Incremental Mode Import in Azure Health Data Services
Published Sep 05 2023 12:48 PM 1,979 Views

This blog has been authored by Ketki Sheth, Senior Program Manager, Microsoft Health & Life Sciences


We are thrilled to announce the General Availability (GA) of incremental import capability in the FHIR service. The FHIR service in Azure Health Data Services facilitates the exchange and persistence of health data using the Fast Healthcare Interoperability Resources (FHIR®) open data standard.


With incremental import, customers can ingest FHIR resource data at high throughput, in batches, without disrupting normal transactions through the API. In addition, customers can also ingest multiple versions of a resource in the same batch without worrying about the order of ingestion.


Overview of incremental import:

The FHIR service's preexisting $import operation provides initial import support. Initial import enables customers to ingest data into an empty FHIR service from a storage account. Initial import has some limitations, such as concurrent write operations via API being blocked, and when multiple resources share the same resource ID, only one of the resources is imported.


While initial import is useful for hydrating an empty FHIR service, we understand the needs of our customers for high-throughput incremental import.


Benefits of incremental import:

The introduction of the incremental import provides enhanced capabilities allowing customers to: 

  • Import data concurrently while executing API CRUD operations on the FHIR server.
  • Ingest multiple versions of FHIR resources in single batch while maintaining resource history.
  • Retain the lastUpdated field value in FHIR resources during the ingestion process while also maintaining chronological order of resources. In other words, customers no longer need to pre-load historical data before inserting the latest version of FHIR resources.


Health care organizations utilizing Azure Health Data Services, FHIR service, often need to run synchronous and asynchronous data flows simultaneously. The asynchronous data flow includes receiving batches of large data sets containing patient records from various sources such as Electronic Medical Record (EMR) systems. These data sets need to be imported into a FHIR server to ensure comprehensive patient information is available. This needs to be done simultaneously with the synchronous data flow to concurrently execute API CRUD (Create, Read, Update, Delete) operations on Azure Health Data Services FHIR service. Concurrently performing data import and API CRUD operations on the FHIR server is crucial to ensure uninterrupted healthcare service delivery and efficient data management. Incremental import allows for organizations to run both synchronous and asynchronous data flows at the same time eliminating this issue.


Incremental import capability will also enable efficient migration and synchronization of data between Azure Health Data Services FHIR servers, and from Azure API for FHIR server to Azure Health Data Services FHIR server.


To learn how to configure import settings in the incremental mode, please refer to the "Configure import settings in the FHIR service" documentation available on Microsoft Learn.


Pricing Information:

With Azure Health Data Services customers pay only for what you use. Customers will incur cost per successfully ingested resource using incremental import.


Incremental import follows the pricing model of API request. It is important to note that initial import continues to be free for customers.


The incremental import capability in the FHIR service of Azure Health Data Services is a result of input and feedback from our customers. We are excited to make this capability available to customers and look forward to feedback!


FHIR® is the registered trademark of HL7 and is used with the permission of HL7 








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