Release notes: Azure API for FHIR
Important
Azure API for FHIR will be retired on September 30, 2026. Follow the migration strategies to transition to Azure Health Data Services FHIR® service by that date. Due to the retirement of Azure API for FHIR, new deployments won't be allowed beginning April 1, 2025. Azure Health Data Services FHIR service is the evolved version of Azure API for FHIR that enables customers to manage FHIR, DICOM, and MedTech services with integrations into other Azure services.
Azure API for FHIR® provides a fully managed deployment of the Microsoft FHIR Server for Azure. The server is an implementation of the FHIR standard. This document provides details about the features and enhancements made to Azure API for FHIR.
November 2024
FHIR service
Bug fixes
- Export Validation Improvement: An issue was found where exports proceeded despite invalid search parameters. A new change is implemented to prevent exports under these conditions. This is the default behavior. Customers can override it using the lenient flag. This change was communicated to customers last month.
- Bundle Performance Enhancement: The profile refresh process during bundle execution has been simplified. If a bundle contains changes to
ValueSet,StructureDefinition, and/orCodeSystem, no profile refreshes will occur until the bundle is fully completed. This change improves the performance of bundles by reducing delays caused by multiple refreshes when handling changes to these resource types. - Content Type Header Parsing: An issue related to parsing the
application/x-www-form-urlencodedcontent type header has been addressed and resolved. - Reindexing Enhancements The reindex operation has been improved by removing an artificial limitation that previously restricted handling of large historical datasets, or cases where customers requested a limited query size. Additionally, reindex process would incorrectly report as "completed" when handling many sequential historical or deleted resources with the default query size. This issue has been addressed to ensure that the reindexing process completes correctly and reports the appropriate status.
October 2024
FHIR service
Bug fixes
- Export Validation: An issue was identified where exports proceeded despite invalid search parameters. We're introducing a change that prevents exports under these conditions. This feature is currently behind a strict validation flag and will become the default behavior on or after October 30.
- Search Parameter Inclusion: We resolved an issue where additional search parameters (for instance,
_include,_has) didn't return all expected results, sometimes omitting the next link. - Export Job Execution: A rare occurrence of
System.ObjectDisposedExceptionduring export job completion has been addressed by preventing premature exits. - HTTP Status Code Update: The HTTP status code for invalid parameters during
$reindexjob creation is now updated to 400, ensuring better error handling. - Search Parameter Cleanup: A fix has been implemented to ensure complete cleanup of search parameters in the database when triggered with delete API calls, addressing issues related to incomplete deletions.
August 2024
FHIR service
Bug Fixes A fix was implemented to address issues with large exports incorrectly displaying a "completed" status while child tasks are still processing. The solution incorporates a delay to mitigate the occurrence of these status errors, improving export reliability.
July 2024
FHIR service
Bug Fixes
Fixed: Exporting Data as SMART User Exporting data as a SMART user no longer requires write scopes. Previously, it was necessary to grant "write" privileges to a SMART user for exporting data, which implied higher privilege levels. To initiate an export job as a SMART user, ensure the user is a member of the FHIR export role in RBAC and requests the "read" SMART clinical scope.
Fixed: Updating Status Code from HTTP 500 to HTTP 400 During a patch operation, if the payload requested an update for a resource type other than Parameter, an internal server error (HTTP 500) was initially thrown. This has been updated to throw an HTTP 400 error instead.
May 2024
FHIR service
Enhancements to the purge-history operation The purge-history operation allows you to perform a partial delete by using the query parameter ‘allowPartialSuccess’. By default, the purge-history operation waits for successful completion before deleting resources. However, if an error occurs during execution, the deletion of resources is rolled back. By using the ‘allowPartialSuccess’ query parameter, you can prevent the transaction from being rolled back in case of an error.
Bug fixes
- Fixed: HTTP status code for long-running requests. FHIR requests that take longer than 100 seconds to execute return an HTTP 408 status code instead of HTTP 500.
- Fixed: History request in bundle. Prior to the fix, a history request in a bundle returned HTTP status code 404.
March 2024
Batch-bundle parallelization Batch bundles are executed serially in FHIR service by default. To improve throughput with bundle calls, we enabled parallel processing of batch bundles.
Learn more:
Bug Fixes
- Fixed: Improve performance for bundle processing. Updates are made to the task execution method, leading to bundle processing performance improvement. See PR#3727.
February 2024
Enables counting all versions (historical and soft deleted) of resources The query parameter _summary=count and _count=0 can be added to _history endpoint to get count of all versioned resources. This count includes soft deleted resources. For more information, see history management.
Improve throughput for export operation The "_isparallel" query parameter can be added to the export operation to enhance its throughput. It's' important to note that using this parameter may result in an increase in Request Units consumption over the life of export. For more information, see Export operation query parameters.
Note
There's a known issue with the $export operation that could result in incomplete exports with status success. Issue occurs when the is_parallel flag was used. Export jobs executed with _isparallel query parameter starting February 13th, 2024 are impacted with this issue.
