Where is your FHIR server?

The decision of where to host a FHIR server — in the cloud or on-prem — is seldom made by developers. But it usually falls on us to implement the decision.

The decision to buy Microsoft instead of a less ‘big-name’ offering — also not a decision made by developers.

When the cloud decision is made, when Microsoft is the vendor of choice, where is the best place for developers to start?

First, be aware that where you start doesn’t have to be where you end up.

Microsoft’s managed FHIR servers are a quick and easy introduction to FHIR. They’re well documented and implement most of the FHIR R4 spec.

Getting up and running so you can start writing code and building your app takes less than an hour.

They form one part of Azure’s Health Data Services, which includes managed DICOM servers in the same workspace.

Quick and easy. A good place to start.

Here’s the alternative.

Microsoft’s managed FHIR servers run the same code (almost) as their open source FHIR server. The OS server comes with a liberal MIT license and is actively maintained, improved and documented.

Essentially, it functions as a ‘test bed’ for the code in their managed servers. Bug fixes, improvements and new features all get rolled out to the OS repository first.

If you’re worried about storing critical healthcare data in a server and environment you don’t manage or control, then running your own instance of a stable version of Microsoft’s OS server is a real alternative.

– Same code
– Same quality
– Same cloud
– Same Microsoft

But you control the upgrades and you control the environment.

Ticks a lot of the boxes.

Microsoft Open Source FHIR server: https://github.com/microsoft/fhir-server

Azure’s managed FHIR server: https://learn.microsoft.com/en-us/azure/healthcare-apis/fhir/overview

In anticipation of the Java devs, Smile CDR are responsible for the HAPI OS server: https://hapifhir.io/



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