Related Experiment Video
Updated: May 24, 2026
07:26
Executing Complexity-Increasing Queries in Relational (MySQL) and NoSQL (MongoDB and EXist) Size-Growing ISO/EN 13606 Standardized EHR Databases
Published on: March 19, 2018
Blaze: A High-Performance Open Source FHIR Server with Embedded CQL Evaluation Engine
Alexander Kiel1, Tobias Kussel2,3,4, Julian Gruendner5
1Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.
Studies in Health Technology and Informatics
|May 23, 2026
Summary
Blaze, a high-performance FHIR server with a Clinical Quality Language engine, efficiently supports large-scale clinical research queries. Its functional database design achieves scalable, standards-compliant performance for data networks.
Area of Science:
- Health Informatics
- Computer Science
- Bioinformatics
Background:
- The German Cancer Consortium (DKTK) and German Medical Informatics Initiative (MII) require robust data infrastructure for research.
- Federated feasibility queries demand high-performance, scalable FHIR servers.
Purpose of the Study:
- To introduce Blaze, an open-source, high-performance FHIR server.
- To demonstrate Blaze's capability in supporting large-scale clinical research data networks.
Main Methods:
- Developed Blaze using Clojure with a functional, immutable database architecture (RocksDB).
- Implemented an embedded Clinical Quality Language (CQL) engine.
- Conducted benchmarks on datasets exceeding one billion FHIR resources.
Main Results:
- Blaze supports lock-free concurrency and efficient query execution.
- Achieved cohort queries over millions of patients in under one minute.
- Deployed in production at over 60 research sites globally.
Conclusions:
- Blaze provides scalable, standards-compliant performance for clinical research data networks.
- A functional, embedded database design is effective for high-performance FHIR servers.
- Blaze facilitates large-scale federated feasibility queries.
Related Concept Videos
01:20Integrated Healthcare System
An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
01:30Health Information Technology and Healthcare Information System
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:27Nursing Clinical Information System
Nursing Clinical Information System (NCIS)
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:29Issues And Trends In Healthcare Delivery System
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:17Assessment of Diffusion and Perfusion
Understanding and evaluating diffusion and perfusion is critical in assessing a patient's respiratory and circulatory health. These processes play key roles in maintaining the body's internal environment, ensuring that tissues receive adequate oxygen while waste products are efficiently removed.
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...
01:02Flame Photometry: Overview
Flame photometry, also known as flame emission spectrometry, is a technique used for the qualitative and quantitative analysis of elements present in a sample using a flame as the source of excitation energy. The concept of flame photometry was realized in the early 1860s by Kirchhoff and Bunsen, who discovered that specific elements emit characteristic radiation when excited in flames. The first instrument developed for this purpose was used to measure sodium (Na) in plant ash using a Bunsen...