Change in name nomenclature for exported file name and default storage account With this change, exported file names follow the format '{FHIR Resource Name}-{Number}-{Number}.ndjson'. The order of the files isn't guaranteed to correspond to any ordering of the resources in the database. Default storage account name is updated to 'Export-{Number}'. There's no change to number of resources added in individual exported files.
Performance Enhancement Parallel optimization for FHIR queries can be enabled using HTTP header "x-ms-query-latency-over-efficiency". This value needs to be set to true to achieve maximum concurrency during execution of query. For more information, see Batch Bundles.
January 2024
Concurrent execution of queries with conditional interactions Conditional interactions can be complex and performance-intensive. To enhance the latency of queries involving conditional interactions, you have the option to utilize the request header x-conditionalquery-processing-logic. For more information, see Performance considerations for conditional API interactions.
December 2023
Additional capabilities added to the Export operation $export operation now supports exporting versioned resources and soft deleted resources. For more information, see Export query parameters.
November 2023
Bulk delete capability now available in preview `$bulk-delete' allows you to delete resources from FHIR server asynchronously. Bulk delete operation can be executed at system level or for individual resource type. For more information, see bulk-delete operation.
Bulk delete operation is currently in public preview. Review disclaimer for details. [!INCLUDE public preview disclaimer]
Bug Fix: FHIR queries using pagination and revinclude resulted in an error on using next link
Issue is now addressed and FHIR queries using continuation token with include/ revinclude, no longer report an exception. For details on fix, visit #3525.
June 2023
Bug Fix: Metadata endpoint URL in capability statement is relative URL Per FHIR specification, metadata endpoint URL in capability statement needs to be an absolute URL. For details on FHIR specification, visit Capability Statement. This fanix addresses the issue, for details visit 3265.
May 2023
SMART on FHIR : Fixed clinical scope mapping for applications
This bug fix addresses issue with clinical scope not interpreted correctly for backend applications. For more details, visit #3250
April 2023
Fixed transient issues associated with loading custom search parameters This bug fix addresses the issue, where the FHIR service wouldn't load the latest SearchParameter status in the event of failure. For more details, visit #3222
November 2022
Fixed the Error generated when resource is updated using if-match header and PATCH
Bug is now fixed and Resource will be updated if it matches the Etag header. For details, see #2877|.
May 2022
Enhancement
| Enhancement | Related information |
|---|---|
| Azure API for FHIR doesn't create a new version of the resource if the resource content hasn't changed. | If a user updates an existing resource and only meta.versionId or meta.lastUpdated have changed then we return OK with existing resource information without updating VersionId and lastUpdated. For more information, see #2519. |
April 2022
Enhancements
| Enhancements | Related information |
|---|---|
| FHIRPath Patch | FHIRPath Patch was added as a feature to both the Azure API for FHIR. This implements FHIRPath Patch as defined on the HL7 website. |
| Move Bundle notification to Core | With the introduction of the Resource.Bundle namespace to Core, the Resource references to the string resources file had to be made more explicit. For more information, see PR #2478. |
| Handles invalid header on versioned update | When the versioning policy is set to "versioned-update", we required that the most recent version of the resource is provided in the request's if-match header on an update. The specified version must be in ETag format. Previously, a 500 would be returned if the version was invalid or in an incorrect format. This update now returns a 400 Bad Request. For more information, see PR #2467. |
Bug fixes
| Bug fixes | Related information |
|---|---|
| Adds core to resource path | Part of the path to a string resource was accidentally removed in the versioning policy. This fix adds it back in. For more information, see PR #2470. |
| SQL timeout is returning a 500 error | Fixed a bug when a SQL request hits a timeout and the request returns a 500. In the logs, this is a timeout from SQL compared to getting a 429 error from front end. For more information, see PR #2497. |
March 2022
Features
| Feature | Related information |
|---|---|
| FHIRPath Patch | This new feature enables you to use the FHIRPath Patch operation on FHIR resources. For more information, see FHIR REST API capabilities for Azure API for FHIR. |
Bug fixes
| Bug fixes | Related information |
|---|---|
Duplicate resources in search with _include |
Fixed issue where a single resource can be returned twice in a search that has _include. For more information, see PR #2448. |
| PUT creates on versioned update | Fixed issue: creating with PUT resulted in an error when the versioning policy is configured to versioned-update. For more information, see PR #2457. |
| Invalid header handling on versioned update | Fixed issue where invalid if-match header would result in an HTTP 500 error. Now an HTTP Bad Request is returned instead. For more information, see PR #2467. |
February 2022
Features and enhancements
| Enhancements | Related information |
|---|---|
| Added 429 retry and logging in BundleHandler | We sometimes encounter 429 errors when processing a bundle. If the FHIR service receives a 429 at the BundleHandler layer, we abort processing of the bundle and skip the remaining resources. We've added another retry (in addition to the retry present in the data store layer) that will execute one time per resource that encounters a 429. For more about this feature enhancement, see PR #2400. |
