Are FHIR Subscriptions supported?

Question

Are FHIR Subscriptions supported?

Chris Stephens 0

We are exploring the use of the Subscription resource within our FHIR instance, and whilst we can create Subscription resources, we are unsure if the feature is fully implemented as they do not appear to generate any action.

Sai Prabhu Naveen Parimi 3,960 Reputation points Microsoft External Staff Moderator

2025-07-02T13:26:34.94+00:00
@Chris Stephens

Thank you for reaching out!!

It seems you're exploring the Subscription resource in your FHIR instance and have some questions about how it's implemented. Subscription resources in FHIR are designed to notify you about changes in specific data but getting them to work correctly—particularly regarding the actions they trigger—can sometimes be challenging.

Here's what you should know:

Subscription Setup: When you create a Subscription resource, it should define the criteria for the notifications you want to receive. Ensure that you're specifying the correct parameters, such as the criteria, channel, and status.

Implementation Status: FHIR subscriptions can have varying support levels depending on the specific implementation of the FHIR server you are using. The Azure API for FHIR supports FHIR R4, which includes Subscription capabilities. However, some features might not be fully implemented. It's always a good idea to check the Azure API for FHIR FAQ for the most current capabilities.

Testing Subscriptions: If you find that subscriptions aren’t generating actions, you might want to test them with different criteria or check for any errors in your setup. Look at the logs, if accessible, to identify any potential issues.

Notification Delivery: Ensure that the channel (like a webhook or an email endpoint) you’ve configured for the Subscription is functioning correctly. If the action defined in the subscription cannot reach its destination, it will appear as if nothing is happening.
Sai Prabhu Naveen Parimi 3,960 Reputation points Microsoft External Staff Moderator

2025-07-04T16:03:30.27+00:00

@Chris Stephens

Just checking in to see if you've had a chance to review my previous response. Let me know if you have any additional questions.
Chris Stephens 0 Reputation points

2025-07-07T14:52:53.7066667+00:00

Thanks for the replies. It looks like Subscriptions are not fully implemented in Azure Health Services. We created a Hapi FHIR instance and once configured the subscriptions behaved as expected but we could not replicate this using the Azure FHIR service.

It would be useful to know if there is a roadmap of any planned updates for the service.

2 answers

Your answer

Sai Prabhu Naveen Parimi 3,960 Reputation points Microsoft External Staff Moderator

2025-07-02T13:26:34.94+00:00

@Chris Stephens

Thank you for reaching out!!

It seems you're exploring the Subscription resource in your FHIR instance and have some questions about how it's implemented. Subscription resources in FHIR are designed to notify you about changes in specific data but getting them to work correctly—particularly regarding the actions they trigger—can sometimes be challenging.

Here's what you should know:

Subscription Setup: When you create a Subscription resource, it should define the criteria for the notifications you want to receive. Ensure that you're specifying the correct parameters, such as the criteria, channel, and status.

Implementation Status: FHIR subscriptions can have varying support levels depending on the specific implementation of the FHIR server you are using. The Azure API for FHIR supports FHIR R4, which includes Subscription capabilities. However, some features might not be fully implemented. It's always a good idea to check the Azure API for FHIR FAQ for the most current capabilities.

Testing Subscriptions: If you find that subscriptions aren’t generating actions, you might want to test them with different criteria or check for any errors in your setup. Look at the logs, if accessible, to identify any potential issues.

Notification Delivery: Ensure that the channel (like a webhook or an email endpoint) you’ve configured for the Subscription is functioning correctly. If the action defined in the subscription cannot reach its destination, it will appear as if nothing is happening.
Sai Prabhu Naveen Parimi 3,960 Reputation points Microsoft External Staff Moderator

2025-07-04T16:03:30.27+00:00

@Chris Stephens

Just checking in to see if you've had a chance to review my previous response. Let me know if you have any additional questions.
Chris Stephens 0 Reputation points

2025-07-07T14:52:53.7066667+00:00

Thanks for the replies. It looks like Subscriptions are not fully implemented in Azure Health Services. We created a Hapi FHIR instance and once configured the subscriptions behaved as expected but we could not replicate this using the Azure FHIR service.

It would be useful to know if there is a roadmap of any planned updates for the service.

Answer 1

Chris Stephens 0

After failing to get Subscriptions working, we ended up using Azure Health Data Service 'Events' in conjunction with our Azure Service Bus and Function Apps.

https://dori-uw-1.kuma-moon.com/en-us/azure/healthcare-apis/events/

Answer 2

@Chris Stephens

Glad to hear you found a working solution using Azure Health Data Services Events with Service Bus and Function Apps — that’s a great workaround and will definitely be helpful for others exploring Near-Real-Time data processing.

Since native FHIR Subscriptions aren't fully implemented yet, I’d also recommend submitting a feature request at https://feedback.azure.com. The product team actively reviews customer feedback, and this could help prioritize support for Subscriptions in the future.

Please do not forget to click "Accept the answer”, this can be beneficial to other community members.

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Are FHIR Subscriptions supported?

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