#InterSystems IRIS for Health

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InterSystems IRIS for Health™ is the world’s first and only data platform engineered specifically for the rapid development of healthcare applications to manage the world’s most critical data. It includes powerful out-of-the-box features: transaction processing and analytics, an extensible healthcare data model, FHIR-based solution development, support for healthcare interoperability standards, and more. All enabling developers to realize value and build breakthrough applications, fast. Learn more.

Question TAZ.R · May 6, 2025

Hi everyone,

I’m new to this community and could really use some help with creating a production in InterSystems IRIS for Health Community 2024.3. I have deployed my instance using Docker.
Here’s what I’m trying to do:

  1. Input: I have an HL7 file that is processed by the standard EnsLib.HL7.Service.FileService.
  2. DTL Transformation: I’ve created a DTL to transform the HL7 content into a custom class like this:
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Question Scott Roth · Jun 4, 2025

Does anyone have a query that I could run to show a Vendor the time difference between when a message was sent out a BO, and when we received the HL7 ACK back that is associated with the message sent?

I am trying to prove to this vendor of the delay we are seeing getting the ACK back because of a Timeout

I know how to pull Ens.MessageHeader, and EnsLib.HL7.Message but not sure how to match up the Message with the HL7 Acknowledgement received.

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Question Scott Roth · Jun 1, 2025

I am attempting to failover my TEST environment to the Backup, and I keep getting an error stating that 

06/01/25-18:47:54:516 (11864) 1 [Utility.Event] Primary startup failed, failed to read header of /archive/journal/MIRROR-IRISTEST-20250513.007 (file #63653)

however, when I go to /archive/journal/, I am not finding any record of MIRROR-IRISTEST-20250513.007 (file #63653)

to get out of this error message I have to restart what was the Primary and restart the Backup to get it back into a state that we can use it. 

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Article Henry Pereira · May 29, 2025 6m read

image

You know that feeling when you get your blood test results and it all looks like Greek? That's the problem FHIRInsight is here to solve. It started with the idea that medical data shouldn't be scary or confusing – it should be something we can all use. Blood tests are incredibly common for checking our health, but let's be honest, understanding them is tough for most folks, and sometimes even for medical staff who don't specialize in lab work. FHIRInsight wants to make that whole process easier and the information more actionable.

FHIRInsight logo

🤖 Why We Built FHIRInsight

It all started with a simple but powerful question:

“Why is reading a blood test still so hard — even for doctors sometimes?”

If you’ve ever looked at a lab result, you’ve probably seen a wall of numbers, cryptic abbreviations, and a “reference range” that may or may not apply to your age, gender, or condition. It’s a diagnostic tool, sure — but without context, it becomes a guessing game. Even experienced healthcare professionals sometimes need to cross-reference guidelines, research papers, or specialist opinions to make sense of it all.

That’s where FHIRInsight steps in.

We didn’t build it just for patients — we built it for the people on the frontlines of care. For the doctors pulling back-to-back shifts, for the nurses catching subtle patterns in vitals, for every health worker trying to make the right call with limited time and lots of responsibility. Our goal is to make their jobs just a little bit easier — by turning dense, clinical FHIR data into something clear, useful, and grounded in real medical science. Something that speaks human.

FHIRInsight does more than just explain lab values. It also:

  • Provides contextual advice on whether a test result is mild, moderate, or severe
  • Suggests potential causes and differential diagnoses based on clinical signs
  • Recommends next steps — whether that’s follow-up tests, referrals, or urgent care
  • Leverages RAG (Retrieval-Augmented Generation) to pull in relevant scientific articles that support the analysis

Imagine a young doctor reviewing a patient’s anemia panel. Instead of Googling every abnormal value or digging through medical journals, they receive a report that not only summarizes the issue but cites recent studies or WHO guidelines that support the reasoning. That’s the power of combining AI and vector search over curated research.

And what about the patient?