Billing for $convert-data and $de-id |
Azure API for FHIR's data conversion and de-identified export features are now Generally Available. Billing for $convert-data and $de-id operations in Azure API for FHIR has been enabled. Billing meters were turned on March 1, 2022. |
Bug fixes
| Bug fixes | Related information |
|---|---|
| Update compartment search index | There was a corner case where the compartment search index wasn't being set on resources. Now we use the same index as the main search for compartment search to ensure all data is being returned. For more about the code fix, see PR #2430. |
December 2021
Features and enhancements
| Enhancements | Related information |
|---|---|
Added Publisher to CapabilityStatement.name |
You can now find the publisher in the capability statement at CapabilityStatement.name. #2319 |
Log FhirOperation linked to anonymous calls to Request metrics |
We weren’t logging operations that didn’t require authentication. We extended the ability to get FhirOperation type in RequestMetrics for anonymous calls. #2295 |
Bug fixes
| Bug fixes | Related information |
|---|---|
Fixed 500 error when SearchParameter Code is null |
Fixed an issue with SearchParameter if it had a null value for Code, the result would be a 500. Now it results in an InvalidResourceException like the other values do. #2343 |
Returned BadRequestException with valid message when input JSON body is invalid |
For invalid JSON body requests, the FHIR server was returning a 500 error. Now we return a BadRequestException with a valid message instead of 500. #2239 |
_sort can cause ChainedSearch to return incorrect results |
Previously, the sort options from the chained search's SearchOption object wasn't cleared, causing the sorting options to be passed through to the chained subsearch, which aren't valid. This could result in no results when there should be results. This bug is now fixed #2347. It addressed GitHub bug #2344. |
November 2021
Features and enhancements
| Enhancements | Related information |
|---|---|
| Process Patient-everything links | We've expanded the Patient-everything capabilities to process patient links #2305. For more information, see Patient-everything in FHIR documentation. |
| Added software name and version to capability statement | In the capability statement, the software name now distinguishes if you're using Azure API for FHIR or Azure Health Data Services. The software version will now specify which open-source release package is live in the managed service #2294. Addresses: #1778 and #2241 |
Log 500s to RequestMetric |
Previously, 500s or any unknown/unhandled errors weren't getting logged in RequestMetric. They're now getting logged #2240. For more information, see Enable diagnostic settings in Azure API for FHIR |
| Compress continuation tokens | In certain instances, the continuation token was too long to be able to follow the next link in searches and would result in a 404. To resolve this, we compressed the continuation token to ensure it stays below the size limit #2279. Addresses issue #2250. |
Bug fixes
| Bug fixes | Related information |
|---|---|
| Resolved 500 error when the date was passed with a time zone. | This fixes a 500 error when a date with a time zone was passed into a datetime field #2270. |
| Resolved issue when posting a bundle with incorrect Media Type returned a 500 error. | Previously when posting a search with a key that contains certain characters, a 500 error was returned. This fixes this issue #2264, and it addresses #2148. |
October 2021
Bug fixes
| Infinite loop bug | Related information |
|---|---|
| Fixed issue where Conditional Delete could result in an infinite loop. | #2269 |
September 2021
Features and enhancements
| Enhancements | Related information |
|---|---|
| Added support for conditional patch | Conditional patch |
| Conditional patch | #2163 |
| Added conditional patch audit event. | #2213 |
| Allow JSON patch in bundles | JSON patch in bundles |
|---|---|
| Allows for search history bundles with Patch requests. | #2156 |
| Enabled JSON patch in bundles using Binary resources. | #2143 |
| New audit event subtypes | Related information |
|---|---|
| Added new audit OperationName subtypes. | #2170 |
| Reindex improvements | Related information |
|---|---|
| Added boundaries for reindex parameters. | #2103 |
| Update error message for reindex parameter boundaries. | #2109 |
| Added final reindex count check. | #2099 |
Bug fixes
| Bug fixes | Related information |
|---|---|
| Wider catch for exceptions when applying patch. | #2192 |
| Fixes history with PATCH in STU3. | #2177 |
| Custom search bugs | Related information |
|---|---|
| Addresses failure with the custom search parameters. | #2133 |
| Added retry logic while deleting search parameter. | #2121 |
| Set max item count in search options in SearchParameterDefinitionManager. | #2141 |
| Provides better exception if there's a bad expression in search parameter. | #2157 |
| Resolved retry 503 error | Related information |
|---|---|
| Retry 503 error from Azure Cosmos DB. | #2106 |
| Fixes processing 429s from StoreProcedures. | #2165 |
| GitHub issues closed | Related information |
|---|---|
| Unable to create custom search parameter for the CarePlan medical device. | #2146 |
| Unclear error message for conditional create with no ID. | #2168 |
IoT connector for FHIR (preview)
| Bug fixes | Related information |
|---|---|
| Fixed broken link. | Updated link to the IoT connector Azure documentation in the Azure API for FHIR portal. |
Next steps
For information about the features and bug fixes in Azure Health Data Services (FHIR service, DICOM service, and MedTech service), see
Note
FHIR® is a registered trademark of HL7 and is used with the permission of HL7.