Firely Server supports most of the features in the FHIR RESTful API.

FHIR Versions

All the operations below can be called for FHIR STU3 or FHIR R4. Firely Server supports the fhirVersion mimetype parameter and fhir version endpoint mappings for that purpose. See Multiple versions of FHIR for more information.

Create, read, update, patch, delete

These five operations to manage the contents of the Firely Server, commonly referenced by the acronym CRUD, are implemented as per the specification. Patch is implemented as FHIR Patch, as this is the most versatile one. This includes version-read and the conditional variations. Only a few limitations apply.

Firely Server enables create-on-update: If you request an update and no resource exists for the given id, the provided resource will be created under the provided id.

Firely Server can reject a resource based on Validating incoming resources.


A conditional delete interaction may match multiple resources. You can configure the server to delete all matches, or reject the operation (effectively only allowing single matches to be deleted). Allowing multiple deletes requires support for transactions on the database (MongoDb, SQL Server or SQLite). If you allow for multiple deletes, you have to specify a maximum number of resources that can be deleted at once, to save you from accidentally deleting too many resources.

"FhirCapabilities": {
    "ConditionalDeleteOptions": {
        "ConditionalDeleteType": "Single", // Single or Multiple,
        "ConditionalDeleteMaxItems": 1

Limitations on CRUD

  1. Simultaneous conditional creates and updates are not entirely transactional safe:

    • Two conditional updates may both result in a create, although the result of one may be a match to the other.

    • Two conditional creates may both succeed, although the result of one may be a match to the other.

    • A conditional create and a simultaneous conditional update may both result in a create, although the result of one may be a match to the other.

  2. It is not possible to bring a resource that has earlier been deleted back to life with a conditional update while providing the logical id of the resource in the request payload. This operation will result in an HTTP 409 Conflict error. As a workaround, it is possible to create a new resource (with a new logical id) by omitting the id field in the payload.

  3. Parameter _pretty is not yet supported.

  4. XML Patch and JSON Patch are not supported.


Firely Server keeps a full version history of every resource, including the resources on the Firely Server Administration API.


History is supported as described in the specification, on the system, type and instance level. The _since and _count parameters are also supported.


"HistoryOptions": {
  "MaxReturnedResults": 100

If a _history call would result in more than MaxReturnedResults, Firely Server asks the user to be more specific. Use this to avoid overloading the server or the connection.

Limitations on history

  1. _at parameter is not yet supported.

  2. Paging is supported, but it is not isolated from intermediate changes to resources.


Batch is fully supported on the usual endpoint. You can limit the number of entries accepted in a single batch. See Batch and transaction.

Note that batches are not supported in the /administration endpoint.


Transactions are supported, but with the following limitation:

  1. The /administration endpoint does not support transactions.

You can limit the number of entries accepted in a single transaction. See Batch and transaction.


On the Capabilities interaction (<firely-server-endpoint>/metadata) Firely Server returns a CapabilityStatement that is built dynamically from the supported ResourceTypes, SearchParameters and interactions. E.g. if you Configure Search Parameters, the SearchParameters that are actually loaded appear in the CapabilityStatement.

Document endpoint

Firely Server supports submitting FHIR document bundles to the base endpoint of the server. The current version of Firely Server will only extract the unstructured part of the document, i.e. the narrative of the document bundle. The submission of the document will return a DocumentReference containing an attachment linking to a Binary resource containing the original narrative. Please note that only the top-level narrative will be extracted. No section narrative will be handled. Updates to narratives from documents with the same document identifier will result in an Update interaction on the DocumentReference.

Please make sure that Vonk.Plugin.DocumentHandling.DocumentHandlingConfiguration is enabled in the pipeline options to use this feature.

Not supported interactions

These interactions are not yet supported by Firely Server:

  1. HEAD

Besides that, Firely Server does not yet return the date header as specified in HTTP return values