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smart-fhir

환자를 꾸며내지 않는 커넥터입니다.

MCP v1 transport stdio FHIR R4 4.0.1 SMART 2.2.0 writes off

tools 4 sandbox public synthetic empty search stays empty unknown id 404 PHI none

설치 · 도구 · 동작 방식 · 제한 사항


설치

stdio 전용입니다. TypeScript 빌드 후 로컬 커넥터를 추가하세요:

name: smart-fhir
command: node
args: dist/index.js
npm install
npm run build

이 env를 추가하세요(기본값이며 비밀값은 아닙니다):

FHIR_ISS = https://launch.smarthealthit.org/v/r4/fhir
FHIR_VERSION = R4
FHIR_AUTH_MODE = open
FHIR_WRITE = off
FHIR_AUDIT_PATH = ./audit/audit.jsonl

저장소에 비밀값을 넣지 마세요. 공개 HTTP 포트를 열지 마세요. TCP를 바인딩하지 마세요.

오전 단축 실행(같은 env)

npx -y tsx src/index.ts

package.json의 스크립트를 참고하세요: install, build, test, prove.

Related MCP server: Healthpoint MCP Server

도구

도구는 네 가지입니다. create / update / delete는 없습니다.

도구

동작

smart_discover

GET {iss}/.well-known/smart-configuration. 파싱된 JSON 또는 명시적 오류를 반환합니다. 엔드포인트를 꾸며내지 않습니다.

fhir_auth_status

{ mode, iss, fhir_version: "R4", write: "off", token_present, discovery_ok, last_error? }. token이나 PEM을 절대 출력하지 않습니다.

fhir_search

GET {iss}/{resourceType}?... _count 기본값 10, 최대 50. 한 페이지만. 빈 Bundle은 그대로 반환합니다.

fhir_read

GET {iss}/{resourceType}/{id}. 404는 찾을 수 없음(not found)을 의미하며, 꾸며낸 리소스가 아닙니다.

resourceType 허용 목록: Patient | Observation | Condition | MedicationRequest | Encounter. 그 외에는 → { ok: false, error: "resourceType not in v1 allowlist" }.

동작 방식

FHIR_VERSION는 R4여야 합니다. 그 외 값이면 시작을 거부합니다.

항목

URL

읽는 방법

FHIR index(현재 바라보는 페이지는 R5 5.0.0)

http://hl7.org/fhir/

공식 인덱스만. https://hl7.org/fhir/R4/ **0.

FHIR R4 (v1)

https://hl7.org/fhir/R4/

FHIR Release 4, 4.0.1. Resource 리소스 모델.

SMART App Launch 2.2.0 (STU 2.2)

https://hl7.org/fhir/smart-app-launch/

현재 발행된 SMART IG. FHIR R4 기반.

App launch + authorization

https://hl7.org/fhir/smart-app-launch/app-launch.html

Discovery, standalone/EHR launch, PKCE, token. App Launch(code+PKCE)는 v1 범위 밖.

Backend Services

https://hl7.org/fhir/smart-app-launch/backend-services.html

client_credentials + private-key JWT. 구현 되어 있으며, env가 설정된 경우에만 사용.

ISS 허용 목록 (끝나는 슬래시는 제거되며, 그 외 값은 거부됩니다):

  • https://launch.smarthealthit.org/v/r4/fhir (기본값)

  • https://r4.smarthealthit.org

  • https://hapi.fhir.org/baseR4

FHIR_ISS를 허용 목록에 있는 다른 base로 설정하면 다른 ISS를 가리킬 수 있습니다. 새 ISS는 먼저 검토가 필요합니다. 검토와 실제 client_id가 없으면 운영 중인 EHR을 가리키지 마세요.

FHIR_AUTH_MODE

동작

open (기본값)

Discovery 후 Authorization 없이 FHIR GET. Discovery 404는 open 모드에서는 치명적이지 않음(로그로 남기고 계속). FHIR 401/403 → { ok: false, http_status, ... }.

bearer

Discovery는 동일하게 수행함. Authorization Bearer 토큰을 붙여 FHIR GET.

backend_jwt

FHIR_CLIENT_ID(또는 SMART_CLIENT_ID)와 FHIR_PRIVATE_KEY_PEM이 모두 있을 때만 정상 동작. SMART Backend Services JWT. env가 없으면 시작을 거부. 자격 증명을 꾸며내지 않습니다.

App Launch(code+PKCE)는 범위 밖입니다. FHIR_REDIRECT_URI는 reserved 되어 있으며 아직 사용하지 않습니다.

