FHIRsmith - FHIR Server toolkit

This server provides a set of server-side services that are useful for the FHIR Community. The set of are two kinds of services:

Modules useful to anyone in the community

• (Coming) R4/R6 interconverter
• terminology server (as running on tx.fhir.org)
• SHL Server - SHL/VHL support services (running on healthintersections.com.au, supporting the ICVP demo and and the Patient Document Generator)

Services useful the community as a whole

• TX Registry - Terminology System Registry as described by the terminology ecosystem specification (as running at http://tx.fhir.org/tx-reg)
• Package server - NPM-style FHIR package registry with search, versioning, and downloads, consistent with the FHIR NPM Specification (as running at http://packages2.fhir.org/packages)
• XIG server - Comprehensive FHIR IG analytics with resource breakdowns by version, authority, and realm (as running at http://packages2.fhir.org/packages)
• Publisher - FHIR publishing services (as running at healthintersections.com.au)
• VCL - Parse VCL expressions into FHIR ValueSet resources (as running at http://fhir.org/vcl)
• (Coming) Token services

Summary Statement

• Maintainers: Grahame Grieve, Italo Macêdo, Josh Mandel, Jose Costa Teixeira
• Issues / Discussion: Use github issues
• License: BSD-3
• Contribution Policy: Make PRs. PRs have to pass all the tests
• Security Information: See security.md

Build Status

Note: In production, this server always runs behind an nginx reverse proxy, so there's no in-build support for SSL, rate limiting etc.

Quick Start

There are 4 executable programs:

• the server (node server)
• the terminology importer (node --max-old-space-size=8192 tx/importers/tx-import XXX) - see Doco
• the test cases (npm test)
• the test cases generater (node tx/tests/testcases-generator.js)

Unless you're developing, you only need the first two

FHIRsmith is open source - see below, and you're welcome to use it for any kind of use. Note, though, that if you support FHIRsmith commercially as part of a managed service or product, you are required to be a Commercial Partner of HL7 - see (link to be provided).

Quick Start

• Install FHIRSmith (using docker, or an NPM release, or just get the code by git)
• Figure out the data directory
• Provide a configuration to tell the server what to run (see documentation below, or use a [prebuilt configuration]/configurations/readme.md)
• Run the server

For further details of these steps, read on

Data Directory

The server separates code from runtime data. All databases, caches, logs, and downloaded files are stored in a single data directory. The location is determined by:

1. The FHIRSMITH_DATA_DIR environment variable (if set)
2. Otherwise, defaults to ./data relative to the working directory (development set up)

The data directory contains (depending on which modules are in use):

• config.json — server and module configuration
• logs/ — server and nginx log files
• terminology-cache/ — downloaded terminology packages and FHIR packages
• packages/ — package server database
• xig/ — XIG database
• shl/ — SHL databases and certificates
• registry/ — registry crawler data
• publisher/ — publisher database and build workspace
• token/ — token database

During development with a cloned repository, the data directory defaults to [root]/data (the test cases require this setup). When deployed via Docker or npm, the data directory is provided by the host — see Deployment below.

Prerequisites

• Node.js 16+
• NPM or Yarn
• Java 17+ (for FHIR validator, also for the test cases)

Installation

These instructions are for Development. For deployment, see below.

# Clone the repository
git clone https://github.com/HealthIntersections/FHIRsmith
cd FHIRsmith
# Install dependencies
npm install
# Create required directories
mkdir -p data data/logs
# Copy example configuration
cp config.example.json data/config.json
# Edit configuration as needed
nano data/config.json

Each Module has it's own entry in the config, as described by the module

Basic Configuration

Create a config.json file in your data directory (use config-template.json as a starting point):

{
"hostName" : "[descriptive name for the server]",
"server": {
"port": 3000,
"cors": {
"origin": "*",
"credentials": true
}
},
"modules": {
// per modules...
}
}

Logging Configuration

Add a logging section to config.json to control log behaviour. All fields are optional and have sensible defaults:

{
"logging": {
"level": "info",
"console": true,
"consoleErrors": false,
"maxFiles": 14,
"maxSize": "50m",
"flushInterval": 2000,
"flushSize": 200
}
}

Option	Default	Description
level	"info"	Minimum level to log: error, warn, info, debug, or verbose
console	true	Write log lines to stdout/stderr. Disable when running as a systemd service where console output goes to the journal and is redundant
consoleErrors	false	Whether error and warn levels appear on the console. When false, errors and warnings are written to the log file only
maxFiles	14	Number of daily log files to retain before old ones are deleted
maxSize	0 (unlimited)	Maximum size per log file before rotation. Accepts human-readable strings: "20m", "1g", or a raw byte count
flushInterval	2000	Milliseconds between buffered writes to disk. Increase to reduce I/O under heavy load
flushSize	200	Number of buffered log lines that trigger an immediate flush regardless of the timer

Log files are written to the logs/ subdirectory of the data directory as server-YYYY-MM-DD.log. A server.log symlink always points to the current day's file, so tail -f data/logs/server.log tracks the active log without needing to know the date.

