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:information_source: Start this ETL Job for incremental load
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The ETL job FHIR-to-OMOP can be executed as incremental load. The incremental load is used to load FHIR resources from FHIR Gateway to OMOP CDM that have been changed (inserts and updates) since the last bulkload or incremental load. To ensure that the ETL job only uses new or changed resources, the resources in the FHIR Gateway are filtered using the `last_updated_at` column. Because filtering is based on the **DATA_BEGINDATE** and **DATA_ENDDATE** parameters in the `sample.env` file, both parameters have to be adjusted before running the ETL job.
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When the job runs as incremental load, all resources are processed in a random order. For this reason, processing FHIR resources is more complex than bulkload. The following sections provide an overview of the data flow and processing of resources depending on their type.
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# Data flow
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## Patient
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