Fire Arrow: FHIR Backend for EHDS-Ready Data Interoperability

Details

This article introduces 'Fire Arrow,' a FHIR-native backend designed for digital health teams aiming to comply with the European Electronic Health Record Exchange Format (EEHRxF). The EHDS framework establishes two regimes: primary use (cross-border access for patients/treatments) and secondary use (research/public health data utilization). Fire Arrow addresses both by maintaining a single database structure while implementing advanced security through role-based access control and property filtering. A key technical advantage is that projections into EEHRxF or exports of International Patient Summaries (IPS) can be handled via configuration changes, avoiding the complexity and auditability issues associated with traditional ETL data warehouse construction. The solution is built on FHIR R4 with European profiles layered on top. This allows for adaptation to new integration scopes (e.g., EHDS integration roles) without altering the core data structure. Furthermore, it supports OIDC integration for cross-border identity resolution and maintains a single audit log covering both domestic and international access. This technology is crucial for platforms exchanging data with national EHRs across EU countries, addressing market needs starting from 2025 as EHDS rolls out.