Start the Server

# Development mode
npm run dev
# Production mode
npm start

The server will be available at http://localhost:{port} using the port specified in the config. In the production servers listed above, the server always sits behind an NGINX server which manages SSL, security, rate limiting etc.

Testing

npm test

Deployment

There are three deployment options: npm global install, Docker, or clone-and-run. All three use the FHIRSMITH_DATA_DIR environment variable to locate the data directory.

npm Global Install

# Install globally
npm install -g fhirsmith
# Create a data directory
mkdir -p /var/lib/fhirsmith
cp node_modules/fhirsmith/config-template.json /var/lib/fhirsmith/config.json
# Edit config.json as needed# Set the data directory and runexport FHIRSMITH_DATA_DIR=/var/lib/fhirsmith
fhirsmith

Or run it inline:

FHIRSMITH_DATA_DIR=/var/lib/fhirsmith fhirsmith

Docker Installation

The server is available as a Docker image. Mount a host directory as the data directory:

# Pull the latest image
docker pull ghcr.io/healthintersections/fhirsmith:latest
# Create and populate data directory on host
mkdir -p /path/to/data
cp config-template.json /path/to/data/config.json
# Edit config.json as needed# Run with data directory mounted
docker run -d --name fhirsmith \
-p 3000:3000 \
-e FHIRSMITH_DATA_DIR=/app/data \
-v /path/to/data:/app/data \
ghcr.io/healthintersections/fhirsmith:latest

Available tags:

• latest: Latest stable release
• vX.Y.Z: Specific version (e.g., v1.0.0)
• cibuild: Latest build from the main branch

Environment Variables

Variable	Description	Default
FHIRSMITH_DATA_DIR	Path to the data directory	./data
PORT	Server port (overrides config)	from config.json
NODE_ENV	Node environment	production

Windows Installation

You can install as a windows service using windows-install.js. You might need to hack that.

Releases

This project follows Semantic Versioning and uses a CHANGELOG.md file to track changes.

What's in a Release

Each GitHub Release includes:

• Release notes extracted from CHANGELOG.md
• Source code archives (zip and tar.gz)
• Docker images pushed to GitHub Container Registry:
  • ghcr.io/healthintersections/fhirsmith:latest
  • ghcr.io/healthintersections/fhirsmith:vX.Y.Z
  • ghcr.io/healthintersections/fhirsmith:X.Y.Z
• npm package published to npmjs.org as fhirsmith(if you add this)

Creating a Release

GitHub Actions will automatically:

• Run tests
• Create a GitHub Release with notes from CHANGELOG.md
• Build and publish Docker images with appropriate tags

Prerequisites:

• All tests passing on main branch
• CHANGELOG.md updated with changes

Steps:

1. Update CHANGELOG.md with your changes under a new version section:

 ## [vX.Y.Z] - YYYY-MM-DD### Added- New feature description
### Changed- Change description
### Fixed- Bug fix description
### Tx Conformance Statement {copy content from text-cases-summary.txt}

2. Update package.json & package-lock.json to have the same release version

3. Commit your changes:

 git commit -m "Prepare release vX.Y.Z"
git push origin main:XXXXXX

or do it via a PR

4. Tag and push the release:

 git tag vX.Y.Z
git push origin vX.Y.Z

5. Monitor the release:

   • Check GitHub Actions for the Release workflow
   • Verify the GitHub Release was created
   • Confirm Docker images are available at GHCR

6. Update package.json to have the next release version -SNAPSHOT

If a release fails:

• Delete the tag: git tag -d vX.Y.Z && git push origin :refs/tags/vX.Y.Z
• Fix the issue
• Re-tag and push

Creating a Release

License

BSD-3

Contributing

1. Fork the repository
2. Create a feature branch
3. Make your changes
4. Add tests if applicable
5. Submit a pull request

Support

• Issues:GitHub Issues
• Documentation:Wiki
• FHIR Community:chat.fhir.org