An important concept for setting up a FHIR repository is defining the search parameters that will be indexed and made available for searching by the system.
Search parameters are essentially named paths within resources that are indexed by the system so that they can be used to find resources that match a given criteria.
For example, the FHIR specification defines the gender search parameter on the Patient resource, giving it a path of Patient.gender. This means that every time a new Patient resource is created – or an existing one is updated – the value found at the path Patient.gender will be indexed. Clients may then use a URL search parameter named gender to find resources with a given gender.
Once these parameters have been defined in your database, clients can use them to find matching resources:
GET [base]/Patient?gender=male
The FHIR specification defines a set of built-in parameters that are wide ranging and broadly useful. For example, the FHIR definition for the Patient resource contains search parameters such as:
name (Search for patient by name)birthdate (Search for patient by date of birth)identifier (Search for patient by identifier)For a general purpose repository, using the default search parameters is useful since these parameters represent a wide variety of use cases. Additionally, using the default parameters is good for interoperability since clients may expect standard parameters to be supported across different servers.
However, it is often useful to customize the supported search parameters. For example:
In a relational FHIR Storage module, each search parameter is represented by a SearchParameter resource in the database. When Smile CDR starts for the first time, the database will be preseeded with search parameter resources that correspond to the various default parameters.
If you want to customize the available search parameters, there are several ways to do so.
To configure search parameters in the Web Admin Console, log into the console then select "Config -> Search Parameters".
You will be presented with a list of all available search parameters. You can create new ones, update existing ones, and disable ones you do not need.
A new search parameter can also be created by simply uploading an appropriate SearchParameter resource. This is same process used to upload any other type of resource.
For example, POSTing the following resource to a server that supports custom search parameters will create a new search parameter on the Patient resource named eyecolour.
{
"resourceType": "SearchParameter",
"title": "Eye Colour",
"base": [ "Patient" ],
"status": "active",
"code": "eyecolour",
"type": "token",
"expression": "Patient.extension('http://acme.org/eyecolour')",
"xpathUsage": "normal"
}
Smile CDR gathers statistics at runtime about the actual values indexed by a search parameter for resources in the database and the use of that search parameter by clients.
The following statistics are gathered:
Patient.gender) will have a low value spread. A parameter that can contain many different values (e.g. Observation.value) could have a much higher value spread.Smile CDR can be configured to enable the FHIR _filter search parameter, using the filter_search.enabled property.
The filter search parameter is extremely powerful, as it allows a level of expressiveness in searches that is not possible with standard REST URL search parameters. It also potentially allows clients to perform searches for which no appropriate database indexes exist, making it a potentially dangerous operation for public servers. As such it is disabled by default.
Users of the Filter Search Parameter are advised to examine the generated SQL (e.g. by enabling Performance Tracing and then examining the Transaction Log) and ensuring that the database has indexes to appropriately support the queries being performed.
It is possible to trigger a manual reindexing of all data in the repository. This is generally done for one of the following reasons:
In cases where Search Parameters have been changed in some way and the Mark Resources for Reindexing After SearchParameter Change property is not enabled, a reindex may be required in order to force data that was created prior to SearchParameter changes to be indexed. This setting is disabled by default. When reindexing because of a SearchParameter change, it is a good idea to include the type parameter shown below.
If Enforce Referential Integrity on Write is not enabled, it is possible to create resources with references that are not valid at the time that the resource is created. In that case, the reference will not be indexed, even if the target resource is later created. A manual reindex is then required in order to correct this.
The following arguments are supported for this operation:
type &nash; (optional) If supplied, specifies the specific resource type to reindex. If not specified, all resource types will be reindexed.To perform a manual reindex, the following operation should be invoked at the server (root) level of the FHIR Endpoint module.
POST /$mark-all-resources-for-reindexing
POST /$mark-all-resources-for-reindexing?type=Patient