They’re no longer left staring at a wall of numbers, wondering what something like “bilirubin 2.3 mg/dL” is supposed to mean — or whether they should be worried. Instead, they get a simple, thoughtful explanation. One that feels more like a conversation than a clinical report. Something they can actually understand — and bring into the discussion with their doctor, feeling more prepared and less anxious.

Because that’s what FHIRInsight is really about: turning medical complexity into clarity, and helping both healthcare professionals and patients make better, more confident decisions — together.

🔍 Under the Hood

Of course, all that simplicity on the surface is made possible by some powerful tech working quietly in the background.

Here’s what FHIRInsight is built on:

  • FHIR (Fast Healthcare Interoperability Resources) — This is the global standard for health data. It’s how we receive structured information like lab results, patient history, demographics, and encounters. FHIR is the language that medical systems speak — and we translate that language into something people can actually use.
  • Vector Search for RAG (Retrieval-Augmented Generation): FHIRInsight enhances its diagnostic reasoning by indexing scientific PDF papers and trusted URLs into a vector database using InterSystems IRIS native vector search. When a lab result looks ambiguous or nuanced, the system retrieves relevant content to support its recommendations — not from memory, but from real, up-to-date research.
  • Prompt Engineering for Medical Reasoning: We’ve fine-tuned our prompts to guide the LLM toward identifying a wide spectrum of blood-related conditions. Whether it’s iron deficiency anemia, coagulopathies, hormonal imbalances, or autoimmune triggers — the prompt guides the LLM through variations in symptoms, lab patterns, and possible causes.
  • LiteLLM Integration: A custom adapter routes requests to multiple LLM providers (OpenAI, Anthropic, Ollama, etc.) through a unified interface, enabling fallback, streaming, and model switching with ease.

All of this happens in a matter of seconds — turning raw lab values into explainable, actionable medical insight, whether you’re a doctor reviewing 30 patient charts or a patient trying to understand what your numbers mean.

🧩 Creating the LiteLLM Adapter: One Interface to Rule All Models

Behind the scenes, FHIRInsight’s AI-powered reporting is driven by LiteLLM — a brilliant abstraction layer that allows us to call over 100+ LLMs (OpenAI, Claude, Gemini, Ollama, etc.) through a single OpenAI-style interface.

But integrating LiteLLM into InterSystems IRIS required something more permanent and reusable than Python scripts tucked away in a Business Operation. So, we created our own LiteLLM Adapter.

Meet LiteLLMAdapter

This adapter class handles everything you’d expect from a robust LLM integration:

  • Accepts parameters like prompt, model, and temperature
  • Loads your environment variables (e.g., API keys) dynamically

To plug this into our interoperability production, we wrapped it in a dedicated Business Operation:

  • Handles production configuration via standard LLMModel setting
  • Integrates with the FHIRAnalyzer component for real-time report generation
  • Acts as a central “AI bridge” for any future components needing LLM access

Here’s the core flow simplified:

set response = ##class(dc.LLM.LiteLLMAdapter).CallLLM("Tell me about hemoglobin.", "openai/gpt-4o", 0.7)
write response

🧭 Conclusion

When we started building FHIRInsight, our mission was simple: make blood tests easier to understand — for everyone. Not just patients, but doctors, nurses, caregivers... anyone who’s ever stared at a lab result and thought, “Okay, but what does this actually mean?”

We’ve all been there.

By blending the structure of FHIR, the speed of InterSystems IRIS, the intelligence of LLMs, and the depth of real medical research through vector search, we created a tool that turns confusing numbers into meaningful stories. Stories that help people make smarter decisions about their health — and maybe even catch something early that would’ve gone unnoticed.

But FHIRInsight isn’t just about data. It’s about how we feel when we look at data. We want it to feel clear, supportive, and empowering. We want the experience to be... well, kind of like “vibecoding” healthcare — that sweet spot where smart code, good design, and human empathy come together.

We hope you’ll try it, break it, question it — and help us improve it.

Tell us what you’d like to see next. More conditions? More explainability? More personalization?

This is just the beginning — and we’d love for you to help shape what comes next.

