By Paul Bastide | Published April 4, 2021

The $everything operation

In IBM FHIR Server 4.7.0, the IBM FHIR Server team turned on the Patient/$everything operation. We have this feature thanks to external contributor and an IBMer, Luis García who implemented the operation in #1044.

So what do you get with Patient/$everything? Well, following the HL7 FHIR R4 specification, you get an operation that returns a “searchset” bundle with the information related to a patient in the context it is invoked. In the IBM FHIR Server’s case, the server returns whatever resources are related to the Patient - e.g. practitioners, medications, locations, organizations etc. You also get support for Patient/[id]/$everything where the [ID] is the logical id specific to a patient.

Let’s build a request and see it in action:

We need to know about the parameters of the $everything operation.

Name	Type	Description
`start`	date	The date range relates to care dates, not record currency dates - e.g. all records relating to care provided in a certain date range. If no start date is provided, all records prior to the end date are in scope.
`end`	date	The date range relates to care dates, not record currency dates - e.g. all records relating to care provided in a certain date range. If no end date is provided, all records subsequent to the start date are in scope.
`_since`	date	Resources updated after this period will be included in the response. The intent of this parameter is to allow a client to request only records that have changed since the last request, based on either the return header time, or or (for asynchronous use), the transaction time
`_type`	code	One or more parameters, each containing one or more comma-delimited FHIR resource types to include in the return resources. In the absence of any specified types, the server returns all resource types
`return`	Bundle	The bundle is “searchset”

Note, currently the implementation ignores the _count parameter.

Now, let’s prepopulate some sample data on the server using the Integration Test data.

Download the Sample Data

curl -L https://raw.githubusercontent.com/IBM/FHIR/main/fhir-server-test/src/test/resources/testdata/everything-operation/Antonia30_Acosta403.json -o Antonia30_Acosta403.json

Load the Sample Data bundle to the IBM FHIR Server

curl -k --location --request POST 'https://localhost:9443/fhir-server/api/v4' \
    --header 'Content-Type: application/fhir+json' \
    --user "fhiruser:${DUMMY_PASSWORD}" \
    --data-binary  "@Antonia30_Acosta403.json" -o response.json

Scan the response.json for any status that is not "status": "201". For example, the status is in the family of User Request Error or Server Side Error.
Check the response.json and find the id for Patient (it should be the first one).

        {
            "response": {
                "id": "178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003",
                "status": "201",
                "location": "Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/_history/1",
                "etag": "W/\"1\"",
                "lastModified": "2021-04-21T13:34:50.207684Z"
            }
        },

Check the Patient/[id]/$everything

Request *

curl -k --location --request GET 'https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/$everything' \
    --header 'Content-Type: application/fhir+json' \
    --user "fhiruser:${DUMMY_PASSWORD}" \

Response *

{
    "resourceType": "Bundle",
    "id": "689856f9-6ef6-4d74-8f77-a813ff7b1c6d",
    "type": "searchset",
    "total": 895,
    "entry": [
        {
            "fullUrl": "https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003",
            "resource": {

Check the Patient/[id]/$everything with a _type constraint and _since.

Request *

curl -k --location --request GET 'https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/$everything?_type=CarePlan,CareTeam&_since=2021-01-01T00:00:00Z&_count=1' \
    --header 'Content-Type: application/fhir+json' \
    --user "fhiruser:${DUMMY_PASSWORD}" -o care.json

Response *

{
    "resourceType": "Bundle",
    "id": "689856f9-6ef6-4d74-8f77-a813ff7b1c6d",
    "type": "searchset",
    "total": 11,
    "entry": [
        {
            "fullUrl": "https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003",
            "resource": {

You’ll see further down CareTeam and CarePlan resources…

This is where we can have a bit of fun… download the fhir-path-cli

curl -L https://github.com/LinuxForHealth/FHIR/releases/download/4.7.0/fhir-path-4.7.0-cli.jar -o fhir-path-4.7.0-cli.jar

Let’s run the fhir-path-4.7.0-cli.jar and test a FHIRPath.

Command Line

java -jar fhir-path-4.7.0-cli.jar --path 'entry.fullUrl' --file care.json

Output

https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003
https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/CarePlan/178f4a3f86a-1a9a1d73-4d1d-46d5-8494-339dddbfe9d2
https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/CarePlan/178f4a3f86b-06c07a6c-3be7-4e6a-abb2-040ff67c8c1f
https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/CarePlan/178f4a3f873-d8069835-938e-45b1-9a70-5aba3794f6f3
https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/CarePlan/178f4a3f87c-ce204596-8037-416c-b2e0-fc7442d9a276
https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/CarePlan/178f4a3f87c-46785bc7-807a-40e0-bc08-792977ac8ec8
https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/CareTeam/178f4a3f86a-b79251c3-5019-426e-8211-748adbdfdf54
https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/CareTeam/178f4a3f86b-22a7baab-77b3-4fb5-b318-9249ea80ec85
https://localhost:9443/fhir-server/api/v4/Patient/178f4a3f869-6abfe1e6-3a4a-4c9a-81a8-fb8c6263e003/CareTeam/178f4a3f873-e370fba2-f45e-4cdd-b13b-781e249f84f8

You’ve seen a brief introduction to fhir-operation-everything and a bonus fhir-path-cli showing the output.

Note, DUMMY_PASSWORD should be replaced with or set as a value when the corresponding curl steps are executed.

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The $everything operation