ballerinax/health.clients.fhir Ballerina library

Overview

A generic FHIR client module for Ballerina, enabling seamless integration with FHIR servers for healthcare applications. This connector supports all standard FHIR operations, including CRUD, conditional interactions, and bulk data export, with support for various authentication mechanisms. It is suitable for building healthcare applications that need to communicate with FHIR-compliant systems.

Key Features

• Connect to any FHIR server supporting standard authentication (OAuth2, Basic Auth, PKJWT, etc.)
• Perform all FHIR CRUD operations and conditional interactions
• Support for FHIR Bulk Data Export
• Handle authentication and token management
• Support for FHIR+JSON and FHIR+XML payloads
• Optionally rewrite FHIR server URLs in responses

Installation

Importing the Package

Install the package using the Ballerina package manager:

bal pull ballerinax/health.clients.fhir

To use the connector in your Ballerina code, import it as follows:

import ballerinax/health.clients.fhir as fhir_client;

Configuration

Authentication

The connector supports multiple authentication methods. For example, to use OAuth2 Client Credentials:

import ballerina/http;

http:OAuth2ClientCredentialsGrantConfig ehrSystemAuthConfig = {
    tokenUrl: "<tokenUrl>",
    clientId: "<clientId>",
    clientSecret: "<clientSecret>"
};

Connector Configuration

fhir_client:FHIRConnectorConfig fhirServerConfig = {
    baseURL: "https://hapi.fhir.org/baseR4",
    mimeType: fhir_client:FHIR_JSON,
    authConfig: ehrSystemAuthConfig
};

Usage

Initialize the Connector

fhir_client:FHIRConnector fhirConnector = check new (fhirServerConfig);

CRUD Operations: Standard (Non-Conditional) and Conditional Interactions

Create a Resource

• Standard (Non-Conditional) Create:

  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->create(resourceJson);

• Conditional Create:

  map<string[]> condition = { "identifier": ["12345"] };
  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->create(resourceJson, onCondition = condition);

Read a Resource

fhir_client:FHIRResponse|fhir_client:FHIRError response =
    fhirConnector->getById("Patient", "123456");

Update a Resource

• Standard (Non-Conditional) Update:

  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->update(resourceJson);

• Conditional Update:

  map<string[]> condition = { "identifier": ["12345"] };
  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->update(resourceJson, onCondition = condition);

Patch a Resource

• Standard (Non-Conditional) Patch:

  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->patch("Patient", patchData, id = "123");

• Conditional Patch:

  map<string[]> condition = { "identifier": ["12345"] };
  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->patch("Patient", patchData, onCondition = condition);

Delete a Resource

• Standard (Non-Conditional) Delete:

  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->delete("Patient", id = "123");

• Conditional Delete:

  map<string[]> condition = { "identifier": ["12345"] };
  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->delete("Patient", onCondition = condition);

Search Operation (GET and POST)

• GET Search:

  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->search("Patient", searchParameters = { "name": ["John"] });

• POST Search:

  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->search("Patient", mode = fhir_client:POST, searchParameters = { "name": ["John"] });

Invoking Custom FHIR Operations

You can invoke custom FHIR operations (e.g., $everything, $lookup) using the callOperation method.

Usage of mode parameter in callOperation

The mode parameter specifies the HTTP method to use when invoking the FHIR operation:

• Use http:POST to invoke the operation with an HTTP POST request (this is the default if not specified).
• Use http:GET to invoke the operation with an HTTP GET request.

This allows you to control whether the FHIR operation is called using GET or POST, depending on the requirements of the specific FHIR operation.

Default value: If you do not specify the mode parameter, the default is POST.

Examples:

// Invoke a custom operation using POST (default)
fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->callOperation("Patient", operationName = "everything", data = {});

// Invoke a custom operation using GET
fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->callOperation("Patient", operationName = "everything", mode = http:GET, id = "123");

Bulk Data Operations

Start Bulk Export:

fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->bulkExport(fhir_client:EXPORT_PATIENT);

Check Bulk Export Status:

• Using content-location URL (polling URL from kickoff response):

  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->bulkStatus("https://example/fhir/bulkstatus/123456");

• Using exportId (from kickoff response body):

  fhir_client:FHIRResponse|fhir_client:FHIRError response = fhirConnector->bulkStatus(exportId = "123456");

CapabilityStatement Validation

Note: This validation is available in ballerinax/health.clients.fhir version 3.0.0 onwards.

