This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
FHIR Infrastructure Work Group | Maturity Level: 4 | Standards Status: Draft |
All of the interactions defined in the RESTful API are described as synchronous operations - that is, the client makes a query and waits for the server to respond with the outcome in the HTTP response. This pattern is not always suitable when substantial amounts of data must be returned.
A good example of this is the $export operation , where simple searches may result in large amounts of data.
The asynchronous request pattern, based on rfc 7240 , caters to this use case and is applicable for for use in Operations and Defined Interactions interactions. Servers may choose which interactions the pattern should be supported on (if at all).
For use cases that return small amounts of data but may take a lot of time to process, see Asynchronous Interaction Request.
The request will support the HTTP methods, URLs, headers and other parameters that normally apply, but servers
SHALL also support the Prefer
header described below, and SHOULD support the Accept
header
and _outputFormat
parameter described below.
Accept
(string)
Specifies the format of the optional OperationOutcome Resource response to the kick-off request. A client SHOULD provide this header. A server may support any subset of the Serialization Format Representations. If omitted, the server MAY return an error or MAY process the request and return a format selected by the server.
Prefer
(string, required)
Specifies whether the response is immediate or asynchronous. Setting this to respond-async
triggers this async pattern.
_outputFormat
(string, optional, defaults to application/fhir+ndjson
)
The format for the generated bulk data files. Currently, ndjson must be
supported, though servers may choose to also support other output formats. Servers SHALL support the full
content type of application/fhir+ndjson
as well as abbreviated representations including
application/ndjson
and ndjson
.
For requests types where the server supports either the Asynchronous Bulk Data Request pattern or the Asynchronous Interaction Request pattern,
requests that include the _outputFormat
parameter SHALL trigger the Asynchronous Bulk Data Request pattern.
202 Accepted
Content-Location
header with the absolute URL of an endpoint for subsequent status requests
(polling location)4XX
or 5XX
After a Bulk Data request has been started, a client MAY send a http DELETE request to the URL provided in the
Content-Location
header to cancel the request. If the request has been completed, a server MAY use the
request as a signal that a client is done retrieving files and that it is safe for the sever to remove those from
storage. Following the delete request, when subsequent requests are made to the polling location, the server SHALL
return a 404 Not Found
error and an associated OperationOutcome
Resource.
202 Accepted
4XX
or 5XX
After a Bulk Data request has been started, the client MAY poll the status URL provided in the
Content-Location
header by issuing HTTP GET requests to the location.
A client SHOULD follow an exponential backoff
approach when polling for status. A server SHOULD supply a Retry-After
header
with a with a delay time in seconds (e.g., 120
to represent two minutes) or a http-date (e.g.,
Fri, 31 Dec 1999 23:59:59 GMT
). When provided, a client SHOULD use this information to inform the
timing of future polling requests. The server SHOULD keep an accounting of status queries received from a given
client, and if a client is polling too frequently, the server SHOULD respond with a
429 Too Many Requests
status code in addition to a Retry-After
header, and optionally a OperationOutcome Resource with further explanation. If excessively frequent status queries
persist, the server MAY return a 429 Too Many Requests
status code without returning a status answer. It may
either return a Retry-after header with the 429 indicating the amount of time that needs to pass before it will again
respond to a status check, or it may choose to abandon the asynchronous operation entirely and force a retry.
Other standard HTTP 4XX
as well as 5XX
status codes may be used to identify
errors as mentioned.
When requesting status, the client SHOULD use an Accept
header indicating a content type of
application/json
. In the case that errors prevent the asynchronous operation from completing, the server SHOULD respond
with a OperationOutcome Resource in JSON format.
202 Accepted
X-Progress
header with a text description of the status of the request that is less
than 100 characters. The format of this description is at the server's discretion and MAY be a percentage complete
value, or MAY be a more general status such as "in progress". The client MAY parse the description, display it to
the user, or log it.4XX
or 5XX
Content-Type
header of application/fhir+json
when body is a OperationOutcome ResourceContent-Type
header.
In the case of a polling failure that does not indicate failure of the original request, a server SHOULD use a transient code from the IssueType valueset when populating the OperationOutcome Resource issue.code
element to indicate to the
client that it should retry the request at a later time.
