Implementation Approach
This guide provides practical advice for implementing the FHIR patterns in real-world healthcare systems, including architectural considerations, technology choices, and deployment strategies.
Getting Started
1. Assessment and Planning
Before implementing patterns, conduct a thorough assessment of your current environment:
Current State Analysis
- Legacy Systems: Inventory existing systems and their data formats (HL7v2, CDA, proprietary)
- Integration Points: Map current integration patterns and data flows
- Technical Debt: Assess existing technical constraints and dependencies
- Compliance Requirements: Understand regulatory and policy requirements
Requirements Gathering
- Use Cases: Define specific healthcare workflows and user scenarios
- Performance Requirements: Establish latency, throughput, and availability targets
- Security Requirements: Document authentication, authorization, and audit needs
- Scalability Needs: Plan for growth in users, data volume, and geographic distribution
2. Pattern Selection
Use the Forces Analysis to identify which patterns address your specific challenges:
| Primary Challenge | Recommended Starting Patterns |
|---|---|
3. Implementation Sequence
Implement patterns incrementally to manage complexity and validate assumptions:
Phase 1: Foundation (Months 1-3)
Phase 2: Core Integration (Months 4-6)
Phase 3: Advanced Features (Months 7-12)
Architectural Considerations
Deployment Architecture
Single-Tenant On-Premises
Multi-Tenant Cloud
Federated Multi-Organization
Technology Stack Recommendations
Backend Technologies
| Component | Recommended Options | Considerations |
|---|---|---|
| FHIR Server | HAPI FHIR Server, Microsoft FHIR Server, IBM FHIR Server | Choose based on language preference, scaling needs |
| API Gateway | Kong, Ambassador, Istio Gateway | Consider service mesh integration |
| Message Queue | RabbitMQ, Apache Kafka, Azure Service Bus | Choose based on throughput and durability needs |
| Cache | Redis, Hazelcast, AWS ElastiCache | In-memory caching for performance |
| Database | PostgreSQL, MongoDB, Azure Cosmos DB | FHIR servers often dictate choice |
| Authentication | Keycloak, Auth0, Azure AD | SMART on FHIR compliance required |
Start Simple
Begin with a minimal viable implementation of 2-3 core patterns. Add complexity gradually as you gain experience and confidence.
Production Readiness
Ensure comprehensive testing, monitoring, and security measures are in place before deploying to production healthcare environments. Patient data requires the highest level of protection and reliability.