The $everything operation retrieves available patient-scoped FHIR R4 resources associated with a specified patient identifier. It returns the patient’s available record as a FHIR Bundle, including the Patient resource and related resources available to the authorized user.

For migration and record retrieval workflows, $everything provides a patient-level export of structured FHIR data in a single transaction pattern. The response may include both resources that directly reference the patient and supporting resources required to preserve clinical context and inter-resource references.

Errors are returned as FHIR OperationOutcome resources.

The operation conforms to HL7 FHIR R4. OAuth 2.0 authentication is required before invoking the operation.

Base URL and Environment

The base URL is environment-specific. Separate base URLs are provided for sandbox and production environments.

Example base URLs

https://sandbox.healthgorilla.com/fhir/R4/
https://api.healthgorilla.com/fhir/R4/

All requests use the versioned FHIR R4 path structure:

/fhir/R4/

All requests require OAuth 2.0 authentication. Your system must obtain an access token and include it in the request header:

Authorization: Bearer YOUR_ACCESS_TOKEN

Required scopes are enforced according to your organization’s configuration.

Request Syntax

Use the following syntax to invoke the $everything operation.

Required Components

Method: GET
Path: /fhir/R4/Patient/{PATIENT_ID}/$everything
Headers:

Authorization: Bearer YOUR_ACCESS_TOKEN
Accept: application/fhir+json

Example Request

curl -X GET \
  'https://sandbox.healthgorilla.com/fhir/R4/Patient/12345/$everything' \
  -H 'Authorization: Bearer YOUR_ACCESS_TOKEN' \
  -H 'Accept: application/fhir+json'

Optional Query Parameters

Optional query parameters can filter returned resources and control response size.

Resource Filtering

Use the following parameters to limit returned resources:

Parameter	Description
`_type`	Comma-separated list of FHIR resource types
`start`	Inclusive lower bound for clinically relevant date
`end`	Inclusive upper bound for clinically relevant date
`_since`	Returns resources modified after the specified timestamp
`_count`	Limits the maximum number of resources returned per page

Parameter formats:

start and end use ISO 8601 date format (YYYY-MM-DD)
_since uses ISO 8601 dateTime format (YYYY-MM-DDThh:mm:ssZ)

The start and end parameters apply to clinically relevant care dates rather than resource update timestamps.

Filtering Example

curl -X GET \
  'https://sandbox.healthgorilla.com/fhir/R4/Patient/12345/$everything?_type=Patient,Encounter,Observation,Condition&_count=100&start=2024-01-01&end=2024-12-31' \
  -H 'Authorization: Bearer YOUR_ACCESS_TOKEN' \
  -H 'Accept: application/fhir+json'

Pagination Controls

Use _count to request the maximum number of resources returned per page, subject to server limits.

When pagination links are returned, follow the link[relation="next"] URL exactly as provided. Do not construct pagination requests manually.

Response Behavior

When the request succeeds, Health Gorilla returns:

HTTP 200 OK
Content-Type: application/fhir+json

Body:

FHIR Bundle

The response Bundle contains the Patient resource and related resources associated with that patient.

The response may include:

entry[]: Patient-scoped FHIR resources
link[]: Pagination links
link[relation="next"]: Present when additional pages are available
total: Total number of matching resources, when supported

If the specified patient identifier does not exist, the server returns: 404 Not Found.

If the patient exists but no associated resources are available, the server may return a Bundle with an empty entry[] array.

Example Response

{
  "resourceType": "Bundle",
  "id": "example-everything-response",
  "type": "searchset",
  "total": 3,
  "entry": [
    {
      "fullUrl": "https://sandbox.healthgorilla.com/fhir/R4/Patient/12345",
      "resource": {
        "resourceType": "Patient",
        "id": "12345",
        "name": [
          {
            "family": "Doe",
            "given": ["Jane"]
          }
        ],
        "gender": "female",
        "birthDate": "1985-06-15"
      }
    }
  ]
}

Data Scope

The $everything operation returns FHIR R4 resources associated with the specified patient. Resource types may include:

Encounter
Condition
Observation
MedicationRequest
MedicationStatement
AllergyIntolerance
DiagnosticReport
Immunization
Procedure
CarePlan
Goal
ServiceRequest
Coverage
DocumentReference
FamilyMemberHistory

Returned resources preserve references between related resources.

The response may also include resources that do not directly reference the Patient but are required to satisfy references from patient-associated resources, such as:

Practitioner
Organization
Location

Error Handling

Errors are returned as FHIR OperationOutcome resources.

Possible HTTP status codes include:

400 Bad Request
401 Unauthorized
403 Forbidden
404 Not Found
410 Gone
429 Too Many Requests
500 Internal Server Error

Example Error Response

HTTP/1.1 404 Not Found
Content-Type: application/fhir+json

{
  "resourceType": "OperationOutcome",
  "issue": [
    {
      "severity": "error",
      "code": "not-found",
      "diagnostics": "Patient 12345 was not found."
    }
  ]
}

For transient failures such as 429 or 500, exponential backoff is recommended.

Operational Considerations

When implementing the $everything operation, consider the following:

Rate limits may apply based on your organization’s configuration
Filtering parameters reduce dataset size and improve performance
Large patient records may result in paginated responses
Returned data reflects the patient record available in Health Gorilla at the time the request is processed

Note: Large $everything requests may take significant time to process. If a request exceeds approximately 60 seconds, it may time out at the communication layer and return an HTTP 504 response. To reduce the likelihood of timeouts, use filtering parameters such as _type, start, end, or _since, and paginate results using _count.

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