Release notes: Azure API for FHIR


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.

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 `$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.

July 2023

Feature enhancement: Change to the exported file name format

FHIR service enables customers to export data with $export operation. Export can be conducted across various levels, such as System, Patient and Group of patients. There are name changes with exported file and default storage account name.

  • Exported file names will follow the format <FHIR Resource Name>-<Number>- <Number>.ndjson. The order of the files is not guaranteed to correspond to any ordering of the resources in the database.
  • Default storage account name is updated to Export-<Number>.

There is no change to number of resources added in individual exported files.

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 address the issue, where the FHIR service would not load the latest SearchParameter status in 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 matches the Etag header. For details , see #2877|

May 2022


Enhancement Related information
Azure API for FHIR does not create a new version of the resource if the resource content has not 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 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


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 where creates 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 You can now find the publisher in the capability statement at #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 will result 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'll 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 500's 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 the delete failure with 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

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