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Article Chi Nguyen-Rettig · Jun 1, 2025 3m read

IRIS supports CCDA and FHIR transformations out-of-the-box, yet the ability to access and view those features requires considerable setup time and product knowledge. The IRIS Interop DevTools application was designed to bridge that gap, allowing implementers to immediately jump in and view the built-in transformation capabilities of the product. 

In addition to the IRIS XML, XPath, and CCDA Transformation environment, the Interop DevTools package now provides:

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Article Muhammad Waseem · May 28, 2025 4m read


Hi Community,
In this article, I will introduce my application iris-fhir-bridge 
IRIS-FHIR-Bridge is a robust interoperability engine built on InterSystems IRIS for Health, designed to transform healthcare data across multiple formats into FHIR and vice versa. It leverages the InterSystems FHIR Object Model (HS.FHIRModel.R4.*) to enable smooth data standardization and exchange across modern and legacy healthcare systems.

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Article Yuri Marx · May 29, 2025 8m read

Google Forms is the most popular solution on the market for collecting data, answering questionnaires and quizzes. So, it is the ideal solution for collecting patient data and responses in a practical way, without the need to expand or develop systems. In this article, I will detail how to create an account on Google Cloud, register the application that will consume the Google Forms API, generate the service user necessary to consume the API and finally perform actions to create new forms and collect data filled in them in an automated way in embedded Python and IRIS.

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Article Landon Minor · May 30, 2025 2m read

Profiling CCD Documents with LEAD North’s CCD Data Profiler
Ever opened a CCD and been greeted by a wall of tangled XML? You’re not alone. Despite being a core format for clinical data exchange, CCD's are notoriously dense, verbose, and unfriendly to the human eye. For developers and analysts trying to validate their structure or extract meaningful insights, navigating these documents can feel more like archaeology than engineering.

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Article Sylvain Guilbaud · May 30, 2025 3m read

Kong provides an open source configuration management tool (written in Go), called decK (which stands for declarative Kong)

  • Check that decK recognizes your Kong Gateway installation via deck gateway ping
deck gateway ping   
Successfully connected to Kong!
Kong version:  3.4.3.11
  • Export Kong Gateway configuration to a file named "kong.yaml" via deck gateway dump
deck gateway dump -o kong.yaml
  • After modifying the IP adcresses in kong.yaml file, show the differences via deck gateway diff
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Article Yuri Marx · May 29, 2025 4m read

Template engines are essential for producing customizable dynamic content, without the need for compilation and opening up great possibilities of extensibility for the template user. Especially if the template engine supports Python. A popular solution for template engine is Mko. It is is a template library written in Python. It provides a familiar, non-XML syntax which compiles into Python modules for maximum performance. Mako's syntax and API borrows from the best ideas of many others, including Django and Jinja2 templates, Cheetah, Myghty, and Genshi. Conceptually, Mako is an embedded

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Question Thembelani Mlalazi · May 29, 2025

I am trying to log in to the Web Gateway Management and I have missed placed the password to access the system I have tried 

changing the password under local settings in the CSP.ini  and that has managed to change the password to access the gateway but cannot log me into the management area I have followed a post here and read here and I seem not to get the answers that actual explain how I can get to the web gateway management.

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Article Laura Blázquez García · May 23, 2025 1m read

 

Let me introduce you to FHIRCraft, a lightweight tool to generate synthetic FHIR resources.

Now, you might be thinking:
“But wait — doesn’t Synthea already do that, and with tons of resources?”
Exactly — and that’s precisely why I created this app.

FHIRCraft is designed to generate simpler, smaller, and more focused FHIR resources. Unlike Synthea, it doesn’t aim to simulate entire patient histories or clinical workflows. Instead, it helps when you’re just getting started with FHIR — when you want to test things incrementally, or explore how specific resources behave in isolation.

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InterSystems Official Bob Kuszewski · May 21, 2025

We have a big update this quarter. 

