AidboxTrigger

The AidboxTrigger resource is available starting from version 2505 and is currently in the alpha stage.

AidboxTrigger is available in FHIR schema mode and allows you to execute custom SQL statements automatically when FHIR resources are created, updated, or deleted.

AidboxTrigger is a powerful feature that enables automatic execution of SQL statements in response to FHIR resource operations. It acts as a database-level hook system that can maintain data consistency, implement custom business logic, or integrate with external systems through database operations.

How AidboxTrigger works

AidboxTrigger works by registering SQL statements that are executed automatically after successful FHIR CRUD operations. The system:

1. Monitors AidboxTrigger resources in your Aidbox instance

2. Executes the configured SQL statements when matching FHIR operations occur

3. Supports parameterized queries using {{id}} template substitution

4. Ensures transactional consistency with automatic rollback on errors

Configure AidboxTrigger

Creating triggers

To set up an AidboxTrigger, create an AidboxTrigger resource with the following structure:

{
  "resourceType": "AidboxTrigger",
  "action": ["create","update","delete"],
  "resource": "Patient",
  "sql": "INSERT INTO audit_log (resource_id, action) VALUES ({{id}}, 'created');"
}

Only SQL statements that modify data (INSERT, UPDATE, DELETE) can be executed. Be cautious when designing your triggers, as this limitation prevents data retrieval operations and ensures that the triggers focus solely on data manipulation.

Required fields

• action (string array): Array of operations that trigger the SQL execution

• resource (string): The FHIR resource type to monitor

• sql (string): The SQL statement to execute

Supported actions

Action	Description	When Triggered
create	Executes when a new FHIR resource is created	POST operations, Bundle entries with POST
update	Executes when an existing FHIR resource is updated	PUT and PATCH operations, Bundle entries with PUT/PATCH
delete	Executes when a FHIR resource is deleted	DELETE operations, Bundle entries with DELETE

Examples

Basic audit logging

Set up a queue table and triggers to log all Patient operations:

-- Create audit table
CREATE TABLE IF NOT EXISTS patient_audit (
  id text NOT NULL,
  resource_type text NOT NULL, 
  status text NOT NULL,
  action text NOT NULL,
  ts timestamp with time zone DEFAULT CURRENT_TIMESTAMP
);

Create triggers for all operations:

# Create trigger
POST /fhir/AidboxTrigger
Content-Type: application/json

{
  "action": ["create","update","delete"],
  "sql": "INSERT INTO patient_audit (id, resource_type, status, action) VALUES ({{id}}, 'Patient', 'completed', 'create');",
  "resource": "Patient"
}

Multiple {{id}} usage

You can use multiple {{id}} references in a single SQL statement:

POST /fhir/AidboxTrigger
Content-Type: application/json

{
  "action": ["create"],
  "sql": "INSERT INTO patient_audit (id, resource_type, encounter_id, action) VALUES ({{id}}, 'Patient', (SELECT id FROM encounter where resource#>>'{subject,id}' = {{id}} LIMIT 1), 'create');",
  "resource": "Patient"
}

SQL without parameters

Triggers don't require the {{id}} parameter:

POST /fhir/AidboxTrigger  
Content-Type: application/json

{
  "action": ["create"],
  "sql": "INSERT INTO patient_stats (total_patients) VALUES (1) ON CONFLICT (id) DO UPDATE SET total_patients = patient_stats.total_patients + 1;",
  "resource": "Patient"  
}

Error Handling and Rollback

Automatic Rollback

AidboxTrigger ensures data consistency through automatic rollback:

• If any trigger SQL fails, the entire FHIR operation is rolled back

• The original FHIR resource operation returns a 500 error

• No partial state changes are persisted

# Example: Invalid SQL causes rollback
POST /fhir/AidboxTrigger
Content-Type: application/json

{
  "action": ["create"],
  "sql": "INVALID SQL STATEMENT",
  "resource": "Patient"
}

# Subsequent Patient creation will fail:
POST /fhir/Patient
# Returns: 500 Internal Server Error
# {
#   "issue": [{
#     "code": "exception",
#     "diagnostics": "Error occured during AidboxTrigger execution", 
#     "severity": "fatal"
#   }]
# }

Bundle Operations

AidboxTrigger respects Bundle transaction semantics:

Batch Bundles: Partial failure is allowed - successful operations have their triggers executed, failed operations are skipped.

Transaction Bundles: Complete rollback on any failure - if any operation or trigger fails, all changes are rolled back.

# Transaction bundle - all or nothing
POST /fhir
Content-Type: application/json

{
  "resourceType": "Bundle",
  "type": "transaction", 
  "entry": [
    {
      "request": {"method": "POST", "url": "/Patient"},
      "resource": {"id": "valid-patient"}
    },
    {
      "request": {"method": "POST", "url": "/Patient"}, 
      "resource": {"id": "invalid-patient", "name": "INVALID"}
    }
  ]
}
# If validation fails on invalid-patient, 
# no triggers execute and no resources are created

Best Practices

• Keep trigger SQL statements lightweight and fast

• Avoid complex queries that might slow down FHIR operations

• Consider using background processing for heavy operations

• Test your SQL statements thoroughly before deploying triggers

• Ensure trigger SQL follows least-privilege principles

• Validate that triggers don't expose sensitive data