Smile CDR 2023.05.R01 and HAPI FHIR 6.6.0 (Code Name: Xenon)

Watch the recorded version of our first-ever live release on YouTube. This release includes:

Smile CDR 2023.05.R01

  • FHIR R5 is here! Both HAPI FHIR and Smile CDR now contain the final R5 resource definitions for the latest FHIR release. Support for the new R5 Subscription model is included, and a new R5 storage module type has been added in Smile CDR.

  • Custom resource types (i.e. resources not defined in the base FHIR specification) are now supported.

  • FHIR Gateway routes now support automatic retry on failures with several available automatic backoff modes.

  • MegaScale-enabled repositories now support resource references that cross MegaScale database boundaries, and the $expunge operation has now been enabled on MegaScale repositories.

  • CDS Hooks services now support CDS Hooks Extensions.

  • The MDM Module now maintains a history of changes to MDM links over time. A new operation called $mdm-link-history has been added to view this history.

  • A new user interface module named MDM UI has been added. This new experimental module provides a web based UI for administering links within the MDM module.

  • All HAPI FHIR 6.6.0 changes listed below are included in Smile CDR 2023.05.R01.


  • The Batch2 Framework (used for jobs such as Resource Reindexing and Bulk Export/Import has been significantly streamlined in order to avoid potential duplicate records, orphaned jobs, and incomplete records when running under heavy load.

  • Bulk Export/Import Operations have been enhanced to be fully partition aware.
    Two new instance-level operations for resource reindexing and reindex simulation have been added. These operations also provide a view of the generated database indexes, which can help with troubleshooting custom search parameters.

  • Sorting on chained search expressions is now supported, and can optionally leverage Uplifted Refchains for better performance as well.

  • Sorting on near-coordinate search parameters is now supported, in order to provide the closest matches first.

Clinical Reasoning

  • Upgraded to the latest CQL engine featuring enhanced compile-time function overload resolution, improving performance up to 10x for CQL with repeated function invocations. These improvements apply to all CR use cases (dQM, DTR, CDS).

  • Added support for the $care-gaps operation defined by the DaVinci Data Exchange for Quality Measures (DEQM) IG

  • Added support for the DaVinci Structured Data Capture (SDC) Questionnaire $extract operation

  • MeasureReports can now be automatically converted to CMS QPP format for submission using a new operation called $qpp-build.


  • Register and manage SMART apps for population health analytics that use bulk FHIR export server-to-server.

Payer-to-Payer Data Exchange Solution

  • Smart on FHIR compliance: support for audience parameter added for OIDC flow with source payers

  • Insight into Data Transfer Requests: Refresh option added in transfer table for improved user experience, allowing members to get the up-to-date status of their data transfer requests

Payer Member Portal 

  • Added MDM support within PMP. Queries for a given member will now include all records that have been linked through MDM. 

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