The document discusses Cerner's use of Amazon Web Services to build a serverless FHIR interface. It describes how Cerner exposed FHIR resources from its EHR system using Amazon API Gateway and AWS Lambda. It provides an example serverless architecture for hosting a FHIR server and details various AWS services used like DynamoDB, S3, Cognito and X-Ray. The document also outlines workshops on building FHIR-enabled healthcare apps using AWS serverless services.

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AWS Serverless Interface Building
and Cerner's FHIR Experience
Dennis Patterson
Lead Software Engineer
Cerner
8 9 0 7 8
Mithun Mallick
Sr. Solutions Architect
AWS
Navneet Srivastava
Sr. Solutions Architect
AWS

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Agenda
Case Study: Cerner’s Ignite APIs on Amazon API Gateway
AWS Sample Architecture for Serverless FHIR
Build On!

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• hl7.org/fhir/
• Fast
• Healthcare
• Interoperability
• Resources

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Ignite APIs
for Millennium

10. © Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner.
Cerner Open Developer Experience: code.cerner.com

11. Developer documentation - fhir.cerner.com

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Challenges
• Growing Number of Apps
• Lower Barrier-to-Entry for Consumer Apps
• Need for Traffic Management
• Rate-limiting
• Usage Plans

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fhir-myrecord.cerner.com
Mutual TLS
@ Edge
Authorizer
Amazon API Gateway
AWS Cloud
On-Premise
FHIR Server Authorization
Server

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• Metadata Resources
• CapabilityStatement (/metadata)
• OperationDefinition, StructureDefinition
• Clinical Resources
• Patient, Observation,…
• URL Format
• E.g. https://fhir-myrecord.cerner.com/dstu2/<tenant-id>/metadata
Exposing FHIR Resources

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Deployment
On-Premise
AWS Cloud

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What’s Next?
• Tackle Challenges
• Timeout
• Payload Size
• Increased Usage Plan Customization
• Global Deployments
• Migrating FHIR Infrastructure to AWS

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Workshop Agenda
Building a serverless FHIR Server using AWS
Building a healthcare FHIR enabled app using AWS code* tools
Continuous integration and Deployment using AWS dev tools
Using AWS X-Ray for debugging and tracing

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Workshops Use Cases
• Loading Patient Observations using FHIR APIs
• Register a list of Patients with observations as Bundle resource through a batch utility
using FHIR server hosted on Amazon API Gateway
• Create a healthcare web app that display Patient Observations
• Create a healthcare app using AWS Cloud9 with CI/CD using AWS Code* tools. This app
will display a dashboard with patient information along with their Observations pulled
securely from the FHIR server and data created in use case #1.

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FHIR Server – Solution Architecture
Client
Process
Bundle resource
documents.
Lambda Function
FHIR Endpoints
Use Amazon Cognito user
pool to generate an
Authorization token.
Lambda function to parse
and validate JSON payload.
Load to DynamoDB.
FHIR Document Repository
FHIR DB to store JSON fields
AWS Serverless Java Container
REST interface to create
patient resources using
JSON payload.
Use SAM template for
API gateway and
lambda deployment.
Lambda integration type
Role
Bucket
AWS Cloud

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Endpoint Services
Amazon API Gateway
• Service to host the REST based FHIR
Endpoints.
• Performs caching of responses.
• Throttles requests as needed.
• Metering of API Calls.
AWS Lambda
• Use AWS Serverless Java
wrapper to run Jersey
framework.
• Serverless compute service to
read and process FHIR payload.
• Perform validation and generate
response.
• Load data to database or
perform search.

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Database & Storage Services
Amazon DynamoDB
• NoSQL and Serverless database
used to store FHIR resource
attributes.
• Horizontally scalable.
• Pay based on usage.
Amazon S3
• Highly available and durable object
store.
• Used to store raw JSON payload.
• Unlimited storage capacity.

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Authorization & Tracking Service
Amazon Cognito
• Service providing a user pool for
clients that need to send FHIR
requests.
• Acts as an identity provider.
• Enables AWS role mapping for the
FHIR request user.
• Maintains a session for each
authenticated user.
AWS X-Ray
• Provides end to end tracking of the
FHIR request message.
• Enables debugging of the message.

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Java Framework
AWS Serverless Java Container
• A Java wrapper to run Spring, Jersey, Spark, and other apps inside AWS Lambda.

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Workshop Reference Architecture
Lambda
Function
FHIR Endpoints
Use Amazon Cognito user
pool to generate an
Authorization token.
Lambda function to parse
and validate JSON payload.
Load to DynamoDB.
FHIR Document Repository
FHIR DB to store JSON fields
AWS Serverless Java Container
REST interface to
create patient
resources using JSON
payload.
Use SAM template
for API gateway and
lambda deployment.
Lambda integration type
Role
Bucket
AWS Cloud

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AWS Development Services
• AWS CodeCommit
• Fully-managed source control service
that hosts secure Git-based
repositories.
• Automatically encrypts your files in
transit and at rest.
• Supports all Git commands and works
with your existing Git tools.
• Collaborate on code with teammates
via pull requests, branching, and
merging.
• AWS CodePipeline
• Fully managed continuous delivery
service.
• Helps automate your release pipelines
for fast and reliable application and
infrastructure updates.
• Automates your software release
process, allowing you to rapidly release
new features to your users.
• Allows you to model the different
stages of your software release
process.

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AWS Development Services
• AWS Cloud 9
• Cloud-based integrated development environment (IDE) that lets you write, run, and
debug your code with just a browser.
• Comes prepackaged with essential tools for popular programming languages,
including JavaScript, Python, PHP, and more.
• Makes collaborating on code easy.
• Preconfigures the development environment with all the SDKs, libraries, and plug-ins
needed for serverless development.

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AWS Core Services
• Amazon EC2
• Web service that provides secure, resizable compute capacity in the cloud.
• Amazon EC2 reduces the time required to obtain and boot new server instances
to minutes.
• Amazon EC2 is integrated with most AWS services.
• Amazon EC2 works in conjunction with Amazon VPC to provide security and
robust networking functionality for your compute resources.

35. Thank you!
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