Note: Even if some of the requested resources cannot successfully be returned, the overall request MAY
still succeed. In this case, the Response.error
array of the completion response body SHALL be
populated with one or more files in ndjson format containing OperationOutcome
Resources to indicate what went wrong (see below). In the case of a partial success, the server SHALL use a
200
status code instead of 4XX
or 5XX
. The choice of when to determine that
a job has failed in its entirety (error status) vs. returning a partial success (complete status) is left up to the
server implementer.
200 OK
Content-Type
header of application/json
Expires
header indicating when the files listed will no longer be
available for access.Fields:
Field | Optionality | Type | Description |
---|---|---|---|
transactionTime |
required | FHIR instant | Indicates the server's time when the query is run. The response SHOULD NOT include any resources modified
after this instant, and SHALL include any matching resources modified up to and including this instant.
Note: To properly meet these constraints, a FHIR server might need to wait for any pending transactions to resolve in its database before starting the asynchronous operation process. |
request |
required | String | The full URL of the original kick-off request. In the case of a HTTP POST request, this URL will not include the request parameters. Note: this field may be removed in a future version. |
requiresAccessToken |
required | Boolean | Indicates whether downloading the generated files requires the same authorization mechanism as kick-off and
status requests.
Value SHALL be true if both the file server and the FHIR API server control access using OAuth
2.0 bearer tokens. Value MAY be false for file servers that use access-control schemes other than
OAuth 2.0 or provide output file URLs that are "capability URLs" (e.g., short-lived high-entropy URLs that can
be dereferenced without additional authentication).
|
output |
required | JSON array | An array of file items with one entry for each generated file. If no resources are returned from the
kick-off request, the server SHOULD return an empty array.
Each file item SHALL contain the following fields: - type - the FHIR resource type that is contained in the file.
Each file SHALL contain resources of only one type, but a server MAY create more than one file for each resource type returned. The number of resources contained in a file MAY vary between servers. If no data are found for a resource, the server SHOULD NOT return an output item for that resource in the response. These rules apply only to top-level resources within the response; as always in FHIR, any resource MAY have a "contained" array that includes referenced resources of other types. - url - the absolute path to the file. The format of the file SHOULD reflect that requested in
the _outputFormat parameter of the initial kick-off request.
Each file item MAY optionally contain the following field: - count - the number of resources in the file, represented as a JSON number.
|
deleted |
optional | JSON array | An array of deleted file items following the same structure as the output array.
The ability to convey deleted resources is important in cases when a server may have previously returned data and wishes to indicate that these data should be removed from downstream systems. When a timestamp parameter such as _since is supported by the request type and supplied in the kick-off
request, this array SHOULD be populated with output files containing
FHIR Transaction Bundles that indicate which FHIR resources match the kick-off request criteria, but have been
deleted subsequent to the timestamp. If no resources have been deleted, or the
timestamp parameter was not supplied, or the server has other reasons to avoid exposing these data,
the server MAY omit this key or MAY return an empty array. Resources that appear in the 'deleted' section of
a manifest SHALL NOT appear in the 'output' section of the manifest.
Each line in the output file SHALL contain a FHIR Bundle with a type of transaction which SHALL
contain one or more entry items that reflect a deleted resource. In each entry, the request.url
and request.method elements SHALL be populated. The request.method element SHALL be
set to DELETE .
Example deleted resource bundle (represents one line in output file):
|
error |
required | Array | Array of message file items following the same structure as the output array.
Error, warning, and information messages related to the asynchronous operation SHOULD be included here (not in output). If there are no relevant messages, the server SHOULD return an empty array. Only the FHIR OperationOutcome resource type is currently supported, so the server SHALL generate files in the
same format as Bulk Data output files that contain FHIR OperationOutcome resources.If the request contained invalid or unsupported parameters along with a Prefer: handling=lenient
header and the server processed the request, the server SHOULD include a FHIR OperationOutcome
resource for each of these parameters.
Note: this field may be renamed in a future version of this specification to reflect the inclusion of FHIR OperationOutcome resources with severity levels other than error.
|
extension |
optional | JSON object | Server implementations may use the extension field to provide custom behavior and information. For example,
a server may choose to provide a custom extension that contains a decryption key for encrypted ndjson files.
The value of an extension element SHALL be a pre-coordinated JSON object.
