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Payer-side FHIR architecture: Da Vinci IG adoption, analytics stacks, and payer platform engineering notes.

  • Terminology server
  • Medical form builder
  • Master patient index
Editorial illustration in bauhaus-grid style depicting version-specific vs current-version references with a highlighted retention window
    • Reference Resolver

Version-Specific References: When You Need Them, When You Don't

A FHIR reference can point at a specific version of a resource by appending _history/N to the URL. That version-specific…

Jacob Berkowitz July 13, 2026
Editorial illustration in bauhaus-grid style depicting reference integrity across two federated FHIR servers with URL and identifier fallback
    • Reference Resolver

Reference Integrity in a Distributed FHIR Deployment

Reference integrity in a single-node FHIR server is a solved problem. Reference integrity across multiple servers, replicas, or federated stores…

Jacob Berkowitz July 13, 2026
Editorial illustration in bauhaus-grid style depicting contained vs external FHIR references with cost and outage-safety annotations
    • Reference Resolver

Contained References vs External References: Cost and Safety

FHIR gives two ways to point one resource at another: contain it inside the parent, or reference it externally by…

Jacob Berkowitz July 12, 2026
Editorial illustration in bauhaus-grid style depicting version-specific vs current-version references with a highlighted retention window
    • Reference Resolver

Version-Specific References: When You Need Them, When You Don't

Jacob Berkowitz July 13, 2026
Editorial illustration in bauhaus-grid style depicting reference integrity across two federated FHIR servers with URL and identifier fallback
    • Reference Resolver

Reference Integrity in a Distributed FHIR Deployment

Jacob Berkowitz July 13, 2026
Editorial illustration in bauhaus-grid style depicting contained vs external FHIR references with cost and outage-safety annotations
    • Reference Resolver

Contained References vs External References: Cost and Safety

Jacob Berkowitz July 12, 2026
Editorial illustration in bauhaus-grid style depicting a Bundle reference resolver with an in-memory index and shape-dispatch lookups
    • Reference Resolver

Resolving FHIR References Without a Full Database Walk

Jacob Berkowitz July 12, 2026
Version-Specific References: When You Need Them, When You Don't

Version-Specific References: When You Need Them, When You Don't

A FHIR reference can point at a specific version of a resource by appending _history/N to the URL. That version-specific…

Reference Integrity in a Distributed FHIR Deployment

Reference Integrity in a Distributed FHIR Deployment

Reference integrity in a single-node FHIR server is a solved problem. Reference integrity across multiple servers, replicas, or federated stores…

Contained References vs External References: Cost and Safety

Contained References vs External References: Cost and Safety

FHIR gives two ways to point one resource at another: contain it inside the parent, or reference it externally by…

Resolving FHIR References Without a Full Database Walk

Resolving FHIR References Without a Full Database Walk

Every non-trivial FHIR client eventually has to resolve references, and the naive resolver — one database read per reference —…

How to Author an SDC ExtractDefinition for a Multi-Answer PROMs Instrument

How to Author an SDC ExtractDefinition for a Multi-Answer PROMs Instrument

PROMs instruments are rarely single-answer. PROMIS-29 covers seven domains with four items each. PHQ-9 has nine items plus a computed…

FHIR Search Performance Across 4 Servers: A First Look at the Numbers

FHIR Search Performance Across 4 Servers: A First Look at the Numbers

FHIR search is where most production payer workloads actually live. Patient Access calls, panel queries, analytics extracts, and prior-auth bundle…

CMS-0057-F Quarterly Reporting Requirements: What Payers Must Compute and Publish

Most of the CMS-0057-F conversation gets consumed by the four APIs and the SLAs that go with them. The quarterly…

Top 6 FHIR Data Store Patterns for Reusable Compliance Investment

Top 6 FHIR Data Store Patterns for Reusable Compliance Investment

The FHIR data store is the architectural decision that determines whether CMS-0057-F compliance becomes a reusable platform investment or stays…

Top 6 Da Vinci IGs Every Health Plan Should Track in 2026

Top 6 Da Vinci IGs Every Health Plan Should Track in 2026

The Da Vinci IG portfolio is large. For health plans implementing CMS-0057-F, not all IGs matter equally. Six IGs deserve…

Top 6 AI/ML Training Data Patterns on FHIR for Payer Models

Top 6 AI/ML Training Data Patterns on FHIR for Payer Models

US health payers are increasingly building AI and ML models for member outreach prioritization, prior auth automation, fraud detection, and…

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Older posts

Fixing broken refs?

Fixing broken refs?

Debugging a Bundle full of broken references? a Bundle reference walker parked here will find the culprits.

Recent Posts

  • Version-Specific References: When You Need Them, When You Don't
  • Reference Integrity in a Distributed FHIR Deployment
  • Contained References vs External References: Cost and Safety
  • Resolving FHIR References Without a Full Database Walk
  • How to Author an SDC ExtractDefinition for a Multi-Answer PROMs Instrument

Categories

  • Da Vinci Ecosystem
  • Fhir Platform Architecture
  • Master patient index
  • Medical form builder
  • Payer Side Analytics Ai
  • Reference Resolver
  • Terminology server

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