$everything Operation

The $everything operation is available in Health Gorilla’s FHIR R4 and STU3 APIs. It returns a Bundle containing all resources for a patient, including data previously retrieved through $p360-retrieve. Use $everything to assemble a complete, paginated record for downstream use.

Use Cases

• Combine all retrieved FHIR resources into one structured response, simplify export or downstream processing
• Prepare patient data for export, transformation, or storage, reduce the number of individual queries
• Retrieve data in bulk following a $p360-retrieve operation, assemble a complete longitudinal view

FHIR Version Support

Request Format

Submit a GET request to the patient-scoped operation. You may include parameters such as _since to filter by last updated date and _count to control page size.

• R4 Example: GET /fhir/4.0.1/Patient/{id}/$everything?_since={isoDateTime}&_count={n}
• STU3 Example: GET /fhir/3.0.1/Patient/{id}/$everything?_since={isoDateTime}&_count={n}

Behavior

• Returns all resources associated with the patient in a paginated Bundle, including Bundle.link navigation for subsequent pages
• Includes previously aggregated content from $p360-retrieve, normalized and deduplicated where applicable
• Large result sets should be retrieved incrementally using the next link in the returned Bundle

Operational Guidance

• Run $everything only after the corresponding $p360-retrieve job completes successfully
• Expect large payloads for patients with extensive histories; plan for pagination and backoff
• Respect rate limits and timeouts defined for your environmenttimeouts defined for your environment

Patient-Specific Queries

You can also retrieve structured data for an individual patient using standard FHIR search operations. Each query targets a single resource type and must include the patient reference parameter ?patient={id}.

Search Patterns

Include ?patient={id} in every query, and add indexed parameters to filter results:

• date or period for temporal filtering
• code to narrow by clinical concept
• category to limit by type or purpose
• _lastUpdated to filter by modification timestamp

Examples

• GET /fhir/R4/Observation?patient=12345&code=2093-3
• GET /fhir/R4/DocumentReference?patient=12345&category=clinical-note
• GET /fhir/R4/MedicationStatement?patient=12345&_lastUpdated=gt2024-01-01

Resource Linkages

Many patient queries return references to other resources that provide context:

• Encounter references establish care setting and visit details
• Provenance indicates source and retrieval details
• DocumentReference includes metadata about associated documents

Follow linked resources to build a timeline or interpret records in context.

Filtering Best Practices

To improve performance and reduce payload size:

• Use the most specific parameters available, such as code, date, or category
• Avoid broad queries without filters on high-volume resource types
• Paginate results with _count and the next link
• Use _summary=data when metadata is not required
• Avoid polling unless tracking updates where webhooks cannot be used

Summary

Patient queries provide flexibility for working with individual records. Use $everything to retrieve a patient’s complete history in a single response, and use targeted queries to pull specific clinical resources with fine-grained filters. Both approaches can be combined in workflows to balance completeness and efficiency.