FHIR Readiness: 10 Common Gaps to Check Before You Integrate

Many systems say they support FHIR, but real integrations fail on edge cases. Use this checklist to find gaps early: auth, scopes, patient context, resource coverage, performance, and auditability.

Quick Summary

Readiness is not a checkbox. It is whether real SMART and FHIR flows work reliably with correct scopes, patient context, resource coverage, performance, and traceability. These ten checks catch most failures early.

The 10 checks

  1. OAuth flow correctness: authorization code flow works end to end, including state and nonce handling.
  2. Scope design: scopes match intended access and do not over grant or under grant.
  3. Patient context: patient launch works reliably and the patient identifier is stable.
  4. Resource coverage: the key resources you claim to support are present and usable (not empty shells).
  5. Search behavior: common search queries return correct results with consistent paging.
  6. Terminology consistency: codes, displays, and units are consistent across payloads.
  7. Provenance and timestamps: data includes capture time and source context where applicable.
  8. Error handling: failures are returned as valid OperationOutcome with actionable details.
  9. Performance: latency, rate limits, and paging performance work under real load.
  10. Auditability: access is logged, and you can trace which app accessed what data and when.

Why this checklist works

Most integrations fail in predictable places: scope mismatch, broken patient context, missing resources, inconsistent terminology, and performance cliffs. A readiness scan should surface these before you sign a rollout plan.

Where Aether fits

Aether can act as a read-only readiness scan layer. Hospitals and labs launch the scan, see pass and fail results, and get a gap report that translates to an implementation plan.

Sources and further reading

Information only. Not medical advice.

Next steps

  • Run the checklist against your real production-like environment.
  • Fix the top failures before adding more resource coverage.
  • Re-test after changes and keep audit logs as evidence.