FHIR Interview Questions & Answers
Prepare for your FHIR job interview with our curated list of real-world FHIR interview questions and answers. Whether you’re just starting out or an experienced health IT professional, you’ll find questions and explanations tailored to your level of expertise.
Beginner Level FHIR Interview Questions
This section is perfect for those new to healthcare integration and the FHIR standard. It introduces the core concepts of FHIR, resources, RESTful architecture, basic resource structures like Patient and Observation, and simple data exchanges. Great for freshers and junior developers learning FHIR basics.
Intermediate Level FHIR Interview Questions
This section is geared toward professionals with working knowledge of FHIR who are involved in building and maintaining FHIR APIs. It covers CRUD operations, resource referencing, profiling, terminology services, bundles, transactions, and real-world use cases.
Advanced Level FHIR Interview Questions
This section dives deep into FHIR’s advanced topics like clinical reasoning, implementation guides, FHIRPath, GraphQL, bulk data export, SMART on FHIR, and security/authentication. Ideal for architects, senior engineers, and anyone designing enterprise-level FHIR solutions.
🔰 Beginner Level FHIR Interview Questions and Answers (40 Q&A)
Q1. What does FHIR stand for?
A: Fast Healthcare Interoperability Resources.
Q2. Who developed FHIR?
A: Health Level Seven International (HL7).
Q3. What are the core goals of FHIR?
A: Simplicity, flexibility, interoperability, and use of modern web technologies.
Q4. What are FHIR resources?
A: Standardized data models (e.g., Patient, Observation) used for healthcare data exchange.
Q5. What data formats does FHIR support?
A: JSON, XML, and Turtle.
Q6. What protocol does FHIR use for communication?
A: HTTP/HTTPS (RESTful APIs).
Q7. What is a REST API in FHIR?
A: An interface that allows interaction with FHIR resources using standard HTTP methods like GET, POST, PUT, and DELETE.
Q8. What is the Patient resource?
A: A resource that holds demographic and administrative information about a person receiving care.
Q9. What is the difference between a resource and an element in FHIR?
A: A resource is a complete data object; an element is a part of a resource.
Q10. How are FHIR resources identified?
A: Using unique URLs or IDs.
Q11. Can FHIR be used for mobile health apps?
A: Yes, FHIR is optimized for mobile, web, and cloud-based apps.
Q12. What is the Observation resource?
A: It represents measurements or clinical assessments, such as blood pressure or lab results.
Q13. What is a Bundle in FHIR?
A: A container for a group of resources sent or received together.
Q14. What is the Composition resource?
A: It provides the structure and metadata for clinical documents.
Q15. What are extensions in FHIR?
A: Mechanisms for adding non-standard data to resources.
Q16. What is the Encounter resource?
A: Describes interactions between patients and healthcare providers.
Q17. What does CRUD mean in FHIR?
A: Create, Read, Update, Delete — standard operations on resources.
Q18. What is a ValueSet in FHIR?
A: A set of codes from a code system used to define acceptable values.
Q19. How do you search for a resource in FHIR?
A: By using query parameters in the URL (e.g., /Patient?name=John).
Q20. What is a CapabilityStatement?
A: A resource that describes the functionalities supported by a FHIR server.
Q21. Is authentication required in FHIR?
A: Yes, for production environments using OAuth2 or other secure methods.
Q22. What is a CodeableConcept?
A: A structure for coded elements like diagnoses, lab test codes, etc.
Q23. What is the Condition resource?
A: It stores information about a diagnosis or medical problem.
Q24. What is the Practitioner resource?
A: It describes healthcare professionals like doctors and nurses.
Q25. What is the Organization resource?
A: It holds data about healthcare organizations such as hospitals or clinics.
Q26. What is the purpose of the Medication resource?
A: It contains details about medications being prescribed or administered.
Q27. What is the Procedure resource?
A: It represents an activity performed on or for a patient.
Q28. What is a SearchParameter in FHIR?
A: It defines criteria for searching resources.
