built pattern expressions are available from demo application.

AI deducing patterns require ten and more sample values to get warmed up.

The entry of a single value for a pattern has therefore been repurposed for retrieving pre-built patterns.

Example: Email address

Paste an sample value for example an email address in description and press "Pattern from Description".

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artisan cover

If you’ve ever watched a true artisan—whether a potter turning mud into a masterpiece or a luthier bringing raw wood to life as a marvelous guitar—you know that magic isn’t in the materials, but in care, craft, and process. I know this firsthand: my handmade electric guitar is a daily inspiration, but I’ll admit—creating something like that is a talent I don’t have.

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Article
· Apr 16, 2025 5m read
Thoughts on Coding with GenAI

Thirteen years ago, I attained dual undergraduate degrees in electrical engineering and math, then promptly started full-time at InterSystems using neither. One of my most memorable and stomach-churning academic experiences was in Stats II. On an exam, I was solving a moderately difficult confidence interval problem. I was running out of time, so (being an engineer) I wrote out the definite integral on the exam paper, punched it into my graphing calculator, wrote an arrow with “calculator” over it, then wrote the result.

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☤ Care 🩺 Compass 🧭 - Proof-of-Concept - Demo Games Contest Entry

Introducing Care Compass: AI-Powered Case Prioritization for Human Services

In today’s healthcare and social services landscape, caseworkers face overwhelming challenges. High caseloads, fragmented systems, and disconnected data often lead to missed opportunities to intervene early and effectively. This results in worker burnout and preventable emergency room visits, which are both costly and avoidable.

Care Compass was created to change that.

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Thank you community for translating an earlier article into Portuguese.
Am returning the favor with a new release of Pattern Match Workbench demo app.

Added support for Portuguese.

The labels, buttons, feedback messages and help-text for user interface are updated.

Pattern Descriptions can be requested for the new language.

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Artificial Intelligence (AI) is getting a lot of attention lately because it can change many areas of our lives. Better computer power and more data have helped AI do amazing things, like improving medical tests and making self-driving cars. AI can also help businesses make better decisions and work more efficiently, which is why it's becoming more popular and widely used. How can one integrate the OpenAI API calls into an existing IRIS Interoperability application?

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Hi developers!

This will be a very short article as in April 2025 with Lovable and other Prompt-to-UI tools it becomes possible to build the frontend with prompting. Even to the folks like me who is not familiar with modern UI techics at all.

Well, I know at least the words javascript, typescript and ReactJS, so in this very short article we will be building the ReactJS UI to InterSystems FHIR server with Lovable.ai.

Let's go!

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If you want to know if a class about a topic already exists asking a simple natural language question, it is possible now. Download and run the application https://openexchange.intersystems.com/package/langchain-iris-tool to know all about your project classes in a Chat.

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Introduction

To achieve optimized AI performance, robust explainability, adaptability, and efficiency in healthcare solutions, InterSystems IRIS serves as the core foundation for a project within the x-rAI multi-agentic framework. This article provides an in-depth look at how InterSystems IRIS empowers the development of a real-time health data analytics platform, enabling advanced analytics and actionable insights. The solution leverages the strengths of InterSystems IRIS, including dynamic SQL, native vector search capabilities, distributed caching (ECP), and FHIR interoperability. This innovative approach directly aligns with the contest themes of "Using Dynamic SQL & Embedded SQL," "GenAI, Vector Search," and "FHIR, EHR," showcasing a practical application of InterSystems IRIS in a critical healthcare context.

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Learning LLM Magic

The world of Generative AI has been pretty inescapable for a while, commercial models running on paid Cloud instances are everywhere. With your data stored securely on-prem in IRIS, it might seem daunting to start getting the benefit of experimentation with Large Language Models without having to navigate a minefield of Governance and rapidly evolving API documentation. If only there was a way to bring an LLM to IRIS, preferably in a very small code footprint....

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We all know that having a set of proper test data before deploying an application to production is crucial for ensuring its reliability and performance. It allows to simulate real-world scenarios and identify potential issues or bugs before they impact end-users. Moreover, testing with representative data sets allows to optimize performance, identify bottlenecks, and fine-tune algorithms or processes as needed. Ultimately, having a comprehensive set of test data helps to deliver a higher quality product, reducing the likelihood of post-production issues and enhancing the overall user experience.

In this article, let's look at how one can use generative AI, namely Gemini by Google, to generate (hopefully) meaningful data for the properties of multiple objects. To do this, I will use the RESTful service to generate data in a JSON format and then use the received data to create objects.

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