FHIR R4 — The Production Standard
Required by the 21st Century Cures Act and most national health exchanges — the version your systems must support today.
Trusted by startups and global leaders
What the FHIR Landscape Looks Like Right Now
R4 is where you must be today, R5 where select use cases are moving, R6 on the horizon — plan for all three.
FHIR R5 — Forward-Looking Use Cases
55+ new resources for patient engagement and care coordination — valuable for specific subscription and medication use cases.
FHIR R6 — On the Horizon
Expected late 2026, with some teams moving R4 → R6 directly. We build in a migration path so R6 never forces a rebuild.
What We Build and Implement — Server-Side and Client-Side, R4 and R5
FHIR for health systems, payers, and digital health companies that need to connect to the modern healthcare data ecosystem.
A production R4 server on your data with correct profiles, search parameters, SMART on FHIR auth, and Bulk Data export.
A client layer that pulls and transforms data from Epic, Cerner, Athena and ABDM — with SMART launch flows and vendor handling.
Topic-based subscriptions, enhanced medication definitions and care-coordination resources — built with R6 migration awareness.
DSTU2 → R4, R4 → R5, or proprietary APIs → standards-based FHIR — handled without disrupting clinical workflows.
US Core, UK Core, AU Base, India ABDM, UAE, Saudi MOH — implemented to the national IG so your system interoperates in your market.
The Gap Between Having FHIR and Having FHIR That Actually Works
FHIR is well-specified, but implementation is still hard — this is where the real engineering decisions live.
Every EHR Vendor Implements FHIR Differently
Epic and Cerner are both FHIR R4, yet differ in resources, auth, profiles and extensions — code for one endpoint rarely works on another unchanged.
Legacy Data Does Not Map Cleanly
Older hospital data lives in terminologies that predate FHIR by decades — mapping it to FHIR without losing clinical meaning takes deep expertise.
Security and Consent Are Not Optional
FHIR endpoints need SMART on FHIR auth, scoped access control and consent management done right — done wrong, they are a breach waiting to happen.
Production Scale Is Not a Demo
A server handling 100 test queries behaves nothing like one at millions — indexing, bulk export and subscriptions break only under real production load.
What a Complete FHIR Implementation Includes
A FHIR server or client is more than an API — a production-ready build includes the parts that only matter once real systems integrate against you.
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Capability Statement & Search Parameters
Capability Statement & Search Parameters
Accurate capability statement for your supported profiles, plus correct search parameters for every resource.
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Pagination & Conditional Operations
Pagination & Conditional Operations
Correct pagination and conditional create/update/delete — no shortcuts.
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Subscriptions for Real-Time Events
Subscriptions for Real-Time Events
Push-based event notifications to connected systems — no polling required.
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Terminology, Provenance & Audit
Terminology, Provenance & Audit
Code validation against SNOMED-CT, LOINC, ICD-10, and RxNorm, with provenance and audit tracking.
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Conformance Testing & Monitoring
Conformance Testing & Monitoring
Conformance test suite plus monitoring that alerts you when a connected system breaks your integration.
Who This Is For
We build FHIR infrastructure for the organisations the modern healthcare data ecosystem runs on.
Health Systems & Hospitals
R4 endpoints for interoperability rules, national exchanges, SMART on FHIR app access, and payer data sharing.
Payers & Health Plans
FHIR-based member data APIs, patient access endpoints, and prior authorisation workflows that meet CMS rules.
Digital Health Companies
The client that connects your product to EHRs, national exchanges, and patient-held FHIR records.
Government Health Programmes
FHIR servers built to the national IG, at the scale and security national exchanges demand.
National Profiles & Standards — Implemented to the IG, Not Just Base FHIR
We implement to national IGs, plus the security, terminology and exchange standards compliance depends on.
National IGs
Regional Implementation Guides
The profile your market requires for national health-exchange interop.
Security
SMART on FHIR & Access Control
Full SMART framework: OAuth 2.0, scoped tokens, and consent management.
Terminology
Code Systems & Validation
Terminology services validate codes against clinical vocabularies.
Versions
FHIR Versions We Implement
R4 in production, targeted R5 adoption, R6 migration designed in.
Exchange
Networks & Bulk Data
National exchange connectivity and population-scale Bulk Data export.
Regulation
Regulatory Drivers
The mandates that make FHIR non-optional, implemented precisely.
The FHIR Stack We Build On
Production-proven FHIR servers and regulated-cloud infrastructure — chosen for what you connect to.
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HAPI FHIR
M
Microsoft FHIR Server
G
Google Cloud Healthcare API
A
AWS HealthLake
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Firely / Vonk
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HL7 FHIR R4
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HL7 FHIR R5
H
HL7 v2 & v3
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DICOM
C
CDA / C-CDA
B
Bulk Data Access
S
SMART on FHIR
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OAuth 2.0
S
Scoped Access Tokens
C
Consent Management
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AES-256 Encryption
S
SNOMED-CT
L
LOINC
I
ICD-10
R
RxNorm
T
TEFCA / QHIN
C
CommonWell
C
Carequality
D
Direct Trust
I
India ABDM
A
AWS GovCloud
A
Azure Health Data Services
D
Docker / Kubernetes
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Terraform
M
Monitoring & Alerting
The Healthcare Data Ecosystem Is FHIR. Your Integration Should Be Too.
R4 today, R5 where it matters, R6 on the horizon — book a consultation and we will scope a production-ready FHIR implementation for your systems.
Book a FHIR Consult
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Highly Rated on Trustpilot
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ASSOCHAM Member
Frequently Asked Questions
[ 1 ]
Should we implement R4, R5, or wait for R6?
R4 is the right choice for production today — it underpins the 21st Century Cures Act, TEFCA QHINs and ONC-certified EHRs. We layer R5 where it helps, designed with R6 migration in mind.
[ 2 ]
How do you handle variation between different vendors' FHIR implementations?
We maintain an integration library covering the profile variations of major EHR vendors — Epic, Cerner, Athena, Meditech. Your FHIR client is built against how they actually behave, not just the spec.
[ 3 ]
What does SMART on FHIR actually require to implement correctly?
SMART on FHIR is an OAuth 2.0 profile for healthcare — authorisation server, scoped access tokens, launch contexts and token refresh. We implement the full framework, not just the token exchange.
[ 4 ]
How long does a production FHIR implementation take?
A focused R4 server for one use case typically takes 8 to 12 weeks. Full infrastructure with bulk data export, SMART on FHIR and national profile conformance is a larger engagement, scoped during discovery.
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