Operations

Ignixa supports standard FHIR operations for validation, bulk data, patient access, and terminology.

Core Operations

$validate

FHIR Spec

Validate a resource against FHIR specifications and profiles:

# Type-level validation
POST /Patient/$validate
Content-Type: application/fhir+json

{
  "resourceType": "Parameters",
  "parameter": [{
    "name": "resource",
    "resource": {
      "resourceType": "Patient",
      "name": [{ "family": "Smith" }]
    }
  }]
}

Validation Modes

# Validate against a profile
POST /Patient/$validate?profile=http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient

# Validation mode (create, update, delete)
POST /Patient/$validate?mode=create

Validation Depth

Control validation depth via Prefer header:

POST /Patient/$validate
Prefer: mode=minimal   # Structure only
Prefer: mode=spec      # FHIR spec compliance (default)
Prefer: mode=full      # Full profile validation with terminology

$everything

FHIR Spec

Retrieve all data for a patient:

GET /Patient/{id}/$everything
GET /Patient/{id}/$everything?start=2024-01-01&end=2024-12-31
GET /Patient/{id}/$everything?_type=Observation,Condition
GET /Patient/{id}/$everything?_since=2024-01-01T00:00:00Z
GET /Patient/{id}/$everything?_count=100

$member-match

Da Vinci HRex Spec

Match patients across different payer systems (HRex specification):

POST /Patient/$member-match
Content-Type: application/fhir+json

{
  "resourceType": "Parameters",
  "parameter": [
    {
      "name": "MemberPatient",
      "resource": {
        "resourceType": "Patient",
        "identifier": [{ "system": "http://example.org", "value": "12345" }],
        "name": [{ "family": "Smith", "given": ["John"] }]
      }
    },
    {
      "name": "CoverageToMatch",
      "resource": {
        "resourceType": "Coverage",
        "status": "active",
        "beneficiary": { "reference": "Patient/member" }
      }
    }
  ]
}

Bulk Data Operations

Operation	Spec	Description
$export	Bulk Data	Async export to NDJSON or Parquet
$import	Bulk Data	Async bulk import from NDJSON

$export

Start an asynchronous bulk export operation:

# System-level export (auto-detect tenant)
POST /$export

# Tenant-scoped export
POST /tenant/{tenantId}/$export

# Group-scoped export (members only)
POST /Group/{groupId}/$export

# Query parameters
POST /tenant/{tenantId}/$export?_type=Patient,Observation&_since=2024-01-01&_outputFormat=ndjson

Supported parameters:

• _type - Comma-separated list of resource types to export
• _since - Only include resources modified after this date
• _typeFilter - Advanced resource filtering
• _outputFormat - ndjson (default) or parquet
• _viewDefinition - SQL on FHIR ViewDefinition for Parquet output

Returns 202 Accepted with Content-Location header pointing to the status endpoint.

$import

Start an asynchronous bulk import operation:

# Tenant-scoped import
POST /tenant/{tenantId}/$import
Content-Type: application/fhir+json

{
  "resourceType": "Parameters",
  "parameter": [
    {
      "name": "inputFormat",
      "valueCode": "application/fhir+ndjson"
    },
    {
      "name": "inputSource",
      "valueUri": "https://example.org/export/patients.ndjson"
    },
    {
      "name": "mode",
      "valueCode": "IncrementalLoad"
    }
  ]
}

Returns 202 Accepted with Content-Location header to poll job status.

See Bulk Operations for detailed usage, parameters, and configuration.

Search Operations

$includes

Fetch additional included resources from a search with independent pagination. When using _include or _revinclude, large result sets can cause performance issues. The $includes operation allows clients to paginate through included resources separately from primary search matches.