Q29. What is the goal of FHIR profiles?
A: To constrain or extend standard resources for specific use cases.
Q30. What are Narrative sections in FHIR resources?
A: Human-readable summaries included in most resources.
Q31. What is an Identifier in FHIR?
A: A unique value used to distinguish an individual resource instance.
Q32. What are common use cases for FHIR?
A: EHR integration, patient portals, mobile apps, lab result sharing.
Q33. Is FHIR backward compatible?
A: Yes, efforts are made to maintain backward compatibility across versions.
Q34. What is a Reference in FHIR?
A: A pointer from one resource to another.
Q35. What is the use of the Immunization resource?
A: To record information about vaccinations.
Q36. What is the role of FHIR in digital health?
A: It enables secure, fast, and standardized data sharing across digital health tools.
Q37. How are time and dates represented in FHIR?
A: Using standard date/time formats like ISO 8601.
Q38. What does the CarePlan resource do?
A: Describes the management of care activities for a patient.
Q39. What are FHIR versions currently in use?
A: DSTU2, STU3, R4 (most widely used), and R5.
Q40. What is the meaning of “resource-centric” in FHIR?
A: Everything in FHIR is modeled as a discrete resource.
⚙️ Intermediate Level FHIR Interview Questions and Answers(45 Q&A)
Q1. What is a FHIR profile?
A: A profile customizes FHIR resources for specific use cases by adding constraints, extensions, and terminology bindings.
Q2. How do extensions work in FHIR?
A: Extensions allow adding additional elements to resources that are not part of the core specification while keeping the base model intact.
Q3. What is the StructureDefinition resource?
A: It defines the structure, constraints, and extensions for resources, profiles, and data types.
Q4. What is a Logical Model in FHIR?
A: A custom data structure defined using StructureDefinition but not necessarily based on FHIR resources.
Q5. What is a ValueSet?
A: A collection of codes from one or more code systems, often used to define valid values for coded elements.
Q6. Explain the concept of Terminology Binding.
A: It associates an element with a ValueSet to ensure semantic consistency.
Q7. What is a ConceptMap?
A: A resource used to define relationships between codes in different code systems.
Q8. What is a SearchParameter resource?
A: It defines how clients can search for resources using specific fields.
Q9. How do FHIR search parameters work?
A: By appending query strings to resource URLs, like /Patient?name=John.
Q10. What is a FHIR Bundle and its types?
A: A Bundle is a container for multiple resources. Types include document, transaction, batch, message, and collection.
Q11. Difference between transaction and batch Bundles?
A: Transactions are atomic (all-or-nothing), while batches are non-atomic (each request is processed independently).
Q12. What is a FHIR Document?
A: A set of resources with a Composition resource as the root, representing a clinical document.
Q13. What is the purpose of a FHIR CapabilityStatement?
A: It describes what operations and resources a FHIR server supports.
Q14. What is the Composition resource used for?
A: It represents clinical documents like discharge summaries and reports.
Q15. What is a contained resource?
A: A resource embedded within another when it doesn’t need to exist independently.
Q16. Explain reference types in FHIR.
A: Reference, canonical, and uri are types of references used to link resources.
Q17. What is a canonical URL in FHIR?
A: A unique, version-independent identifier for conformance resources like StructureDefinitions and ValueSets.
Q18. What is slicing in FHIR?
A: A method for differentiating repeated elements in a resource based on specific criteria.
Q19. What are must-support elements?
A: Fields that systems are expected to handle even if they are not required by the standard.
Q20. What is the difference between fixed and pattern constraints?
A: fixed requires an exact value; pattern allows values that conform to a defined pattern.
Q21. How do you validate a FHIR resource?
A: By using FHIR validators (e.g., HL7 validator.jar) or built-in validation APIs.
Q22. What is a Bundle entry?
A: An individual resource item within a FHIR Bundle.
Q23. What is the Subscription resource in FHIR?
A: It allows a system to be notified when changes happen to resources.
Q24. What is the purpose of the Provenance resource?
