Features
Aidbox FHIR server features including CRUD, search, validation, bulk operations, terminology, security, and analytics.
Core FHIR Capabilities
- Supports STU3, R4, R4B, R5, R6 ballot3
- Full CRUD, history/versioning, conditional operations, transactions
- High-performance rich-featured validation
- FHIRPath support for updating, filtering, derived values, and expressions
- Advanced Search:
- _include, _revinclude, _has, chained parameters, _filter, _list
- Custom SearchParameters
- Full-text search with optimized indexing
- Full implementation of Structured Data Capture (SDC): extract, populate, Questionnaire, and QuestionnaireResponse
- Bulk import and export
Database
- PostgreSQL JSONB data storage model
- Advanced data access
- Analytics and reporting on FHIR data
- Deployable on self-hosted and managed PostgreSQL services (AWS, GCP, Azure)
- Rich Indexing
- Support for read-only replica for delegating read-only workload
FHIR Configuration
- FHIR Package Registry including 500+ ready-to-use FHIR IGs
- Load official IGs from FHIR Package registry (e.g., US Core, IPS, DE Basisprofil, ISIK, AU Core, CL Core, etc.)
- Load custom IGs as FHIR packages using UI and API
- Integration with external NPM package registries
- Pinning and tree shaking for optimizing IG dependency resolution
- Support for multiple versions of the same IG
- GUI and API support for loading FHIR IGs and canonicals
- Terminology engine with local and external server support
- Terminology supplements for CodeSystems and ValueSets
Customization & Extensibility
- Custom resource types, extensions
- Custom search parameters and operations
- Custom logic via Aidbox Apps
- AidboxTrigger for automatic SQL execution in response to FHIR resource operations
Advanced Data Access
- SQL API
- SQL-on-FHIR for analytics and reporting
- $run operation for direct querying through ViewDefinition
- $materialize operation for creating database tables/views
- AI-assisted ViewDefinition generation
- GraphQL API for nested and filtered access (including contained resources)
- REST-exposed SQL endpoints
Subscriptions
- Topic-based FHIR Subscriptions (R4B/R5 compliant)
- Multi-destination push:
- Kafka
- GCP Pub/Sub
- AMQP
- ClickHouse for real-time analytics
- Webhook
- Organization-based hierarchical filtering in subscriptions
- %previous and %current functions for tracking changes between resource versions
- Changes API for polling resource changes
Security, Identity & Access Control
- OAuth 2.0, OpenID Connect, Basic Auth, SSO, SCIM
- External identity providers: GitHub, Apple, Okta, Azure AD, Keycloak
- SMART App Launch (EHR and standalone)
- SMART-on-FHIR v1 and v2 scopes
- SMART scopes with search parameters
- Access control: RBAC, ABAC
- Label-based Access Control with Security Labels
- Scoped APIs
- Multitenancy: physical isolation (Multibox), Organization-based hierarchical access control
- AuditEvent logging with support for external FHIR AuditRecord Repository
Terminology
- Terminology engine with local and external server support
- $translate operation on ConceptMap resources
- expand, validate-code, $lookup operations
- Supplements for CodeSystems and ValueSets
Integrations
- HL7 v2 inbound module
- C-CDA bidirectional converter
- X12 support (e.g., 270/271, 837)
- MCP Server for AI-assisted FHIR development
Deployment & Operations
- Kubernetes-native (on AWS, Azure, GCP, OpenShift, etc)
- On-premises installations
- Deployment to air-gapped environments
- Horizontal scaling
- Helm charts
- HIPAA-compliant architecture
- OpenTelemetry protocol for metrics, traces, and structured logs
- Performance monitoring tools
- Init Bundle for simple and effective configuration
- Settings API for runtime configuration
File Storage
- GCP Cloud Storage with Workload Identity
- Azure Blob Storage with Workload Identity
- AWS S3
- Oracle Cloud Storage
Developer experience and tools
- Local installation support and cloud sandboxes
- Administrative UI
- REST and SQL consoles
- Notebooks
- FHIR resource browser with version history and resource diffs
- Runtime-editable configuration
- SDKs for TypeScript, Python
- FHIR Schema Code Generator for TypeScript, C#, Python
- Template projects and examples for quick start
- User community
Scalability and Performance
- Aidbox's storage capacity is directly tied to PostgreSQL's capabilities. We have production installations handling 20+ TBs of data.
- Performance:
- ~2,500 resources per second using standard RESTful CRUD operations (POST with validation) under concurrent load (300 threads)
- ~3,500 resources per second using FHIR transaction bundles (bulk inserts of 10–100 resources each)
- Bulk Import: Up to 21,000 resources per second using the optimized /v2/fhir/$import endpoint
- Bulk Export: Up to 15,500 resources per second during /fhir/$export of 100M resources
Load performance testing results here
High-availability and Disaster Recovery
- Cloud-native: AWS, Azure, GCP, hybrid, and private
- Zero-downtime updates
- Support for Kubernetes-native HA deployments
Modules
- Aidbox Forms:
- Ready-made medical form repository (Aidbox Form Gallery)
- UI Builder for creating forms without code (based on FHIR SDC Implementation Guide )
- AI assistance for creating and editing forms from text descriptions
- Adaptive forms with $next-question operation
- Template-based extraction
- FHIRPath expression editor
- Offline forms
- Multilingual forms
- OpenEHR Templates conversion
- NHS design system support
- External FHIR servers as data backend
- Multitenancy support
- Web component embedding
- ePrescriptions
- MPI (Master Patient Index)
- Smartbox FHIR API for health plans and EHRs
- Audit record repository
Compliance & Certifications
- ONC Health IT Certification and CMS Interoperability solutions
- ISO 27001-certified
- HIPAA, HITECH, and GDPR compliant
- Secure SDLC: vulnerability scans, dependency SBOM, etc.
- Audit and traceability for all access
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