Organization-based hierarchical access control

Hierarchical organization-based access control in Aidbox allows for the restriction of access to data based on the organization to which it belongs. When this feature is enabled, the FHIR Organization resource in Aidbox gains new semantics and functionality.

This means that when users interact with the Organizational FHIR API, they are only able to access the resources that belong to their organization or tenant. The hierarchical organization-based access control ensures that data is logically isolated and accessible only within the appropriate organizational context.

Problem

FHIR resources must be separated per organizations. Organizations can be nested. Every organization has access to their own resources and to the nested organization resources.

Solution

Let's consider the next organization structure. There are two independent organizations Org A & Org D, each of them has nested, dependent organizations. Org B & Org C are nested to Org A, and Org E is nested to Org D.

Organization hierarchy structure

To achieve such a behavior, you may consider an Aidbox feature called organization-based access control.

Let's create the organization structure in Aidbox:

POST /fhir

type: batch
entry:
- request:
    method: PUT
    url: Organization/org-a
  resource:
    name: Organization A
- request:
    method: PUT
    url: Organization/org-b
  resource:
    name: Organization B
    partOf: 
      reference: Organization/org-a
- request:
    method: PUT
    url: Organization/org-c
  resource:
    name: Organization C
    partOf: 
      reference: Organization/org-a
- request:
    method: PUT
    url: Organization/org-d
  resource:
    name: Organization D
- request:
    method: PUT
    url: Organization/org-E
  resource:
    name: Organization E
    partOf: 
      reference: Organization/org-d

When an Organization resource is created, a dedicated FHIR API is deployed for that organization. This API provides access to the associated FHIR resources. Nested organization FHIR resources are accessible through the parent Organization API.

The Organization-based FHIR API base url:

<AIDBOX_BASE_URL>/Organization/<org-id>/fhir

The Organization-based Aidbox & FHIR formatsbase url:

<AIDBOX_BASE_URL>/Organization/<org-id>/aidbox

FHIR APIs reflection in organization-based access control

Try Org-BAC

Let's play with new APIs.

We will create a Patient resource in Org B:

PUT /Organization/org-b/fhir/Patient/pt-1
content-type: text/yaml
accept: text/yaml

name: [{given: [John], family: Smith}]
gender: male

Now we can read it:

GET /Organization/org-b/fhir/Patient/pt-1

Note, that patient has a https://aidbox.app/tenant-organization-id extension, which references org-b.

id: >-
  pt-1
meta:
  extension:
    - url: https://aidbox.app/tenant-organization-id
      valueReference:
        reference: Organization/org-b
    - url: ex:createdAt
      valueInstant: '2024-10-03T15:02:09.039005Z'
  lastUpdated: '2024-10-03T15:02:09.039005Z'
  versionId: '336'
name:
  - given:
      - John
    family: Smith
gender: male
resourceType: Patient

The resource is also accessible through Org A API:

GET /Organization/org-a/fhir/Patient/pt-1

But this resource is not accessible through Org C, Org D and Org E API:

GET /Organization/org-c/fhir/Patient/pt-1 
# 403 Forbidden

Limitations

Some Aidbox features do not respect Organization-based access control. The resources managing these features are inaccessible under the Organization API.

For example, there is SubsSubscription resource.

Any request to the SubsSubscription resource will return OperationOutcome with the 422 HTTP code and issue code not-supported.

If SubsSubscription resource is created using regular API (not Organization API), Aidbox Subscriptions will send notifications irrespectively of Organization hierarchy.

FHIR API over Organization resources

Create

POST <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/<resource-type>

Read

GET <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/<resource-type>/<id>

Update

Put

PUT <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/<resource-type>/<id>

Patch

The default patch method is merge-patch:

PATCH <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/<resource-type>/<id> 

Also, json-patch is supported.

Using application/json-patch+json header

PATCH <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/<resource-type>/<id>
content-type: application/json-patch+json

Using _method=json-patch search parameter:

PATCH <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/<resource-type>/<id>?_method=json-patch

See also patch.md

Delete

DELETE <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/<resource-type>/<id>

Search

GET <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/<resource-type>

The search API does not support search parameters:

  • _has
  • _assoc
  • _with

$everything

GET <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/Patient/$everything

History

Resource full history

GET <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/<resource-type>/<id>/_history

Specific version history entry

GET <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/<resource-type>/<id>/_history/<vid>

Bundle

Supported transaction and batch bundle types.

yaml
POST /Organization/org-a/fhir/
Accept: text/yaml
Content-Type: text/yaml

resourceType: Bundle
# transaction | batch
type: transaction
entry:
- request:
    method: POST
    url: 'Patient'
  resource:
    birthDate: '2021-01-01'
    id: 'pt-1'
    meta:
      organization:
        id: 'org-c'
        resourceType: 'Organization'
- request:
    method: POST
    url: 'Patient'
  resource:
    birthDate: '2021-01-01'
    id: 'pt-2'
- request:
    method: PATCH
    url: 'Patient/pt-3?_method=json-patch'
  resource:
  - op: replace
    path: birthDate
    value: '2021-01-01'

It is also possible to use org-based url in a request.url:

POST / Accept: text/yaml Content-Type: text/yaml  resourceType: Bundle # transaction | batch type: transaction entry: - request:     method: GET     url: '/Organization/org-a/fhir/Patient/pt-1' - request:     method: PUT     url: '/Organization/org-b/fhir/Patient/pt-3'   resource:     birthDate: '2021-01-01' - request:     method: POST     url: '/Organization/org-a/fhir/Patient'   resource:     birthDate: '2021-01-01'     id: 'pt-4' 

See also transaction.md

Metadata

GET <AIDBOX_BASE_URL>/Organization/<org-id>/fhir/metadata

AidboxQuery

AidboxQuery.

To use $query endpoint under organization-based hierarchical access control it is necessary to explicitly create organization param in AidboxQuery.

yaml
PUT /AidboxQuery/<query-name>

params:
  organization:
    type: string
query: "SELECT * from patient pt WHERE pt.resource#>>'{meta,organization,id}' = {{params.organization}}"
count-query: "SELECT count(*) from patient pt WHERE pt.resource#>>'{meta,organization,id}' = {{params.organization}}"
type: query

Now org-id is automatically available in the query in {{params.organization}}.

yaml
GET /Organization/<org-id>/$query/<query-name>

Shared resource mode

By default, nested API has no access to a resource that belongs to the upper organizations. Sometimes it is necessary to have resources that can be accessed by the nested APIs. To achieve it the resource should be marked as share.

Update and delete operations are not allowed from nested organizations' APIs. To update or delete sharedresource use its root organization API.

Create a shared resource

To create a shared resource, use the https://aidbox.app/tenant-resource-mode extension.

PUT /Organization/org-a/fhir/Practitioner/prac-1
content-type: text/yaml

meta:
  extension:
  - url: https://aidbox.app/tenant-resource-mode
    valueString: "shared"

Access shared resource from a nested API

GET /Organization/org-b/fhir/Practitioner/prac-1