A: To track the origin and authorship of a resource.
Q25. What is the AuditEvent resource?
A: Records events for security and audit logging.
Q26. Explain the use of _include and _revinclude in FHIR search.
A: _include returns referenced resources; _revinclude returns resources that reference the matched resource.
Q27. What are compartments in FHIR?
A: Logical groupings of resources related to a single entity, like a patient or practitioner.
Q28. What is a MessageHeader resource?
A: Used to define the context of a message Bundle.
Q29. How are pagination and sorting handled in FHIR?
A: Through query parameters like _count, _sort, and navigation links.
Q30. What is the role of SMART on FHIR?
A: A set of open specifications that extend FHIR with OAuth2-based authentication for secure data access.
Q31. What is the significance of Resource.id vs. Resource.identifier?
A: id is system-generated; identifier is a business-specific ID.
Q32. What is versioning in FHIR?
A: Resource versions are tracked via meta.versionId.
Q33. Explain conditional create and update in FHIR.
A: These allow operations based on search criteria instead of a fixed ID.
Q34. What is the Questionnaire resource?
A: Represents a structured set of questions.
Q35. What is the QuestionnaireResponse resource?
A: Captures the answers to a Questionnaire.
Q36. What are bundles used for in EHR integration?
A: Sending related clinical data like patient demographics, encounters, and observations in one transaction.
Q37. What is the use of OperationDefinition?
A: It defines custom operations or extended functionality on resources.
Q38. How do you perform a conditional delete?
A: By sending a DELETE request with a search URL: DELETE /Patient?identifier=123.
Q39. What is the effect of resource versioning on auditability?
A: It improves traceability and compliance.
Q40. What is the purpose of meta tags in FHIR?
A: Used for versioning, tagging, and tracking resource state.
Q41. What is the Composition resource’s role in document generation?
A: Serves as the root resource linking all document content.
Q42. How are time zones handled in FHIR date/time fields?
A: FHIR supports ISO 8601 with optional time zone offsets.
Q43. What is the HealthcareService resource?
A: Describes services offered by a healthcare organization.
Q44. What is the difference between a DiagnosticReport and an Observation?
A: DiagnosticReport summarizes multiple Observations; Observation contains individual data points.
Q45. What are best practices for implementing FHIR servers?
A: Use validated libraries, adhere to CapabilityStatement, apply security (OAuth2), and implement caching for performance.
Advanced Level FHIR Interview Questions and Answers (40 Questions)
Q1. What are FHIR Implementation Guides (IGs)?
A: IGs define how FHIR should be used in specific contexts by providing profiles, ValueSets, and workflows.
Q2. How do you create a custom profile in FHIR?
A: Using a StructureDefinition resource with constraints, bindings, and extensions applied to a base resource.
Q3. What tools are used for IG development?
A: IG Publisher, FHIR Shorthand (FSH), and SUSHI (a compiler for FSH).
Q4. What is FHIR Shorthand (FSH)?
A: A domain-specific language for defining FHIR artifacts concisely.
Q5. What is SUSHI?
A: A tool that converts FSH definitions into FHIR-compliant JSON files.
Q6. What is the purpose of the ImplementationGuide resource?
A: It holds metadata, profiles, and examples to publish a formal implementation guide.
Q7. Explain the difference between canonical and absolute URLs.
A: Canonical URLs identify conformance resources logically; absolute URLs include the full path (protocol + domain).
Q8. How does versioning apply to StructureDefinitions and ValueSets?
A: They support versioning via canonical URLs and version metadata for compatibility and tracking.
Q9. What is a terminology server in FHIR?
A: A server that provides terminology services like expansion, validation, and translation of code systems.
Q10. What is the difference between a FHIR server and a FHIR client?
A: The server hosts and manages resources; the client consumes and interacts with them.
Q11. How does FHIR support real-time data exchange?
A: Via the Subscription resource, WebSockets, and Pub/Sub mechanisms.
Q12. What is the role of OAuth2 in SMART on FHIR?
