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Azure API for FHIR access token validation

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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.

How Azure API for FHIR validates the access token will depend on implementation and configuration. In this article, we'll walk through the validation steps, which can be helpful when troubleshooting access issues.

Validate token has no issues with identity provider

The first step in the token validation is to verify that the token was issued by the correct identity provider and that it hasn't been modified. The FHIR server will be configured to use a specific identity provider known as the authority Authority. The FHIR server will retrieve information about the identity provider from the /.well-known/openid-configuration endpoint. When you use Microsoft Entra ID, the full URL is:

GET https://login.microsoftonline.com/<TENANT-ID>/.well-known/openid-configuration

where <TENANT-ID> is the specific Microsoft Entra tenant (either a tenant ID or a domain name).

Microsoft Entra ID will return a document like this one to the FHIR server.

{
    "authorization_endpoint": "https://login.microsoftonline.com/<TENANT-ID>/oauth2/authorize",
    "token_endpoint": "https://login.microsoftonline.com/<TENANT-ID>/oauth2/token",
    "token_endpoint_auth_methods_supported": [
        "client_secret_post",
        "private_key_jwt",
        "client_secret_basic"
    ],
    "jwks_uri": "https://login.microsoftonline.com/common/discovery/keys",
    "response_modes_supported": [
        "query",
        "fragment",
        "form_post"
    ],
    "subject_types_supported": [
        "pairwise"
    ],
    "id_token_signing_alg_values_supported": [
        "RS256"
    ],
    "http_logout_supported": true,
    "frontchannel_logout_supported": true,
    "end_session_endpoint": "https://login.microsoftonline.com/<TENANT-ID>/oauth2/logout",
    "response_types_supported": [
        "code",
        "id_token",
        "code id_token",
        "token id_token",
        "token"
    ],
    "scopes_supported": [
        "openid"
    ],
    "issuer": "https://sts.windows.net/<TENANT-ID>/",
    "claims_supported": [
        "sub",
        "iss",
        "cloud_instance_name",
        "cloud_instance_host_name",
        "cloud_graph_host_name",
        "msgraph_host",
        "aud",
        "exp",
        "iat",
        "auth_time",
        "acr",
        "amr",
        "nonce",
        "email",
        "given_name",
        "family_name",
        "nickname"
    ],
    "microsoft_multi_refresh_token": true,
    "check_session_iframe": "https://login.microsoftonline.com/<TENANT-ID>/oauth2/checksession",
    "userinfo_endpoint": "https://login.microsoftonline.com/<TENANT-ID>/openid/userinfo",
    "tenant_region_scope": "WW",
    "cloud_instance_name": "microsoftonline.com",
    "cloud_graph_host_name": "graph.windows.net",
    "msgraph_host": "graph.microsoft.com",
    "rbac_url": "https://pas.windows.net"
}

The important properties for the FHIR server are jwks_uri, which tells the server where to fetch the encryption keys needed to validate the token signature and issuer, which tells the server what will be in the issuer claim (iss) of tokens issued by this server. The FHIR server can use this to validate that it's receiving an authentic token.

Validate claims of the token

Once the server has verified the authenticity of the token, the FHIR server will then proceed to validate that the client has the required claims to access the token.

When you use Azure API for FHIR, the server will validate:

  1. The token has the right Audience (aud claim).
  2. The user or principal that the token was issued for is allowed to access the FHIR server data plane. The oid claim of the token contains an identity object ID, which uniquely identifies the user or principal.

We recommend that the FHIR service be configured to use Azure RBAC to manage data plane role assignments. However, you can also configure local RBAC if your FHIR service uses an external or secondary Microsoft Entra tenant.

When you use the OSS Microsoft FHIR server for Azure, the server will validate:

  1. The token has the right Audience (aud claim).
  2. The token has a role in the roles claim, which is allowed access to the FHIR server.

Consult details on how to define roles on the FHIR server.

A FHIR server may also validate that an access token has the scopes (in token claim scp) to access the part of the FHIR API that a client is trying to access. Currently, Azure API for FHIR and the FHIR server for Azure don't validate token scopes.

Next steps

Now that you know how to walk through token validation, you can complete the tutorial to create a JavaScript application and read Fast Healthcare Interoperability Resources (FHIR®) data.

Web application tutorial

FHIR® is a registered trademark of HL7 and is used with the permission of HL7.