- The big cloud providers do not produce the best FHIR servers.
- The most fully featured servers are provided by small companies.
- FHIR servers rarely implement all FHIR features.
- Support for FHIR R5 is sporadic.
- Smart-on-FHIR can be difficult to implement on many servers.
- No FHIR server is “production ready.” You will have to write code.
- Advanced features are still in their infancy amongst all providers.
- Cloud based FHIR servers are not available in all regions.
- Implementation Guides can be difficult to install.
- Custom SearchParameters can be difficult to configure.
- Some FHIR servers truncate query results.
- Price is not an indicator of quality.
- Server pricing models can dictate architectural decisions such as multi-tenancy.
- Your first question should not be “Which server provider will we use?” It should be: “Is FHIR the answer to our problem?”
Bottom line: Not all FHIR servers are equal. Do your homework before choosing a provider.
Work out what you need from that server and be sure the provider you choose can meet those needs.
If possible, talk to existing users before making a decision. The shortcomings of many FHIR servers are not always apparent from reading the documentation.
LinkedIn is a good way to find non-affiliated users of a particular server.
Lastly, while your budget and internal “ways of working” may dictate choosing one of the big name cloud providers, be very very aware that this could be a costly mistake.
---