FHIR Bulk Data Access

Why it matters

Ministries need data about populations, not one patient at a time. National analytics, research extracts, migration to a new system and backups all need a complete copy of the data in a standard format. Bulk export provides that without a custom extract for every request, and the guide itself names server backup among its uses [1].

Key points

• Exports can be requested at three levels: the whole system, all patients, or a defined group such as a cohort or a facility register [1].
• The exchange is asynchronous: the client requests an export, checks its status and downloads the files when they are ready [1].
• Servers must support newline delimited JSON, all exchanges must use TLS 1.2 or later, and clients are encouraged to authorise through SMART Backend Services [1].
• HL7 began work on the bulk API in 2017 and published the first implementation guide in 2019; in the United States, certified systems must now provide this export [2].
• A bulk export is a copy of identifiable data, so it falls under the same governance as any other disclosure.

In Moana

Moana supports FHIR bulk export, so an organisation can take a complete copy of its data in a standard format for national analytics or for its own records.

Sources

1. Bulk Data Access implementation guide, export specification, HL7 International, 2020
2. ONC supports adoption and implementation of bulk data APIs, Office of the National Coordinator for Health IT, 2023