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HealthLake for EHRs - AWS HealthLake
Core capabilitiesRegulatory complianceDifferentiationUse casesCase studies

HealthLake for EHRs

For EHR builders, AWS HealthLake provides a fully managed FHIR R4 data store that serves as the unified foundation for your transactional FHIR server, analytics, and AI workloads. Rather than building and operating a custom FHIR server — including the database, search index, bulk export pipeline, and compliance infrastructure — you delegate that layer to HealthLake and focus on clinical workflows, UI, and business logic.

AWS HealthLake stores data natively as FHIR JSON resources. Every resource is indexed and versioned at ingest and immediately queryable through standard FHIR RESTful APIs. The service scales automatically. You don't need to plan capacity, tune databases, or perform administration.

Core capabilities

HealthLake provides the following capabilities for EHR builders:

  • Comprehensive FHIR R4 API — CRUD operations across 105+ FHIR R4 resource types. Includes FHIR Search with chained parameters and _include/_revinclude, batch/transaction bundles, resource versioning with _history, and the $export operation writing NDJSON directly to Amazon S3.

  • US Core IG — Supports profiles up to US Core STU v7.0.0, starting with US Core v3.1.1 (the normative basis for ONC certification).

  • SMART on FHIR — Supports SMART App Launch Framework IG v2.0.0, including standalone launch, EHR launch, and backend services flows through any OAuth 2.0 compliant Identity Provider host including Amazon Cognito.

  • Bulk Data Access — Supports FHIR Bulk Data Access IG v2.0.0 for Patient, Group, and System-level $export.

  • ONC Inferno Validation — You can use HealthLake's FHIR API to pass the ONC Inferno test suite to support EHR certification requirements for §(g)(10) Single Patient API and Multi-Patient API sequences.

  • Zero-ETL Access — Automatically transforms FHIR data into Apache Iceberg formats for direct SQL queries through Athena, Redshift, or .

Note

HealthLake is not itself an ONC-certified Health IT Module — certification applies to your complete EHR product. HealthLake provides the FHIR infrastructure layer.

Regulatory compliance

The following table maps regulatory requirements to HealthLake support:

Requirement Standard HealthLake Support
US Core IG US Core STU v7.0.0 Native profile validation
SMART on FHIR SMART App Launch IG v2.0.0 Cognito integration; standalone, EHR, and backend service flows
Bulk Data Access Bulk Data Access IG v2.0.0 Patient, Group, and System-level $export
ONC Inferno §(g)(10) test sequences Validated Single and Multi-Patient API

Differentiation

HealthLake differentiates from self-managed FHIR servers in the following ways:

  • No infrastructure to operate

  • Delivers performance at scale with thousands of transactions per second, petabytes of storage, and sub-second latency.

  • Pay-as-you-go cost structure with no upfront licensing

  • Compliance inheritance — HIPAA-eligible under AWS BAA, ISO/SOC, AES-256, TLS 1.2+, IAM, VPC endpoints, and CloudTrail

  • Speed to production — transactional database, analytics database, and data-as-service in one managed offering

Use cases

The following are common EHR use cases for HealthLake:

  • ONC-Certified EHR FHIR Backend — HealthLake serves as the transactional FHIR server layer for EHR applications pursuing ONC certification.

  • EHR Data Analytics — HealthLake's zero-ETL integration makes real-time clinical data available for SQL-based analytics through Athena or Redshift.

Case studies

The following case studies demonstrate how EHR companies use HealthLake: