A Scalable and Secured HL7 FHIR Healthcare Platform: Architecture, Load Testing, and Preliminary Findings

This paper presents a healthcare platform based on the HL7 FHIR standard that addresses two critical needs in modern healthcare information systems: secure interoperability and scalability. The platform uses a robust FHIR data model to support standardized integration with existing PROs and analytics systems. By deploying microservices as containerized services on virtual infrastructure and managing identities with Keycloak, the platform enables real-time, secure data exchange between clinicians and patients in compliance with data protection regulations. Load testing with up to 5,000 concurrent users demonstrates efficient resource utilization and highlights areas for potential optimization. These findings contribute a reference architecture and initial performance results that can guide implementation of large-scale, FHIR-compliant solutions in clinical or research settings. This approach supports secure, real-time data exchange between patients and clinicians. As a result, this study offers valuable insights into interoperability, security considerations, and system scalability in digital health environments.