Normalization Service

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

flowchart LR
nNormalizationService_4A3628B6["Service: Normalization Service"]
  nNormalizationService_4A3628B6 -->|produces| nresources_normalized_28215193["Event: resources-normalized"]
  nresources_acquired_566EB692["Event: resources-acquired"] -->|consumed by| nNormalizationService_4A3628B6
  subgraph nCompliance_DBAE25D_domain["Domain: Compliance"]
    nresources_normalized_28215193
  end
  subgraph nDataAccess_2A523756_domain["Domain: Data Access"]
    nresources_acquired_566EB692
  end
  subgraph nReport_4D4FBBDA_domain["Domain: Report"]
    nNormalizationService_4A3628B6
  end

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

Service Configurations

• ResourceCache__Redis__ConnectionString: Connection string to access the deployed Redis environment.
• ResourceCache__Redis__Password: Password for the deployed Redis environment.
• ResourceCache__BlobStorage__ConnectionString: Connection string to access the deployed Azure Blob Storage environment.
• ResourceCache__BlobStorage__BlobContainerName: The Azure Blob Storage container name where cached resources will be stored.
• ResourceCache__BlobStorage__BlobRoot: Root Azure Blob Storage directory the cached resources will be located.

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

• Normalizations are applied to each FHIR resource acquired from the EHR. When a ResourcesAcquired event is consumed, the Normalization service will retrieve the patient FHIR resources from a cache destination and process the resource types that have tenant normalization configurations.
• The process is executed immediately after data acquisition.
• Tenant-specific configuration ensures normalization aligns with each tenant's requirements.

Resource Caching

The CacheType value on consumed ResourcesAcquired events will inform the Normalization service whether patient FHIR resources are stored on Redis or Azure Blob Storage. The event contains a CacheKeys array that details which FHIR resource types were collected for the patient. This was done to optimize the normalization workflow to only process resource types that are applicable to a tenant's configurations.

For Redis caching, after normalization is complete, all FHIR resources for the patient are added to a new hash key to optimize the evaluation phase. When a ResourcesNormalized event is generated, a singular CacheKey will be on each event that will represent all of the related resources for the patient.

Supported Operations

Normalization is supported by the following configurable operations:

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

Relationships

flowchart LR
nNormalizationService_4A3628B6["Service: Normalization Service"]
  nNormalizationService_4A3628B6 -->|produces| nresources_normalized_28215193["Event: resources-normalized"]
  nresources_acquired_566EB692["Event: resources-acquired"] -->|consumed by| nNormalizationService_4A3628B6
  subgraph nCompliance_DBAE25D_domain["Domain: Compliance"]
    nresources_normalized_28215193
  end
  subgraph nDataAccess_2A523756_domain["Domain: Data Access"]
    nresources_acquired_566EB692
  end
  subgraph nReport_4D4FBBDA_domain["Domain: Report"]
    nNormalizationService_4A3628B6
  end