Azure AHDS FHIR MCP Server 🚀

A Model Context Protocol (MCP) server implementation for Azure Health Data Services FHIR (Fast Healthcare Interoperability Resources). This service provides a standardized interface for interacting with Azure FHIR servers, enabling healthcare data operations through MCP tools.

Setup 🛠️

Installation 📦

Requires Python 3.13 or higher and uv.

Install uv first.

Configuration ⚙️

See the FastMCP guidance on mcp.json here: https://gofastmcp.com/integrations/mcp-json-configuration

Client Credentials Flow (default):

• Used for service-to-service authentication
• Leave USE_FAST_MCP_OAUTH_PROXY=false
• Keep HTTP_TRANSPORT=false to use stdio transport
• Uses Azure AD client credentials flow

{
    "mcpServers": {
        "fhir": {
            "type": "stdio",
            "command": "uvx",
            "args": [
                "azure-fhir-mcp-server"
            ],
            "env": {
                "fhirUrl": "https://your-fhir-server.azurehealthcareapis.com/fhir",
                "clientId": "your-client-id",
                "clientSecret": "your-client-secret",
                "tenantId": "your-tenant-id"
            }
        }
    }
}

OAuth On-Behalf-Of Flow:

Create the Azure App Registration

The OAuth on-behalf-of flow requires a confidential Azure AD application that represents the MCP server.

1. In the Azure portal, go to Microsoft Entra ID ➜ App registrations ➜ New registration. Give it a descriptive name such as FHIR-MCP-Server, set Supported account types to Single tenant, and leave the redirect URI unset for now.
2. After the app is created, capture the generated Application (client) ID and Directory (tenant) ID for later use.
3. Under Expose an API, select Set for the Application ID URI and accept the suggested value api://{appId}. Add a scope named user_impersonation with admin consent display/description also set to user_impersonation.
4. Under Certificates & secrets, create a New client secret (for example FHIR-MCP-Secret-New). Copy the secret value immediately; it is required for the MCP server clientSecret setting.
5. Under Authentication, add the following Web redirect URIs to support the FastMCP OAuth proxy:
   • http://localhost:9002/auth/callback Ensure Default client type remains No so the app stays confidential.
6. Under API permissions, choose Add a permission ➜ APIs my organization uses, search for your Azure Health Data Services FHIR server, and add the delegated scopes required for your scenario. Grant admin consent so the FastMCP proxy can request tokens without an interactive prompt.

• Environment variables:

  • Set USE_FAST_MCP_OAUTH_PROXY=true
  • Requires HTTP_TRANSPORT=true

• Start the MCP server with:

uv pip install -e .
uv run --env-file .env azure-fhir-mcp-server

• Update mcp.json:

{
    "mcpServers": {
        "fhir": {
            "type": "http",
            "url": "http://localhost:9002/mcp"
        }
    }
}

The following is a table of available environment configuration variables:

Variable	Description	Default	Required
fhirUrl	Azure FHIR server base URL (include /fhir)	-	Yes
clientId	Azure App registration client ID	-	Yes
clientSecret	Azure App registration client secret	-	Yes
tenantId	Azure AD tenant ID	-	Yes
USE_FAST_MCP_OAUTH_PROXY	Enable FastMCP Azure OAuth proxy integration	false	No
HTTP_TRANSPORT	Run the MCP server over HTTP transport (required for OAuth proxy)	false	No
FASTMCP_HTTP_PORT	Port exposed when HTTP_TRANSPORT=true	9002	No
FHIR_SCOPE	Override FHIR audience scope for the OBO flow (space-separated)	{fhirUrl}/.default	No
FASTMCP_SERVER_AUTH_AZURE_BASE_URL	Public base URL of your FastMCP server	http://localhost:9002	No
FASTMCP_SERVER_AUTH_AZURE_REDIRECT_PATH	OAuth callback path appended to the base URL	/auth/callback	No
FASTMCP_SERVER_AUTH_AZURE_IDENTIFIER_URI	Azure App registration Application ID URI	api://{clientId}	No
FASTMCP_SERVER_AUTH_AZURE_REQUIRED_SCOPES	Space-separated scopes requested by the Azure provider	user_impersonation	No
FASTMCP_SERVER_AUTH_AZURE_ADDITIONAL_AUTHORIZE_SCOPES	Optional space-separated scopes added to the authorize request	-	No
LOG_LEVEL	Logging level	INFO	No

Available Tools 🔧

FHIR Resource Operations

• search_fhir - Search for FHIR resources based on a dictionary of search parameters
• get_user_info - (OAuth only) Returns information about the authenticated Azure user

Resource Access

The server provides access to all standard FHIR resources through the MCP resource protocol:

• fhir://Patient/ - Access all Patient resources
• fhir://Patient/{id} - Access a specific Patient resource
• fhir://Observation/ - Access all Observation resources
• fhir://Observation/{id} - Access a specific Observation resource
• fhir://Medication/ - Access all Medication resources
• fhir://Medication/{id} - Access a specific Medication resource
• And many more...

Development 💻

Local Development Setup

1 - Clone the repository:

git clone https://github.com/erikhoward/azure-fhir-mcp-server.git
cd azure-fhir-mcp-server

2 - Create and activate virtual environment:

Linux/macOS:

python -m venv .venv
source .venv/bin/activate

Windows:

python -m venv .venv
.venv\Scripts\activate

3 - Install dependencies:

pip install -e ".[dev]"

4 - Copy and configure environment variables:

cp .env.example .env

Edit .env with your settings:

fhirUrl=https://your-fhir-server.azurehealthcareapis.com/fhir
clientId=your-client-id
clientSecret=your-client-secret
tenantId=your-tenant-id

5 - Claude Desktop Configuration

Open claude_desktop_config.json and add the following configuration.

On MacOs, the file is located here: ~/Library/Application Support/Claude Desktop/claude_desktop_config.json.

On Windows, the file is located here: %APPDATA%\Claude Desktop\claude_desktop_config.json.

{
    "mcpServers": {
        "fhir": {
            "command": "uv",
            "args": [
                "--directory",
                "/path/to/azure-fhir-mcp-server/repo",
                "run",
                "azure_fhir_mcp_server"
            ],
            "env": {
                "LOG_LEVEL": "DEBUG",
                "fhirUrl": "https://your-fhir-server.azurehealthcareapis.com/fhir",
                "clientId": "your-client-id",
                "clientSecret": "your-client-secret",
                "tenantId": "your-tenant-id"
            }
        }
    }
}

6 - Restart Claude Desktop.

Running Tests

# Run all tests
python -m pytest tests/ -v

# Run with coverage
pytest tests/ --cov=src/azure_fhir_mcp_server

# Run specific test
pytest tests/test_fastmcp_metadata.py::TestFastMCPMetadata::test_fastmcp_server_discovery -v

# Run with detailed output
pytest tests/test_fastmcp_metadata.py::TestFastMCPMetadata::test_output_detailed_metadata -v -s

Contributions 🤝

Contributions are welcome! Please feel free to submit a Pull Request.

1. Fork the repository
2. Create your feature branch (git checkout -b feature/AmazingFeature)
3. Commit your changes (git commit -m '✨ Add some AmazingFeature')
4. Push to the branch (git push origin feature/AmazingFeature)
5. Open a Pull Request

License ⚖️

Licensed under MIT - see LICENSE.md file.

This is not an official Microsoft or Azure product.