인증 실패 형태: { ok: false, http_status, guide?, error? }. 합성 Patient는 반환하지 않습니다.

FHIR_WRITE 기본값은 off입니다. v1은 누가 on을 설정해도 쓰기 도구가 없습니다. 쓰기 통신은 FHIR에 AuditEvent를 POST하지 않습니다.

이름

기본값

설명

FHIR_ISS

default launcher R4

반드시 allowlisted 유지

FHIR_VERSION

R4

다른 값은 거부

FHIR_AUTH_MODE

open

open / bearer / Backend_jwt

FHIR_WRITE

off

v1에서는 쓰기(write)는 항상 off

FHIR_AUDIT_PATH

/workspace/smart-fhir-mcp/audit/audit.jsonl

Append-only JSONL; 로컬에서는 ./audit/audit.jsonl

FHIR_ACCESS_TOKEN

미설정

Bearer 전용

FHIR_CLIENT_ID

미설정

Backend Services용

SMART_CLIENT_ID

미설정

FHIR_CLIENT_ID의 별칭

FHIR_PRIVATE_KEY_PEM

미설정

Backend Services JWT 용

FHIR_JWKS_URL

미설정

EHR가 JWKS를 원할 경우에 사용

FHIR_SCOPE

five system/*. 못한 types

Available Tools

4 tools
fhir_auth_statusFHIR auth statusA

Report mode, ISS, R4 lock, write=off, token_present, discovery_ok. Never prints token or PEM.

ParametersJSON Schema
NameRequiredDescriptionDefault

No parameters

TDQS

A3.5/5.0
Behavior3/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

The description adds the behavioral note 'Never prints token or PEM', which is a valuable safety disclosure not available in annotations (since none are provided). It also lists exactly what will be reported. However, it does not state whether the operation is read-only, whether it can fail (e.g., if discovery hasn't been run), or what the response format will be. Given zero annotations, the description carries the burden but provides only partial behavioral transparency.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The description is a single, tightly written sentence that front-loads the verb 'Report' and then enumerates the status fields. It ends with a concise safety disclaimer. There is no fluff or repetition; every word earns its place. This is an exemplary model of conciseness.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a zero-parameter tool with no output schema, the description lists all the status values it reports and adds a safety constraint. It lacks details on the exact output structure (e.g., JSON keys vs. plain text) and does not specify whether the tool requires prior setup (like discovery), but these are minor given the tool's simplicity. Overall, it provides enough context for an agent to call and interpret the results reasonably.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters4/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

The tool has zero parameters (schema is an empty object), so the baseline for parameter semantics is 4 according to the rubric. The description correctly mentions the fields that will be reported, which are effectively the tool's 'output' rather than input parameters. Since there are no parameters to document, the description adds what little meaning is needed.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose4/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description uses the verb 'Report' and lists specific status fields (mode, ISS, R4 lock, etc.), making the tool's purpose clear: to report FHIR authentication status. It is distinguishable from siblings like fhir_search and fhir_read by focusing on auth state rather than data operations, and from smart_discover by being a status check. However, it does not explicitly differentiate itself from siblings in the text.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines2/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

The description provides no guidance on when to use this tool versus the sibling tools. It doesn't mention scenarios like 'before calling fhir_search' or 'when you need to verify authentication state'. The purpose is implicit from the name and list of status fields, but no explicit usage context is given, and no exclusions or alternatives are referenced.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

fhir_readFHIR readB

GET {iss}/{resourceType}/{id} as FHIR R4. 404 is not found, not a made-up resource. Same resourceType allowlist as search.

