FHIR Documents vs. APIs: Two Approaches for Interoperability
FHIR Documents vs FHIR APIs - SanteNet
Summary
In data exchange, using 'FHIR Documents' is recommended when a complete clinical context is needed, while utilizing 'FHIR APIs' is necessary for accessing specific, real-time operational data. Since the two have different purposes and technical characteristics, proper differentiation of use is required.
Details
Achieving high quality in data exchange requires considering more than just moving information. This article explains two primary approaches to interoperability: 'FHIR Documents' and 'FHIR APIs'. FHIR Documents are suitable for exchanging a complete and auditable clinical snapshot (e.g., a Bundle containing Composition), such as discharge summaries or referral packages, proving valuable when comprehensive records are needed during care transitions. Conversely, FHIR APIs enable granular access to specific resources—such as the latest lab values, active medications, or appointment statuses—through RESTful endpoints. For instance, data retrieval can be performed using specific search queries like `/Observation` or `/MedicationRequest`. In practice, combining both approaches is most powerful; for example, a hospital might exchange a discharge summary (Document) while simultaneously retrieving real-time lab results and vital signs (API) from connected applications. Implementation requires applying security standards like OAuth2 and SMART on FHIR, alongside ensuring alignment between technical design and legal/clinical governance.
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