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Server Configuration

Describes the environment variables required to run the server.

NameRequiredDescriptionDefault
PORTNoHTTP listener port.5000
BIND_HOSTNoHTTP bind address.0.0.0.0
FHIR_AUTHNosmart (SMART Backend Services) or none (unauthenticated, for public test endpoints).smart
LOG_LEVELNoLog verbosity: error, warn, info, or debug.info
MCP_AUTHZNoAuthorization provider: none or entra. Gates tools per caller (HTTP + Authorization: Bearer only).none
FHIR_VERSIONNoActive R4+ FHIR release; controls derived URL, FHIRPath model, and compact model metadata.R4
ALLOWED_HOSTSNoComma-separated hostnames for DNS rebinding protection.
FHIR_BASE_URLNoBase URL used to derive the FHIR server URL and token URL. Optional when FHIR_SERVER_URL is set (and, for smart auth, FHIR_TOKEN_URL).
FHIR_JWKS_URLNoExternal JWKS URL. Omit in HTTP mode to enable built-in /jwks.
MCP_TRANSPORTNohttp or stdio.http
FHIR_CLIENT_IDNoSMART Backend Services client ID (not needed when FHIR_AUTH=none).
FHIR_MAX_COUNTNoCap on explicit caller _count values; 0 = no cap.0
FHIR_TOKEN_URLNoExplicit token endpoint override.<base>/oauth2/token
MCP_JSON_LIMITNoMax accepted MCP request body size (Express json limit string); raise if large write/bundle payloads are rejected.4mb
FHIR_ACTIVE_KEYNoBase64-encoded PKCS#8 PEM signing key, RSA or EC P-384 (not needed when FHIR_AUTH=none).
FHIR_AUDIT_FILENoJSONL file used when the file audit sink is enabled../audit.jsonl
FHIR_AUDIT_SINKNoAny combination of console, file, http.
FHIR_OPERATIONSNoComma-separated operation keys; none disables all catalog operations. Default catalog: everything, lastn, validate, docref, expand, lookup, translate, summary, match.
FHIR_SERVER_URLNoExplicit FHIR API URL override.<base>/api/FHIR/<FHIR_VERSION>
MCP_ROLE_PREFIXNoPrefix on granted role values (e.g. FhirHydrant.Patient.Read).FhirHydrant
FHIR_RETIRED_KEYSNoComma-separated base64-encoded PEMs for JWKS rotation.
FHIR_DEFAULT_COUNTNoDefault _count injected into searches when allowed; 0 = server decides.0
FHIR_METADATA_MODENostrict, warn, or off for /metadata validation.strict
FHIR_RESPONSE_MODENocompact, full, or compact-locked; unset means search defaults compact and direct reads default full.
FHIR_WRITE_DRY_RUNNoSet to true to validate and log writes without executing them against the FHIR server.false
MCP_ENTRA_AUDIENCENoAPI application (client) ID expected in the v2 access token aud; required when MCP_AUTHZ=entra.
FHIR_AUDIT_HTTP_URLNoDestination URL for the http audit sink; required when http is enabled.
MCP_ENTRA_TENANT_IDNoEntra tenant GUID (not a domain alias); required when MCP_AUTHZ=entra.
FHIR_AUDIT_HTTP_AUTHNoAuthorization header value sent verbatim by the http sink.
FHIR_MAX_ARTIFACT_MBNoSeparate byte ceiling (MiB) for native/binary artifact bodies; independent of the JSON limit (base64 transport ≈ +33%).16
FHIR_VALIDATE_WRITESNooff, local (client-side structural checks), or server (local + server $validate preflight for create/update).local
FHIR_AUDIT_HTTP_FORATNoraw (internal AuditEvent JSON) or fhir-auditevent (FHIR R4 AuditEvent).raw
FHIR_PAGINATION_PATHSNoExtra allowed path prefixes for pagination links, e.g. FHIRProxy.
FHIR_AUDIT_USER_HEADERNoProxy-authenticated user header copied into audit events.
FHIR_MAX_RESPONSE_BYTESNoByte limit for model-facing JSON responses; oversized Bundles are chunked.262144
FHIR_PREFETCH_MAX_BYTESNoMax raw bytes fetched before stopping.2097152
FHIR_PREFETCH_MAX_PAGESNoMax upstream pages fetched per coalesced compact search.5
FHIR_REQUEST_TIMEOUT_MSNoPer-attempt timeout for outgoing FHIR requests.30000
FHIR_WRITE_CAPABILITIESNoComma-separated write actions: create, update, patch, delete.
FHIR_BUNDLE_CAPABILITIESNoComma-separated Bundle types: batch, transaction; enables bundle tool.
FHIR_PREFETCH_TIMEOUT_MSNoWall-clock budget for the coalescing loop.25000
FHIR_TEMINOLOGY_BASE_URLNoEnables terminology tools, e.g. https://tx.fhir.org/r4.
FHIR_PREFETCH_MAX_ENTRIESNoMax upstream entries accumulated before stopping.5000
FHIR_BUNDLE_WRITES_ENABLEDNoSet to true to allow write entries inside Bundles (also requires FHIR_WRITE_CAPABILITIES).false

Instructions

Guidance the server publishes about itself, which clients place ahead of the tool catalog so the model reads it before choosing anything.

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Capabilities

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Tools

Functions exposed to the LLM to take actions

NameDescription

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Prompts

Interactive templates invoked by user choice

NameDescription

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Resources

Contextual data attached and managed by the client

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