  • RHEL 10 was released yesterday, read on for what that means for you
  • 2025.3 will use OpenSSL 3 across all operating systems SUSE 15 sp6 will be the minimum OS for orgs using SUSE
  • The minimum CPU standards are going up in 2025.3
  • Older Windows Server operating systems will no longer be supported in 2025.3
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Article Kate Lau · May 28, 2025 6m read

Hi everyone,

It's me again😁. As usual I would like to share something I study recently, and today, I would like to share about the document DB😁.

1st of all, let's go to the documentation https://docs.intersystems.com/irislatest/csp/docbook/DocBook.UI.Page.cls?KEY=GDOCDB_intro
Well, I must say, this one is much better to follow than the others, which I read before. 😭 Finally😭😭

Ok, let's start walking through it together

Here we go😀, we start a terminal from VSCode to connect to our IRIS

We are going to created Document DB demo.docpatient
 

1.1 Check the Document DB exist or not

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Question Feng Wang · Apr 25, 2025

hey everyone,

we are new to InterSystems health share, we are running health connect in a cluster with primary, backup and dr nodes.

we kept noticing that web applications definitions aren't showing in the backup or dr node.

is that normail? would they show up after failover to backup node or cutover to dr node?

thanks

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Article Theo Stolker · May 23, 2025 2m read

After we rolled out a new cointainer based on containers.intersystems.com/intersystems/irishealth:2023.1 this week, we suddenly noticed that our FHIR Repository started responding with an Error 500. This turns out to be caused by PROTECT violations on the new HSSYSLOCALTEMP namespace and database used by this version of the IRIS for Health FHIR components.

The trick to solve that is to add the "%DB_HSSYSLOCALTEMP" to the Web Application(s) that handle FHIR Requests. You can script that by running the following Class method in the namespace(s) that define these Web Applications:

do ##class(HS.HealthConnect.FHIRServer.Upgrade.MethodsV6).AddLOCALTEMPRoleToCSP()

In our case that was not enough. In some of our custom code we actually need access to the jwt Bearer token as sent by the client, which we could fetch from the AdditionalInfo "USER:OAuthToken" element, which is no longer present in the 2023.6.1.809 build as described in https://docs.intersystems.com/upgrade/results?product=ifh&versionFrom=2023.1.0&versionTo=2023.1.6&categories=Business%20Intelligence,Cloud,Core,Development%20Tools,Driver%20Technologies,Embedded%20Python,External%20Languages,FHIR,Healthcare%20Interoperability,Interoperability,Machine%20Learning,Mirroring,Monitoring,Natural%20Language%20Processing,SQL,Security,Sharding,Web%20Applications&audience=All&changes=121

We worked around that issue by the adding the following logic to fetch the token from the token cache:

	$$$ThrowOnError(##class(HS.HC.Util.InfoCache).GetTokenInfo(pInteropRequest.Request.AdditionalInfo.GetAt("USER:TokenId"), .pTokenInfo))
	set OAuthToken = pTokenInfo("token_string")
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Question Edmara Francisco · Feb 14, 2025

Hello, community!

I am working on implementing OAuth 2.0 authentication in InterSystems IRIS and need to correctly define a CSRF token that will be validated by OAuth.Response. However, I am having trouble finding a clear method to configure the CSRF token correctly.

So far, I have tried:

  • Setting the CSRF token in the request header.
  • Inserting the CSRF token via InsertCookie.

Despite these attempts, I haven’t been successful. On the OAuth.Response page, the CSRF token is empty, and I get the error message “Invalid CSRF token” because the csrfToken is empty.

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Question Mark OReilly · Oct 25, 2024

We have a scenario where we use the best practice article of a BP and DTL to split up HL7 messages mainly ORUS 

https://community.intersystems.com/post/splitting-oru-messages-using-ob…

It is really useful but we have this code in many places that we are trying to consolidate it in one place. 

We do not want to split it at the first stage in our rules as there is a lot of messages that go to sink. So we are trying for specific rules and the incoming hl7 matches certain rules and classified for certain downstream systems that it is then split and transformed. 

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