Note: In addition to extensions being supported on the root object level, extensions may also be included within the fields above (e.g., in the 'output' object). |
Example response body:
{
"transactionTime": "2021-01-01T00:00:00Z",
"request" : "https://example.com/fhir/Patient/$export?_type=Patient,Observation",
"requiresAccessToken" : true,
"output" : [{
"type" : "Patient",
"url" : "https://example.com/output/patient_file_1.ndjson"
},{
"type" : "Patient",
"url" : "https://example.com/output/patient_file_2.ndjson"
},{
"type" : "Observation",
"url" : "https://example.com/output/observation_file_1.ndjson"
}],
"deleted": [{
"type" : "Bundle",
"url" : "https://example.com/output/del_file_1.ndjson"
}],
"error" : [{
"type" : "OperationOutcome",
"url" : "https://example.com/output/err_file_1.ndjson"
}],
"extension":{"https://example.com/extra-property": true}
}
Using the URLs supplied by the FHIR server in the Complete Status response body, a client MAY download the
generated Bulk Data files (one or more per resource type) within the time period specified in the
Expires
header (if present). If the requiresAccessToken
field in the Complete Status body
is set to true
, the request SHALL include a valid access token.
As long as servers are following relevant security guidance, they MAY choose to generate output manifests where
requiresAccessToken
is true or false; this applies even for servers available on the public internet.
When requiresAccessToken
is set to false
and no additional authorization-related
extensions are present on the completion manifest's output entry, then the output URLs SHALL be dereferenceable
directly, and SHALL be short lived following the expiration timing requirement that have been documented for bearer
tokens in the SMART Backend Services
Authorization Guide . In this case, a client MAY re-fetch the output manifest if output links have expired and
MAY use the Expires header on the output response, when present, as a hint to know when capability URLs will expire.
The output data SHALL include only the most recent version of any FHIR resources unless the client explicitly
requests different behavior in a fashion supported by the server (e.g., via a new query parameter yet to be
defined). Inclusion of the Resource.meta
information in the resources is at the discretion of the
server (as it is for all FHIR interactions).
References in the resources returned MAY be relative URLs with the format
resourceType
/id
, or MAY be absolute
URLs with the same structure rooted in the base URL for the server from which the asynchronous operation was performed.
Example NDJSON output file:
{"resourceType":"Patient","id":"5c41cecf-cf81-434f-9da7-e24e5a99dbc2","name":[{"given":["Brenda"],"family":["Jackson"]}],"gender":"female","birthDate":"1956-10-14T00:00:00.000Z"}
{"resourceType":"Patient","id":"3fabcb98-0995-447d-a03f-314d202b32f4","name":[{"given":["Bram"],"family":["Sandeep"]}],"gender":"male","birthDate":"1994-11-01T00:00:00.000Z"}
{"resourceType":"Patient","id":"945e5c7f-504b-43bd-9562-a2ef82c244b2","name":[{"given":["Sandy"],"family":["Hamlin"]}],"gender":"female","birthDate":"1988-01-24T00:00:00.000Z"}
Accept
(optional, defaults to application/fhir+ndjson
)Specifies the format of the file being requested.
200 OK
Content-Type
header that matches the file format being delivered. For files in ndjson format, SHALL
be application/fhir+ndjson
4XX
or 5XX
If resources in an output file contain elements of the type Attachment
, the server SHOULD populate the
Attachment.contentType
code as well as either the data
element or the url
element. When populated, the url
element SHALL be an absolute url that can be de-referenced to the
attachment’s content.
When the url
element is populated with an absolute URL and the requiresAccessToken
field
in the Complete Status body is set to true
, the url location must be accessible by a client with a
valid access token, and SHALL NOT require the use of additional authentication credentials. When the
url
element is populated and the requiresAccessToken
field in the Complete Status body is
set to false
and no additional authorization-related extensions are present on a the Complete Status
body's output entry, the url location SHALL be dereferenceable directly, and SHALL be short lived following the
expiration timing requirement that have been documented for bearer
tokens in the SMART Backend Services Authorization Guide .
Note that if a server copies files to the Bulk Data output endpoint or proxies requests to facilitate access from
this endpoint, it may need to modify the Attachment.url
element when generating the Bulk Data output
files.