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Given a list of clinics, all having their own FHIR server, we can suppose a system registry containing all the Endpoints as explained here https://www.hl7.org/fhir/managing.html.

1: How do you authenticate and authorize an actor(a clinic) that wants to query over all the servers from the system registry?

2: What if a patient wants to query his data from multiple servers?

Chris
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1 Answers1

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  1. You can't, necessarily. It would depend on the scope of the registry and whether the different endpoints had a shared authentication protocol/service. It's certainly possible for someone to have a registry where all of the end-points did share a common authorization service and even single-sign-on, but it's not something that can be presumed without prior agreement/knowledge of that server/community

  2. Unless one of the servers performs an aggregation function or synchronizes data from the other servers, the only choice is to query each server. This could theoretically be done in parallel. However, it may be desirable/necessary to detect duplicate records from different result sets and filter/merge the results.

Lloyd McKenzie
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  • Thank you for the responses. Who would be responsible to aggregate all the servers and provide a common authorization service? More exactly who could have the authority to do that? An NGO, a medical association, the government or anybody who wants to do it and have enough support? Do you know any real example? One of the FHIR strengths is interoperability, but I don't see how is it possible if you don't make all the servers communicate, at least at city or regional level. – Chris Oct 10 '19 at 11:19
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    The business models to do that will vary by country. Some jurisdictions have regional health registries. Some countries have national ones. Some organizations can set up facades to the external world that hide multiple servers internally. FHIR is an interoperability standard. It doesn't make real-world governance and data ownership issues go away :( – Lloyd McKenzie Oct 10 '19 at 15:00