Release notes: 2023 Azure Health Data Services
This article describes features, enhancements, and bug fixes released in 2023 for the FHIR® service, DICOM® service, and MedTech service in Azure Health Data Services.
December 2023
Azure Health Data Services
Encryption with customer-managed keys for the FHIR and DICOM services
Data stored in Azure Health Data Services is automatically and seamlessly encrypted with service-managed keys managed by Microsoft. You can enable data encryption with customer-managed keys (CMK) for new and existing FHIR and DICOM services, providing your organization with improved flexibility to manage access controls.
Learn more:
- Configure customer-managed keys for the FHIR service
- Configure customer-managed keys for the DICOM service
DICOM service
Store and manage medical imaging data with Azure Data Lake Storage (preview)
With the integration of the DICOM service with Azure Data Lake Storage available for preview, organizations have full control over their imaging data and increased flexibility to access and work with that data through the Azure storage ecosystem and APIs. By using Azure Data Lake Storage with the DICOM service, organizations are able to:
- Enable direct access to medical imaging data stored by the DICOM service using Azure storage APIs and DICOMweb APIs, providing more flexibility to access and work with the data.
- Open medical imaging data up to the entire ecosystem of tools for working with Azure storage, including AzCopy, Azure Storage Explorer, and the Data Movement library.
- Unlock new analytics and AI/ML scenarios by using services that natively integrate with Azure Data Lake Storage, including Azure Synapse, Azure Databricks, Azure Machine Learning, and Microsoft Fabric.
- Grant controls to manage storage permissions, access controls, tiers, and rules.
Learn more:
- Azure Data Lake Storage integration for the DICOM service in Azure Health Data Services
- Deploy the DICOM service with Azure Data Lake Storage
FHIR service
Enhancement of the export operation
The export operation supports exporting versioned resources and soft deleted resources.
Learn more:
November 2023
Azure Health Data Services
Unified Azure portal landing page
In the Azure portal, we launched a unified landing page that lets users access all Microsoft Health Data and AI Services in one place. The landing page makes it easier to find and use all related Health Data and AI Services and includes links to relevant documentation to help users get started. To check out the landing page, sign into your Azure subscription and then search for Health Data and AI Services.
FHIR service
Bulk delete capability (preview)
The bulk delete operation allows you to delete resources from the FHIR server asynchronously. The bulk delete operation can be executed at the system level or for individual resource types.
Learn more:
Import operation supports soft deleted resources
The capability to import soft deleted resources is useful during migration from Azure API for FHIR to Azure Health Data Services. See PR #3530
Performance improvement for queries
We improved performance of FHIR queries with the _include parameter. See PR #3572.
Bug fixes
Fixed: Searching with
_includeand wildcard results in query failure. The issue is fixed and permits only the wild character*to be present for_includeand_revincludesearches. PR #3541.Fixed: Multiple export jobs created results in increase data storage volume. Due to a bug, export jobs created multiple child jobs when used with the typefilter parameter. The fix addresses the issue. See PR #3567.
Fixed: Retriable exception for import operation when using duplicate files. If there are duplicate files during import, an exception would be thrown. This exception was considered as a retriable exception. The fix addresses the issue. Import operations with same file are no longer retriable. See PR #3557.
October 2023
DICOM service
Bulk import (preview)
Bulk import simplifies the process of adding data to the DICOM service. When enabled, the capability creates a storage container and .dcm files that are copied to the container are automatically added to the DICOM service. For more information, see Import DICOM files (preview).
September 2023
Azure Health Data Services
Documentation navigation improvements
Documentation navigation improvements include a new hub page for Azure Health Data Services: Azure Health Data Services Documentation. Also, fixes to breadcrumbs across the FHIR, DICOM, and MedTech services documentation and the table of contents make it easier and more intuitive to find documentation.
FHIR service
Retirement announcement for Azure API for FHIR
Azure API for FHIR will be retired on September 30, 2026. 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. Due to retirement of Azure API for FHIR, new deployments won't be allowed beginning April 1, 2025. For more information, see migration strategies.
August 2023
FHIR service
Incremental import
The import operation supports incremental load mode, which is optimized to periodically load data into the FHIR service.
With incremental load mode, healthcare organizations can:
- Perform concurrent ingestion of data while simultaneously executing API CRUD operations on the FHIR server.
- Ingest versioned FHIR resources.
- Maintain the
lastUpdatedfield value in FHIR resources during ingestion. - Support conditional references.
Learn more:
Batch-bundle parallelization (preview)
Batch bundles are executed serially in FHIR service by default. To improve throughput with bundle calls, we enabled parallel processing of batch bundles for preview.
Learn more:
Bug fixes
Fixed: Decimal value precision aligns with the FHIR specification. Before the fix, FHIR service allowed precision value of [18,6]. The service was updated to support decimal value precision of [36,18] per the FHIR specification. See FHIR specification data types.
Fixed: Reindex on targeted search parameter sets the status correctly. We identified a bug where after performing targeted search parameter reindex, resource data with search parameter wasn't searchable. This bug was addressed by changing the status of the search parameter. See PR #3400.
July 2023
FHIR service
Bug fixes
Fixed: Continuous retry on the import operation. We observed an issue where $import kept retrying when the NDJSON file size is greater than 2 GB. The issue is fixed. See PR #3342.
Fixed: Patient and group level export job restart. Patient and group level exports on interruption would restart from the beginning. This bug is fixed to restart the export jobs from the last successfully completed page of results. See PR #3205.
DICOM service
API version 2
The DICOM service API version 2 (v2) introduces several changes and new features. Most notable is the change to validation of DICOM attributes during store (STOW) operations. Beginning with v2, the request fails only if necessary attributes fail validation.
