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Jul 10, 2026: New FHIR Relational Schema v2 is here

July 9th, 2026 by Sonya Huang

We're excited to share that v2 of the FHIR Relational Schema is now available in Snowflake. This new version addresses several usability challenges.

What's changed in v2

Based on customer feedback, we've made meaningful improvements to the v1 schema:

  • Every table now has an id column that uniquely identifies each row, and duplicate rows are now near-zero across the schema.
  • Wider availability via Snowflake listing. v2 is now accessible to Zus customers using Snowflake in any US region (v1 was AWS-only, limited to us-east-1, us-east-2, and us-west-2).
  • Simpler queries. Foreign data like contact points, identifiers, names, and dosages has been folded directly into the resource tables it belongs to, eliminating many joins.

Migrating from v1 to v2

Because v2 includes breaking schema changes, existing queries will need to be updated. Both v1 and v2 will be supported in parallel to provide customers a smooth transition period.

To start the process:

  1. Accept the Snowflake listing. In your Snowflake account, a listing called FHIR has been shared with you already, which contains both v1 and v2 schemas. Follow these instructions to accept the listing.
  2. Rewrite your queries against the new schema. Most changes are mechanical (renamed tables and columns). Our migration guide has side-by-side v1/v2 examples for every breaking change.
  3. Cut over from v1 to v2 in your downstream applications.

Timeline

  • Today: v2 is live and ready to use
  • October 10, 2026: End of support for v1 schema
  • December 10, 2026: v1 schema is retired

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