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WV United

WV United

EHR development notes on FHIR APIs, terminology server infrastructure, and clinical data interoperability.

WV United

WV United

EHR development notes on FHIR APIs, terminology server infrastructure, and clinical data interoperability.

  • Terminology server
  • Medical form builder
  • Ehr development
  • Emr development

Benjamin Kowalski

Clinical data engineer in Buffalo. Writes about integration engine modernization for hospital systems still running 1990s tooling.
Concurrency Test Scenarios Worth Running Before Go-Live
Posted on July 15, 2026July 13, 2026 by Benjamin Kowalski

Concurrency Test Scenarios Worth Running Before Go-Live

The concurrency plan sitting in the spreadsheet is not the same as a plan validated by a test. Every deployment eventually finds the gap; the ones that find it during a test are cheaper than the ones that find it during go-live. Naming the...

  • Fhir Concurrency
Throttling Policies That Keep FHIR Fair Under Contention
Posted on July 14, 2026July 13, 2026 by Benjamin Kowalski

Throttling Policies That Keep FHIR Fair Under Contention

Throttling is the operational lever that keeps a FHIR API responsive when demand outstrips supply. The policy that governs throttling matters more than the mechanism. A blunt policy that caps every client identically produces its own...

  • Fhir Concurrency
Background Jobs vs Interactive Requests in the Same FHIR Pool
Posted on July 14, 2026July 13, 2026 by Benjamin Kowalski

Background Jobs vs Interactive Requests in the Same FHIR Pool

The single sharpest FHIR concurrency failure mode is background jobs competing with interactive requests on the same connection pool. Interactive requests need pool slots for milliseconds; background jobs hold slots for seconds or minutes....

  • Fhir Concurrency
A 2026 Buyer's Guide to FHIR Form Builders for US Health Systems
Posted on July 13, 2026July 13, 2026 by Benjamin Kowalski

A 2026 Buyer's Guide to FHIR Form Builders for US Health Systems

A FHIR form builder is the system that takes a FHIR Questionnaire resource and turns it into a screen a patient or clinician can interact with, then stores the result as a QuestionnaireResponse. For a US health system in 2026, that capabili

  • Medical form builder
Concurrency Limits That Come From the Database, Not the API
Posted on July 13, 2026July 13, 2026 by Benjamin Kowalski

Concurrency Limits That Come From the Database, Not the API

FHIR concurrency plans usually target the API layer. Threads per instance, workers per pod, HTTP timeout budgets, requests-per-second ceilings. The layer that actually bounds a mature deployment is the database, not the API, and plans that...

  • Fhir Concurrency
Queue Depth as the Leading Indicator of Trouble
Posted on July 13, 2026July 13, 2026 by Benjamin Kowalski

Queue Depth as the Leading Indicator of Trouble

Every FHIR API dashboard eventually converges on a small set of metrics. Latency, error rate, RPS, and utilization sit on the main panel. Queue depth is usually somewhere in the appendix and it should be on the main panel, because queue...

  • Fhir Concurrency
Why Active Users Are Not the Same as Concurrent Requests
Posted on July 12, 2026July 13, 2026 by Benjamin Kowalski

Why Active Users Are Not the Same as Concurrent Requests

Sizing meetings almost always start with a user count. The vendor asks how many users the FHIR API will serve; the answer becomes the target for the capacity plan; the plan is sized against that number. The trap is that active users and...

  • Fhir Concurrency
Predicting Concurrency for a FHIR API Before You Have Real Users
Posted on July 12, 2026July 13, 2026 by Benjamin Kowalski

Predicting Concurrency for a FHIR API Before You Have Real Users

You are asked to size a FHIR API before it has any real users. The traffic is hypothetical, the workflows are being redesigned as you plan, and the partner integrations exist only as slides. That is a hard exercise, and the shortcut most...

  • Fhir Concurrency
Top 4 FHIR Code Lookup Services for American Clinical Apps
Posted on July 10, 2026July 13, 2026 by Benjamin Kowalski

Top 4 FHIR Code Lookup Services for American Clinical Apps

Clinical apps in 2026 lean heavily on FHIR code lookup services, whether they call them by that name or not. A doctor types into an autocomplete and the app calls $lookup or $expand. A care plan validates an entered ICD-10 code against a va

  • Terminology server
Open-Source vs Commercial Terminology Servers for US Hospitals
Posted on July 6, 2026July 13, 2026 by Benjamin Kowalski

Open-Source vs Commercial Terminology Servers for US Hospitals

Open-source or commercial is the second-most-important question a US hospital terminology team answers, right after which code systems to host. The license cost is the visible difference, but the actual decision rests on operational load, g

  • Terminology server

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