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Advisory: FHIR Server Search May Not Find Known Resource

This problem affects the following products:

  • InterSystems IRIS® for Health versions earlier than 2023.1.3
  • HealthShare® Health Connect (with FHIR server add-on) earlier than 2023.1.3

Requirements:

  • FHIR server in use
  • FHIR server under heavy load
  • multiple conditional parallel FHIR updates occurring

This advisory identifies an operational issue when using FHIR in InterSystems IRIS for Health. The issue is seen only when the server is under high load, with multiple conditional parallel FHIR updates.

When attempting to post several FHIR bundles in parallel with conditional updates, a user may encounter an issue where the search does not return an existing resource, for example “Search by Identifier”. As a result of the issue, duplicate resources were created using the same business identifier. Resources that reference one of these duplicate resources were supposed to all reference a single resource with that identifier.

Internally, the FHIR resource table was not locked during these rapid updates.

The correction for this defect is identified as IF-5461 which is included in InterSystems IRIS for Health 2023.1.3 and later product releases. For customers using InterSystems FHIR and OAUTH 2.0 on a version prior to 2023.1.3 it is also available via ad hoc change file (patch) or full kit from the Worldwide Response Center (WRC).

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