# Initial search with limited includes
GET /Patient?_include=Patient:organization&_count=10&_includesCount=50

# Response includes:
# - Up to 10 patients (primary matches)
# - Up to 50 organizations (included resources)
# - "related" link if more organizations exist

# Follow "related" link for more includes
GET /Patient/$includes?_includesContinuationToken=xyz123&_include=Patient:organization

Parameters

Parameter	Type	Description
_includesContinuationToken	string	Required. Continuation token from previous search "related" link
_include	string	Include parameters (inherited from original search)
_revinclude	string	Reverse include parameters (inherited from original search)
_includesCount	integer	Maximum number of included resources per page (optional)

Behavior

The $includes operation:

• Returns a Bundle with only included resources (no primary matches)
• Uses standard "next" link for additional pages of includes
• Requires _includesContinuationToken parameter from initial search
• Re-executes the search but filters to include entries only

Use Cases

1. Large include sets: When a search has many primary matches, each with related resources
2. Progressive loading: Load primary results first, then fetch related resources on demand
3. Performance optimization: Prevent response size explosion from large include sets

Example Flow

# 1. Initial search with _includesCount
GET /Observation?subject=Patient/123&_include=Observation:performer&_includesCount=25
# Returns: 100 observations + 25 practitioners (if more practitioners exist, includes "related" link)

# 2. Fetch next page of practitioners
GET /Observation/$includes?_includesContinuationToken=abc...&_include=Observation:performer
# Returns: Next 25 practitioners (no observations)

# 3. Continue until no "next" link
GET /Observation/$includes?_includesContinuationToken=def...&_include=Observation:performer
# Returns: Remaining practitioners

Experimental Operations

These operations are available when experimental features are enabled.

$summary (IPS)

IPS Spec

Generate an International Patient Summary:

# By patient ID (GET)
GET /Patient/{id}/$summary

# By patient ID (POST)
POST /Patient/{id}/$summary

# By patient identifier (GET)
GET /Patient/$summary?identifier=http://example.org|12345

# With specific profile
GET /Patient/{id}/$summary?profile=http://hl7.org/fhir/uv/ips/StructureDefinition/Bundle-uv-ips

$expand (ValueSet)

FHIR Spec

Expand a ValueSet to a list of codes:

GET /ValueSet/$expand?url=http://hl7.org/fhir/ValueSet/observation-codes
GET /ValueSet/$expand?url=http://hl7.org/fhir/ValueSet/observation-codes&filter=blood
GET /ValueSet/$expand?url=http://hl7.org/fhir/ValueSet/observation-codes&count=100&offset=0

$translate (ConceptMap)

FHIR Spec

Translate codes between systems using ConceptMap:

POST /ConceptMap/$translate
Content-Type: application/fhir+json

{
  "code": "123",
  "system": "http://source.org",
  "url": "http://example.org/ConceptMap/my-map"
}

$subsumes (CodeSystem)

FHIR Spec

Test subsumption relationship between codes:

POST /CodeSystem/$subsumes
Content-Type: application/fhir+json

{
  "codeA": "parent-code",
  "codeB": "child-code",
  "system": "http://example.org/CodeSystem/my-codes"
}

$transform (StructureMap)

FHIR Spec

Transform data using a StructureMap:

# Using a stored StructureMap
POST /StructureMap/{id}/$transform
Content-Type: application/fhir+json

{
  "resourceType": "Parameters",
  "parameter": [{
    "name": "content",
    "resource": { ... }
  }]
}

# Using an inline StructureMap
POST /StructureMap/$transform
Content-Type: application/fhir+json

{
  "resourceType": "Parameters",
  "parameter": [
    {
      "name": "sourceMap",
      "resource": { "resourceType": "StructureMap", ... }
    },
    {
      "name": "content",
      "resource": { ... }
    }
  ]
}

Not Yet Implemented

The following operations are planned but not yet available:

• $document - Generate document from Composition
• $validate-code - Validate code in ValueSet
• $lookup - CodeSystem code lookup
• $snapshot - Generate StructureDefinition snapshot

Related Documentation

• Bulk Operations
• Validation