What problem does it solve? Ingesting large FHIR datasets from external Data Providers requires coordinating asynchronous manifest fetching, NDJSON file retrieval, authentication, encryption, and status tracking. This Skill documents how the Helios FHIR Server implements the $bulk-submit operation as a Data Consumer so you can configure, operate, and troubleshoot bulk ingestion correctly. ## Core Features & Use Cases - Asynchronous Bulk Ingestion: Kick off $bulk-submit with a manifest URL, poll status via poll tokens, cancel submissions, and fetch paginated status manifests. - Secure File Retrieval: Supports SMART Backend Services OAuth with private_key_jwt client assertions and JWE-encrypted files via fileEncryptionKey with ECDH-ES and AES key wrapping algorithms. - Import Modes and Indexing Controls: Choose replace or merge (RFC 7396) import semantics, deferred search indexing, index-during-ingest for Elasticsearch composites, and drift verification with $reindex repair. - Use Case: A Data Provider posts a $bulk-submit kick-off referencing an export manifest; HFS fetches and ingests the NDJSON files in batches, and you poll /bulk-submit-status/{poll_token} until the manifest reports completed. ## Quick Start Ask the assistant to kick off a $bulk-submit with a submitter identifier, submissionId, and manifestUrl, then poll the returned status URL until the manifest completes.