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Enterprise-level FHIR Architecture Design for Lab Testing

Reduced data processing time by ~30% with integrated data flow approach into FHIR Server


  • The client receives data from multiple stakeholders like sampling centers, labs, employers in various formats, and it is challenging to manage the data
  • Loading bulk data into the FHIR server is a challenge and is a blocker for real-time analysis
  • The client faced a dilemma in choosing the best-suited FHIR server for their interoperability needs
  • Lab reports and diagnosis data needed to be handled securely, along with sample tracking


  • Implemented scalable backend solution using azure functions and azure service bus topic for translating the excel file data into FHIR format
  • Implemented auto-scale azure functions based on need and load. Azure Front Door global load balancer is implemented based on region
  • Uploaded all members of a batch in a single POST call to FHIR. Current Implementation is at the member level
  • Utilized Azure FHIR server to push the data for further consumption by downstream applications
  • Created APIs authentication framework and API gateway to manage multiple requests inflow
  • Developed a template that can help in gathering required information as per the FHIR standards
  • Utilized Fire Hose and Fire Hydrant to process all requests securely

Tools & Technologies

Azure SQL Server, Azure BLOB, Azure Functions, Azure API Management, Azure Event Grid, Azure Front Door, .NET Core, Azure FHIR, Angular

Key benefits

  • Client onboarding and data processing time reduced by close to 30% with integrated data flow approach into FHIR Server
  • New API creation and management are now easy and achievable in significantly lesser time
  • Flexible architecture design helps continuous improvement and related implementations
  • Manual intervention and operational difficulties in converting the file data is completely avoided using automated process using Azure functions
Case Study KeyPoints