Learn more:
June 2023
FHIR service
Bug fixes
Fixed: Reindex operation provides job status at resource level. The
reindexoperation supports determining the status of thereindexoperation with help of the API callGET {{FHIR_URL}}/_operations/reindex/{{reindexJobId}}. To see how many resources were reindexed, look for the resourceReindexProgressByResource field in the response. This field shows the progress for each resource type. See PR #3286.Fixed: Optimization of complex search queries. Some organizations experienced issues where complex FHIR queries with reference search parameters would time out. The issue was fixed by updating the SQL query generator to use an INNER JOIN for reference search parameters. See PR #3295.
Fixed: Metadata endpoint URL in the capability statement is a relative URL. According to the FHIR specification, the metadata endpoint URL in the capability statement needs to be an absolute URL. The fix addresses the issue. See PR #3265.
Learn more:
DICOM service
Retrieve rendered images
Rendered images can be retrieved from the DICOM service by using the new rendered endpoint. This API allows a DICOM instance or frame to be accessed in a consumer format (jpeg or png), a capability that can simplify scenarios such as a client application displaying an image preview.
Bug fixes
Fixed: Issue where DICOM events and the change feed may miss changes. The DICOM change feed API returned results that incorrectly skipped pending changes when the DICOM server was under load. Identical calls to the change feed resource resulted in new change events appearing in the middle of the result set.
For example, if the first call returned sequence numbers
1,2,3, and5, then the second identical call might incorrectly return1,2,3,4, and5. This behavior also impacted the DICOM events sent to Azure Event Grid system topics, and resulted in missing events in downstream event handlers. See PR #2611.
MedTech service
Link device messages to FHIR encounters
Device messages can have encounter identifiers that match the ones in FHIR encounters. This way, healthcare organizations can easily find and link the FHIR encounters to the observations from the device data. Open Source Software (OSS) supports the look-up feature, which customers of the MedTech service asked for.
May 2023
FHIR service
Bug fixes
Fixed: SMART on FHIR clinical scope mapping for applications. This bug fix addresses an issue with clinical scope not interpreted correctly for backend applications. See PR #3250.
Fixed: Duplicate key error when passed in request parameters and body. This fix handles the issue when using the POST {resourcetype}/search endpoint to query FHIR resources, the server returns
415 Unsupported Media Type. This issue is due to repeating a query parameter in the URL query string and the request body. The fix considers all the query parameters from request and body as input. See PR #3232.
April 2023
Azure Health Data Services
Availability in West Central US region
Azure Health Data Services is generally available in the West Central US region.
FHIR service
Bug fixes
Fixed: Performance for search queries with identifiers. This bug fix addresses timeout issues observed for search queries with identifiers by using the OPTIMIZE clause. See PR #3207
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 a failure. See PR #3222
March 2023
Azure Health Data Services
Availability in the Japan East region
Azure Health Data Services is generally available in the Japan East region.
February 2023
FHIR service
The _till parameter and throughput improvement by 50x
The _till parameter is an optional parameter and allows you to export resources that were modified until the specified time. This improvement applies to system export.
Learn more:
Bug fixes
Fixed: Chained search with :contains modifier results but no resources. This bug fix addresses the issue and identified resources, per search criteria with :contains modifier are returned. See PR #2990.
Fixed: The ability to tweak continuation token size limit header. Before this change, during pagination a Cosmos DB continuation token had a default limit of 3 KB. With this change, you can send a Cosmos DB continuation token limit in the header. Valid range is set to 1-3 KB. The header value to send the value is
x-ms-documentdb-responsecontinuationtokenlimitinkb. See PR #2971.Fixed: HTTP Status code 500 encountered when :not modifier is used with chained searches. This bug fix addresses the issue. Identified resources are returned per search criteria with :contains modifier. See PR #3041.
Fixed: Versioning policy enabled at resource level required If-match header for transaction requests. The fix addresses the issue. Versioned policy at the resource level doesn't require if-match header. See PR #2994.
MedTech service
Mapping Debugger (preview)
The MedTech service Mapping Debugger is a self-service tool for creating, updating, and troubleshooting the MedTech service device and FHIR destination mappings. It enables you to easily view and make inline adjustments in real-time without having to leave the Azure portal.
Learn more:
Error message capability (preview)
The MedTech service error message feature allows you to view any errors generated, and the message that caused each error. You can learn the context behind any errors without manual effort.
Learn more:
DICOM service
DICOM event types
DICOM events are available in Azure Health Data Services workspace-level event subscriptions. These new event types enable event-driven workflows in medical imaging applications by subscribing to events for newly created and deleted DICOM images.
Learn more:
Toolkit and samples open source
Two more sample apps are available in the open source samples repo. See Azure-Samples/azure-health-data-services-samples).
Bug fixes
- Fixed: Validation errors included with the FailedSOPSequence. Previously, DICOM validation failures returned by the Store (STOW) API lacked the detail necessary to diagnose and resolve problems. The API changes improve the error messages by including more information about the attributes that failed validation and the reason why.
Learn more:
January 2023
Azure Health Data Services
Azure Health Data services available in more regions
Azure Health Data Services is generally available in the France Central, North Central US, and Qatar Central regions.
DICOM service
Support for ModalitiesInStudy attribute
The DICOM service supports ModalitiesInStudy as a searchable attribute at the study, series, and instance level. Support for this attribute allows for the list of modalities in a study to be returned more efficiently without needing to query each series independently.
Learn more:
Support for NumberOfStudyRelatedInstances and NumberOfSeriesRelatedInstances attributes
Two attributes for returning the count of instances in a study or series are available in search responses.
Learn more:
Toolkit and samples open source
Another sample app is available
One new sample app is released in the Azure Health Data Services samples repo.