The invalid oref error because of the target object "osuwmc.Epic.FHIR.DataStructures.PatientSearch.Response" not initiated.  instantiating  the target if it's not OREF.

If '$IsObject(target){
 Set target = ##class(osuwmc.Epic.FHIR.DataStructures.PatientSearch.Response).%New()
}'

Hi @Evgeny Shvarov 

Class queries (%SQLQuery) are designed specifically for SELECT operations (retrieving data) rather than for data modification (INSERT, UPDATE, DELETE). This is because the class compiler translates the query definition into ObjectScript code that implements Cursor Logic, which consists of three distinct segments:

• The Execute Logic: Prepares the SQL statement and opens a cursor to manage the result set.
• The Fetch Logic: Performs the actual 'read' from the database globals to retrieve rows one by one.
• The Close Logic: Cleans up memory and closes the cursor once the data is exhausted.

Because this framework and its constraints, it does not support INSERT, UPDATE, or DELETE.