Most FHIR benchmark write-ups land as a marketing PDF with a few bar charts and no path to verify. The newest one is different. On June 29, Health Samurai published a public test harness that runs HAPI FHIR, Medplum, the Microsoft FHIR…
Category: Ehr development
ADT vs ORM Messages: Which Is Harder to Convert to FHIR?
ADT and ORM are the two HL7v2 message families that almost every US integration team has to handle. ADT carries admit, discharge, and transfer events; ORM carries clinical orders. They look superficially similar, and the conversion to…
Achieving Seamless Digital Health with a Terminology Server
The digital revolution has profoundly altered many aspects of our lives, and healthcare is no exception. From electronic health records (EHRs) to telemedicine platforms, technology promises to make healthcare more accessible, efficient, and personalized. But what happens when different systems speak different languages? This is where a terminology server enters the picture, acting as a […]
CDS Hooks for FHIR: What Actually Works at Point of Care
CDS Hooks is the FHIR-native pattern for clinical decision support in EHR workflow. In 2026, three hook types ship in production; two others are aspirational. Understanding which is which affects integration timelines. Production-ready hooks 1. patient-view. Fires when a clinician opens a patient chart. CDS returns cards with alerts, reminders, and links to more context. […]
GraphQL vs REST for FHIR: 5 Questions to Decide
FHIR GraphQL is a real spec option in 2026, and some servers (HAPI, Aidbox, Medplum) support it alongside REST. GraphQL isn't better than REST — it's better for specific patterns. Five questions decide the fit. 1. Do you have complex nested queries with heavy _include chains? GraphQL's shape-driven query is cleaner than iterative REST _include:iterate. […]
Which FHIR Resources Actually Matter for EHR Integration
FHIR defines 140+ resources but production EHR integrations touch a smaller set. Understanding which resources are the workhorse and which are edge-case avoids overinvesting in exotic resource support. Tier 1: Core clinical (must-have for any US integration) - Patient — identity, demographics - Encounter — visits and admissions - Observation — labs, vitals, notes - […]
FHIR Subscription in R5: SubscriptionTopic Practical Notes
FHIR R5 Subscription replaced R4's per-endpoint criteria-and-hook model with a topic-based model where multiple subscribers reference shared SubscriptionTopic definitions. This scales much better in production; understanding the model matters for anyone building event-driven FHIR integrations. SubscriptionTopic structure A SubscriptionTopic defines: resourceTrigger (what change fires the topic), notificationShape (which fields ride the notification), and canFilterBy (filter […]
FHIR Data Validation: How `$validate` Actually Works in Production
FHIR `$validate` operation validates a resource against a profile and returns an OperationOutcome. In production the operation is invoked in three modes, each with different semantics and different failure modes. Mode 1: Write-time validation. POST or PUT with x-fhir-request-headers: return=OperationOutcome. The server validates, rejects on error, and returns the OperationOutcome with issues. Best for strict […]