SQL on FHIR - Tabular views of FHIR data using FHIRPath

Challenges exist with the adoption of Fast Healthcare Interoperability Resources (FHIR) within analytics, including the difficulty in transforming complex data structures, and performance issues when querying large datasets in their native JSON or XML formats. In 2023, an international working group began work on a solution to this problem that would be easier to implement than existing approaches. Over the course of 18 months, the group authored a new specification and validated it through the development and testing of multiple independent implementations. The outcome of this work is a standard, implementation-agnostic method for defining views that produce tabular data from FHIR resources. SQL on FHIR view definitions can be written to cover common use cases and can be executed across a variety of technology platforms. We evaluate the feasibility of this approach by replicating findings from an existing study across multiple view runner and database implementations, demonstrating portability and consistency.

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Publication Details

Journal
npj Digital Medicine
Published
2025-06-09
DOI
https://doi.org/10.1038/s41746-025-01708-w
Citations
3
Primary Topic
Electronic Health Records Systems
Type
article
Field-Weighted Citation Impact
8.81
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article

SQL on FHIR - Tabular views of FHIR data using FHIRPath

Joshua C. Mandel, Grahame Grieve, Piotr Szul, Bashir Sadjad et al.
3 citations
npj Digital Medicine
Electronic Health Records Systems
8.81
article

SQL on FHIR - Tabular views of FHIR data using FHIRPath

Joshua C. Mandel, Grahame Grieve, Piotr Szul, Bashir Sadjad, Arjun Sanyal, John Grimes, D. M. Gottlieb, Ryan Brush, Nikolai Rhyzhikov
article en
3 citations

Abstract

Challenges exist with the adoption of Fast Healthcare Interoperability Resources (FHIR) within analytics, including the difficulty in transforming complex data structures, and performance issues when querying large datasets in their native JSON or XML formats. In 2023, an international working group began work on a solution to this problem that would be easier to implement than existing approaches. Over the course of 18 months, the group authored a new specification and validated it through the development and testing of multiple independent implementations. The outcome of this work is a standard, implementation-agnostic method for defining views that produce tabular data from FHIR resources. SQL on FHIR view definitions can be written to cover common use cases and can be executed across a variety of technology platforms. We evaluate the feasibility of this approach by replicating findings from an existing study across multiple view runner and database implementations, demonstrating portability and consistency.

npj Digital MedicineVol. 8(1)
Microsoft (United States) (US), Google (United States) (US), Harvard University (US), Antelope Valley College (US), Intersect (AU), National Statistical Institute of Portugal (PT), Clinical Solutions (US), Australian e-Health Research Centre (AU), CSIRO Health and Biosecurity (AU), Google (Canada) (CA)
Partnerships for the goals
Openalex Percentile: Top 3%
Electronic Health Records Systems
8.81
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SQL on FHIR - Tabular views of FHIR data using FHIRPath — Joshua C. Mandel, Grahame Grieve, et al. · npj Digital Medicine (2025) | TGRS Research Map | TGRS