Overview

FHIR resources queried from EHR endpoints can vary from location to location. There will be occasions where data for specific resources may need to be adjusted to ensure that Link Cloud properly evaluates a patient against dQM’s. The Normalization service is a component in Link Cloud to help make those adjustments in an automated way. The service operates in between the resource acquisition and evaluation steps to ensure that the tenant data is in a readied state for measure evaluation.

Nodes

Common Configurations

• Swagger
• Azure App Configuration
• Kafka Configuration
• Kafka Consumer Retry Configuration
• Service Registry Configuration
• CORS Configuration
• Token Service Configuration
• Service Authentication
• SQL Server Database Configuration

Features and Functionality

The Normalization functionality is a critical step in preparing FHIR resources for further processing, such as measure evaluation or submission. It ensures that data adheres to expected formats, codes, and structures, enabling consistent and accurate downstream workflows.

Key Features

• Normalization is applied to each FHIR resource acquired from the EHR.
• The process is executed immediately after data acquisition.
• Tenant-specific configuration ensures normalization aligns with each tenant’s requirements.
• When a property is normalized, an extension is added to the FHIR resource containing the original value for reference.

Supported Operations

Normalization is supported by the following configurable operations:

Tail Messages

Normalization propagates the end-of-stream signal by forwarding a tail Resource Normalized Resource Normalized Event v0.7.0 Indicates that a FHIR resource has been standardized. Schema Map View docs event with acquisitionComplete = true for the same (patientId, reportTrackingId, queryType) tuple it received from acquisition. Measure Evaluation uses this tail to start evaluation for the current phase. See:

• Events → Resource Normalized Resource Normalized Event v0.7.0 Indicates that a FHIR resource has been standardized. Schema Map View docs
• Docs → Tail Messages: Patient Completion Signals

Configuration

Normalization settings are tenant-specific and configured to meet the unique requirements of each tenant. This ensures flexibility and adaptability across different EHR implementations.

The order of operations in the normalization configuration is defined by the index of each operation in the dictionary/configuration.

Example:

{
  "OperationSequence": {
    "1": {
      "$type": "CopyLocationIdentifierToTypeOperation"
    },
    "0": {
      "$type": "ConceptMapOperation"
    },
    "2": {
      "$type": "ConditionalTransformationOperation"
    }
  }
}

In this case, “ConceptMapOperation” is executed first, followed by “CopyLocationIdentifier…”, followed by “ConditionalTransform…”.

Notes

• Normalization ensures that all FHIR resources are processed in compliance with the applicable standards and requirements.
• Extensions added to properties retain original values, enabling transparency and traceability in the normalization process.