ParametersJSON Schema
NameRequiredDescriptionDefault
idYes
issNo
resourceTypeYes

TDQS

B3.3/5.0
Behavior3/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

With no annotations provided, the description carries the full burden. It does disclose that a 404 means genuinely not found, which is valuable error semantics. It also indicates the response is FHIR R4 format. However, it does not mention authentication requirements, rate limits, or what happens on other errors (e.g., 401, 500). For a read-only GET operation, this is above minimum but not rich.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The description is two sentences with no wasted words. The URL template is front-loaded, followed by a critical error-handling note and a cross-reference to search. Every sentence earns its place, making it highly efficient.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness3/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a simple single-resource read, the description covers the URL construction, 404 semantics, and resource type allowlist. It does not explicitly state the tool's overall purpose (fetching one resource) or mention authentication, which might be assumed from a prior auth step. Given no output schema, it could also clarify the response shape, though 'FHIR R4' implies a FHIR resource. Slight gaps remain in purpose clarity and auth context.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema description coverage is 0%, so the description must compensate. The URL template '{iss}/{resourceType}/{id}' gives meaning and ordering to the three parameters, and the allowlist note constrains resourceType. However, it does not explain what iss represents (likely the server base URL) or any format expectations for id or resourceType beyond being strings. This is partial compensation for the lack of schema documentation.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose4/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description states 'GET {iss}/{resourceType}/{id} as FHIR R4', which clearly indicates a read operation targeting a specific FHIR resource. It also clarifies the 404 semantics, which helps distinguish it from a search that might return empty results. However, it does not explicitly say 'retrieve a single resource by ID', relying on the URL pattern to imply it, and it does not contrast with fhir_search directly beyond the allowlist note.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines2/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

The description provides no explicit guidance on when to use this tool versus fhir_search or other siblings. It only mentions 'Same resourceType allowlist as search', which hints at shared constraints but does not explain the core difference (single resource lookup vs query). A clear statement like 'Use this to fetch one resource by ID; use fhir_search for queries' is missing.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

smart_discoverSMART discoverA

GET {iss}/.well-known/smart-configuration (SMART App Launch 2.2.0). Optional iss must be v1-allowlisted. Does not invent endpoints.

ParametersJSON Schema
NameRequiredDescriptionDefault
issNo

TDQS

A3.8/5.0
Behavior3/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

With no annotations, the description carries the full burden of behavioral disclosure. It includes one genuinely useful behavioral note ('Does not invent endpoints'), signaling the tool only returns what the server actually advertises. However, it omits other relevant behavior such as error handling when iss is not allowlisted, whether authentication is needed, or any required scopes, leaving the behavioral profile only partially disclosed.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

Three terse, information-dense sentences with no filler. The endpoint is front-loaded, followed by the spec version, the parameter constraint, and the single most important behavioral caveat. Every sentence earns its place.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a simple one-optional-parameter discovery tool with no output schema, the description covers the endpoint, the constraint, and the key behavior. Return format is not described, but SMART discovery responses are standardized by the cited spec, reducing the need. Only edge-case behavior (unallowlisted iss handling) is left unspecified, which is minor for this tool's simplicity.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema coverage is 0%, so the description must compensate. It does add meaning by substituting iss into the URL path and by stating the v1-allowlist constraint. However, it never explicitly defines iss as the FHIR server base URL or describes the valid format/value domain beyond the allowlist, leaving some semantic burden on inference from the '{iss}' placeholder.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

States a specific verb (GET) plus a concrete resource (.well-known/smart-configuration) with a spec version (SMART App Launch 2.2.0). The '{iss}' prefix clarifies it targets a specific FHIR server's discovery document, and it is clearly distinct from the sibling tools (fhir_auth_status, fhir_search, fhir_read) which handle auth status and searches/reads rather than capability discovery.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines3/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

Provides a useful precondition (iss must be v1-allowlisted) and clarifies the call is optional-parameter. However, it gives no explicit guidance on when to prefer smart_discover versus sibling tools like fhir_auth_status, nor any exclusion criteria. The 'when to use vs alternatives' context is implied by its distinct purpose but never stated.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

Tool Schema Changelog

Recent tool additions, removals, and schema changes observed during successful MCP inspections.

  1. 4 tool updatesv1.0.0
    • First observedfhir_auth_status
    • First observedfhir_read
    • First observedfhir_search
    • First observedsmart_discover

TDQS

A3.6/5.0

Scored across 4 tools

Disambiguation5/5

Each tool targets a distinct function: smart_discover retrieves server metadata, fhir_auth_status reports client-side authentication state, fhir_search performs list queries, and fhir_read fetches individual resources. There is no overlap or ambiguity between the four operations.

Naming Consistency4/5

Tools use a consistent prefix pattern (smart_ for auth/discovery, fhir_ for data operations) and each suffix clearly indicates the action (discover, auth_status, search, read). While the prefixes differ by domain, the overall structure is predictable and not chaotic.

Tool Count4/5

Four tools is on the lower end but appropriate for a narrowly scoped read-only FHIR access server focused on discovery and basic querying. It avoids bloat while covering the primary use cases.

Completeness3/5

The server covers read and search for a limited set of resources, but lacks pagination (only one page), search parameters beyond resource type, and a capability statement. Given the explicit read-only nature, core operations are present but notable gaps exist in search depth and server metadata.

Maintenance

ActivityMaintained
ResponsivenessNo issues

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