A: Provides secure, delegated access to patient data with token-based authorization.
Q13. How do you ensure conformance in FHIR?
A: By validating resources against profiles and using CapabilityStatements to declare supported features.
Q14. How does resource linking work with external systems?
A: Using URLs or identifiers that point to external references or APIs.
Q15. How do FHIR packages work in IG publishing?
A: They bundle all resources, profiles, and examples used in an Implementation Guide for sharing and reuse.
Q16. What is a custom operation in FHIR?
A: A user-defined function (like $match, $everything) defined using an OperationDefinition.
Q17. How do you use modifiers and prefixes in search queries?
A: Modifiers (e.g., :exact, :contains) and prefixes (lt, gt) refine search criteria.
Q18. What is a Clinical Reasoning module?
A: A group of FHIR resources used for clinical decision support and quality measurement.
Q19. How is quality reporting implemented in FHIR?
A: Using Measure and MeasureReport resources in combination with Clinical Quality Language (CQL).
Q20. What are Library and PlanDefinition resources?
A: Used in decision support; Library contains logic, and PlanDefinition defines workflows or clinical pathways.
Q21. What are the differences between CareTeam and CarePlan?
A: CareTeam defines the individuals involved in the care of a patient, while CarePlan outlines the specific activities and goals for patient care.
Q22. What is Clinical Quality Language (CQL) in FHIR?
A: CQL is a standard for expressing clinical logic used in FHIR resources like Measure and PlanDefinition.
Q23. What is the SubscriptionTopic resource in FHIR R5?
A: It defines the criteria and notification rules for subscriptions in the new PubSub model.
Q24. What is the use of GraphDefinition?
A: It defines a set of related resources and how they are linked, useful for navigation and data extraction.
Q25. What is a Resource.meta.security tag?
A: A tag
Q26. What is the Evidence resource used for in FHIR?
A: It captures research evidence data used in clinical decision-making or guidelines.
Q27. How is the EvidenceReport resource different from Composition?
A: EvidenceReport focuses on structured summaries of evidence (clinical trials, research), while Composition is for general clinical documents.
Q28. What is the VerificationResult resource?
A: Used to record the verification status of information (like credentialing of a provider or organization).
Q29. What is FHIRPath and how is it used?
A: FHIRPath is an expression language used to query and navigate elements in FHIR resources, often used in constraints and mappings.
Q30. How is the Parameters resource used in FHIR operations?
A: It allows input/output of named parameters when invoking custom operations on FHIR resources.
Q31. What is the purpose of StructureMap in FHIR?
A: It defines rules for transforming data from one structure (or resource) to another, often used in mappings between different systems.
Q32. What are the types of Subscription channels supported in FHIR?
A: REST Hook, WebSocket, Email, and FHIR Messaging (depending on the FHIR version).
Q33. How does AuditEvent differ from Provenance?
A: AuditEvent logs system-level events for security and auditing; Provenance tracks who created or modified a resource.
Q34. What are implementation patterns for enterprise-scale FHIR solutions?
A: Use of microservices, caching layers, external terminology services, asynchronous processing, and secure APIs.
Q35. How can FHIR be integrated with legacy HL7 v2 systems?
A: Via integration engines (like Mirth) that map HL7 v2 messages to FHIR resources and vice versa.
Q36. What is the purpose of the MeasureReport resource?
A: It captures the result of a Measure, typically for quality or performance reporting.
Q37. What is DataRequirement in FHIR?
A: Specifies what data is required by a system or module (e.g., for decision support or measure evaluation).
Q38. What are the privacy considerations for FHIR APIs?
A: Secure endpoints, OAuth2 scopes, logging, auditing, access control, and data minimization.
Q39. What are some challenges in scaling a FHIR server?
A: Handling large volumes of data, performance of search queries, security, data versioning, and maintaining referential integrity.
Q40. How can you test FHIR-based applications?
A: Using FHIR test servers (e.g., HAPI, Inferno), Postman, HL7 validator, custom test suites, and simulated datasets.
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