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Demystifying the Implementation of the FAST Security FHIR® IG: A Closer Look

[fa icon="calendar"] Apr 24, 2024 4:41:44 PM / by FAST Project Management Team


The HL7 FHIR at Scale Taskforce (FAST) UDAP Security for Scalable Registration, Authentication and Authorization Implementation Guide (FAST Security IG) was designed to streamline and secure data exchange across different healthcare stakeholders. This blog post seeks to dispel common misconceptions about the complexity of implementing the FAST Security IG. 

The FAST Security IG originates from the foundational work done by, incorporating workflows defined in the Unified Data Access Profiles (UDAP™). These workflows have been instrumental in several FHIR Specifications, such as the Carequality Implementation Guide, Carin Blue Button IG, and Da Vinci Health Record Exchange (HRex) IG, to name a few. The primary goal is to harmonize workflows for consumer-facing and business to business (B2B) applications, thereby enhancing cross-organizational and cross-network interoperability. An additional enhancement includes the formal definition for a B2B Authorization Extension Object, further facilitating seamless transactions. 

Ease of Implementation: Contrary to common belief, integrating the FAST Security IG into existing systems is more straightforward than anticipated. Many organizations already possess an OAuth 2.0 stack and have the capability for certificate validation. Leveraging open source or reference implementation code can expedite the process, enabling quick and efficient setup. The FAST Implementer Support page is a helpful resource that offers links to FAST and community-developed open-source reference implementations, in addition to testing artifacts that can be used to gauge how development is progressing if you’re not ready to test against another system. 

Scalability through Automation: Manual registration processes in combination with SMART impose a heavy resource burden on both the requester and the data holder. The FAST Security IG eliminates manual processes, enabling FHIR to scale rapidly and efficiently across organizations. 

Sandbox Testing and Continuous Improvement: Extensive sandbox testing has fostered numerous discussions and lessons learned, leading to specification changes and future guidance. These adjustments are instrumental in the evolution of the FAST Security IG ensuring it meets the community's needs. 

Unparalleled Guide for Network Scalability: This IG is the only known guide that facilitates the scaling of FHIR across networks effectively, marking a significant milestone in healthcare interoperability. 

Community Engagement: The call to action is clear – get involved in Connectathons. These events are crucial for learning, participating and testing, offering a collaborative platform for continuous improvement and innovation. Attend FAST Implementer Support Office Hours on the first Tuesday of each month at 1pm ET to ask questions, make connections with other implementers and get more hands-on support in between Connectathons (see the HL7 Conference Call Center for call details). 

Ongoing Learning and Development: The journey of enhancing FHIR interoperability is ongoing, with continuous testing, idea generation and feedback gathering from the community. This iterative process is vital for refining and advancing the implementation guide. Don’t miss the upcoming FAST Focus Webinar on May 30 for a deeper dive on the FAST Security work.  

Alignment with TEFCA Requirements: The FAST Security IG is aligned with TEFCA's mandate to move full FAST Security support. It underscores the scalability of FHIR API exchange, incorporating elements like FHIR endpoint directories, record location services and a comprehensive security certificate infrastructure. This approach not only facilitates exchange among QHINs, Participants and Subparticipants but also enhances the overall value and efficiency of FHIR API usage through additional services. 

Enhanced Scalability with Tiered OAuth: The introduction of Tiered OAuth significantly enhances the scalability of the FAST Security solution for Auth Code Flow use cases, further cementing the IG's role in facilitating broad-scale interoperability and security. 

The FAST Security IG represents a pivotal advancement in the realm of healthcare interoperability, offering a streamlined, secure framework for data exchange. By addressing common misconceptions and highlighting the IG's ease of implementation, scalability and continuous improvement, we invite the health technology community to engage, contribute and drive the future of healthcare innovation. Let's harness the power of collaboration to make healthcare better for everyone through smart technology and process changes. 

For further details and supporting materials on the FAST Security IG, visit FAST - Confluence. 


Topics: OAuth2, FAST, FHIR Connectathon, FHIR Implementation Guides, ONC FAST, FHIR API, TEFCA, FAST Security

FAST Project Management Team

Written by FAST Project Management Team

The FHIR at Scale Taskforce (FAST) identifies Fast Healthcare Interoperability Resources (FHIR) scalability gaps, defines solutions to address current barriers, and identifies needed infrastructure for scalable FHIR solutions.

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