Smile CDR v2022.08.PRE
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39.0Amazon HealthLake Export
Experimental

 

Amazon HealthLake is a HIPAA-eligible service offering healthcare and life sciences companies a complete view of individual or patient population health data for query and analytics at scale.

When Smile CDR is deployed on AWS, the Amazon HealthLake Export module can be used to automatically populate HealthLake with data from the FHIR repository.

Exporting data to HealthLake uses a special FHIR Subscription in order to track resources as they are created and changed in the repository and replicate these events to HealthLake.

The following diagram shows the overall architecture:

Architecture

39.0.1Subscription
Experimental

 

In order to trigger delivery to HealthLake, a Subscription resource must be created in the FHIR Storage module that references the Amazon HealthLake Export module. This Subscription can use any valid criteria in order to determine which data will be exported. Multi-Type Criteria may be helpful in order to propagate all resources of one or more resource types.

Note that unlike a standard FHIR Subscription, DELETE events are also replicated, meaning that if a resource is deleted in Smile CDR, a delete operation for the resource will be sent to HealthLake.

Automatically Creating the Subscription

By setting the Auto-Manage Subscription Resource to true, the HealthLake Export module will automatically create a Subscription in the FHIR Storage module upon startup. This Subscription will use the criteria specified in Auto-Managed Subscription Criteria.

This subscription will be automatically created with a client-assigned ID matching the HealthLake Export module ID (any _ characters in the module ID will be replaced by - in the Subscription ID due to FHIR limitations in the allowable characters in resource ID).

Letting the export module manage its own Subscription is generally the easiest option.

Manually Creating the Subscription

The following example shows a Subscription for triggering the HealthLake Export module. Note that:

  • The criteria may be adjusted to match your requirements
  • The Amazon HealthLake Export module ID must be specified in the second extension (replacing the string "healthlake_delivery")

It is possible to create multiple subscriptions to the same export module, although care must be taken to avoid having overlapping criteria (this may result in the same resource being delivered twice).

{
  "resourceType": "Subscription",
  "id": "healthlake-subscription",
  "status": "requested",
  "criteria": "[*]",
  "channel": {
    "extension": [ {
      "url": "https://smilecdr.com/fhir/ns/StructureDefinition/subscription-channel-rest-delivery-class",
      "valueString": "ca.cdr.awshl.out.deliverer.OutboundAwsHealthlakeSubscriptionDeliverer"
    }, {
      "url": "https://smilecdr.com/fhir/ns/StructureDefinition/subscription-channel-awshealthlake-sender-module-id",
      "valueString": "healthlake_delivery"
    } ],
    "type": "rest-hook"
  }
}