If you're using IRIS to transform other message formats to and from FHIR using DTLs/Apis or some other way then you'll need to implement the profiles yourself. You can create your own DTLs based on the ones in IRIS to implement the profile constraints and extensions or you can code it yourself.
What are the advantages of doing this over using a fhir server?
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They can exist without SQL access but you can always make them available through SQL at a later date by mapping a class to them.