When initializing the FHIRConnector, the connector automatically retrieves and validates the FHIR server's CapabilityStatement as part of its init function. This validation ensures that the target service is a genuine FHIR server and supports the required FHIR version (such as R4 or R5). If the CapabilityStatement is missing, invalid, or indicates an unsupported FHIR version, the connector initialization will fail. This mechanism is essential for verifying that the service you are connecting to is a compliant FHIR service before performing any operations.

Bulk Export Usage with FHIR Client

This section describes how to use the bulk export functions provided by the FHIR client, including configuration, execution flow, and example code.

1. Configuring bulkExportConfig

To enable bulk export, you must configure the bulkExportConfig in your FHIRConnectorConfig. This configuration specifies the file server details where exported files will be stored or retrieved from. Example configuration:

fhir_client:BulkExportConfig bulkExportConfig = {
    fileServerType: fhir_client:LOCAL,   // type of the file server 'fhir', 'ftp' or 'local'
    fileServerUrl: "<url>",              // host url of the file server 
    fileServerDirectory: "<dir-path>",   // directory to save the exported files in the file server, if type is ftp
    fileServerPort: 21,                  // port of the file server (ftp), default = 21 
    fileServerUsername: "<username>",    // username to access the server, if type is ftp
    fileServerPassword: "<password>",    // password to access the server, if type if ftp
    tempDirectory = "temp_bulk_export",  // local directory to save the exported files (default = 'bulk_export'), if type is local
    tempFileExpiryTime = 7200,           // expiration period for temporary export files in seconds (default = 86400.0d), if type is local
    pollingInterval: 2.0d                // bulk status polling interval in seconds (default = 2.0d)
};

fhir_client:FHIRConnectorConfig fhirServerConfig = {
    baseURL: "https://bulk-data.smarthealthit.org/fhir",
    mimeType: fhir_client:FHIR_JSON, 
    bulkExportConfig: bulkExportConfig
};

Note:
When the export is completed, the bulkStatus function returns the file URLs as part of the response.
If the export is still in progress, bulkStatus returns the current status of the export operation.

2. Sample: Bulk Export with FHIR Client (Service Example)

import ballerina/http;
import ballerinax/health.clients.fhir as fhir_client;

fhir_client:BulkExportConfig bulkExportConfig = {
    fileServerType: fhir_client:LOCAL,
    tempFileExpiryTime: 7200, // two hours
    tempDirectory: "temp_bulk_export"
};

fhir_client:FHIRConnectorConfig fhirServerConfig = {
    baseURL: "https://bulk-data.smarthealthit.org/fhir",
    mimeType: fhir_client:FHIR_JSON, 
    bulkExportConfig: bulkExportConfig
};

fhir_client:FHIRConnector fhirConnector = check new (fhirServerConfig, enableCapabilityStatementValidation = false);

service /Patient on new http:Listener(8080) {
    resource function get export(http:Request req) returns http:Response|error? {
        fhir_client:FHIRResponse response = check fhirConnector->bulkExport(fhir_client:EXPORT_PATIENT);
        json responseBody = response.'resource.toJson();
        http:Response httpResponse = new;
        httpResponse.setJsonPayload({
            exportId: check responseBody.exportId,
            pollingUrl: check responseBody.pollingUrl
        });
        httpResponse.setHeader("X-Progress", response.serverResponseHeaders["X-Progress"] ?: "In-progress");
        httpResponse.statusCode = response.httpStatusCode;
        return httpResponse;
    }

    resource function get [string exportId]/status() returns http:Response|error? {
        fhir_client:FHIRResponse response = check fhirConnector->bulkStatus(exportId = exportId);
        http:Response httpResponse = new;
        httpResponse.setJsonPayload(response.'resource.toJson());
        httpResponse.setHeader("X-Progress", response.serverResponseHeaders["X-Progress"] ?: "In-progress");
        httpResponse.statusCode = response.httpStatusCode;
        return httpResponse;
    }
}

Advanced Features

• Bulk Data Export: Configure bulkExportConfig in the connector config to support file servers for exported data.
• URL Rewriting: Enable urlRewrite and set replacementURL in the config to rewrite FHIR server URLs in responses.
• PKJWT Authentication: Supported via auth:PKJWTAuthConfig.

References

• FHIR REST API Specification
• FHIR Bulk Data Export IG
• Ballerina Language

This README provides a comprehensive guide for using your Ballerina FHIR client module, including setup, configuration, and practical code samples for common FHIR operations.