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library for transforming FHIR (Fast Healthcare Interoperability Resources) bundles into normalized database tables following Third Normal Form (3NF).","maintainers":[{"name":"icedlee337","email":"lee.e.norris@gmail.com"}],"readme":"# @onivoro/isomorphic-fhir\n\nA library for transforming FHIR (Fast Healthcare Interoperability Resources) bundles into normalized database tables following Third Normal Form (3NF).\n\n## Overview\n\nThis library takes FHIR R4 bundles containing healthcare resources and transforms them into a set of normalized tables that can be used to populate a relational database. The transformation process:\n\n- Eliminates data redundancy across FHIR resources\n- Ensures referential integrity between healthcare entities\n- Creates proper foreign key relationships\n- Generates unique IDs for normalized records\n- Preserves FHIR resource relationships through reference tables\n- Handles complex nested structures like CodeableConcepts and Extensions\n\n## Supported FHIR Resources\n\nThe library currently supports normalization of the following FHIR R4 resources:\n\n- **Patient**: Demographics, identifiers, names, contacts, addresses\n- **Practitioner**: Healthcare providers, qualifications, contact information\n- **Organization**: Healthcare organizations, types, contact details\n- **Encounter**: Healthcare encounters, participants, locations\n- **Condition**: Medical conditions, clinical status, evidence\n- **Observation**: Clinical measurements, vital signs, lab results\n- **MedicationRequest**: Medication prescriptions, dosage instructions\n- **Procedure**: Medical procedures, performers, outcomes\n- **Immunization**: Vaccinations, reactions, protocols\n- **AllergyIntolerance**: Allergies, reactions, manifestations\n- **DiagnosticReport**: Diagnostic test results, conclusions\n- **Location**: Healthcare facilities, positions, contact info\n- **Appointment**: Scheduled appointments, participants\n- **CareTeam**: Care team members, roles, periods\n- **CarePlan**: Care plans, activities, goals\n\n## Usage\n\n```typescript\nimport { normalizeFhirBundle } from '@onivoro/isomorphic-fhir';\n\nconst fhirBundle = {\n  resourceType: 'Bundle',\n  type: 'searchset',\n  entry: [\n    {\n      resource: {\n        resourceType: 'Patient',\n        id: 'patient-123',\n        name: [{ family: 'Doe', given: ['John'] }],\n        gender: 'male',\n        birthDate: '1985-03-15'\n      }\n    },\n    {\n      resource: {\n        resourceType: 'Observation',\n        id: 'observation-456',\n        status: 'final',\n        code: { coding: [{ code: '8867-4', display: 'Heart rate' }] },\n        subject: { reference: 'Patient/patient-123' },\n        valueQuantity: { value: 72, unit: 'beats/min' }\n      }\n    }\n  ]\n};\n\nconst normalizedData = normalizeFhirBundle(fhirBundle);\n\n// normalizedData contains normalized tables:\nconsole.log(normalizedData.patients);      // Patient demographics\nconsole.log(normalizedData.patientNames);  // Patient names (separate table)\nconsole.log(normalizedData.observations);  // Clinical observations\nconsole.log(normalizedData.addresses);     // Addresses (deduplicated)\nconsole.log(normalizedData.telecoms);      // Contact points\nconsole.log(normalizedData.references);    // Resource relationships\n```\n\n## Normalized Tables Generated\n\nThe library generates 30+ normalized tables following healthcare data patterns:\n\n### Core Resource Tables\n- **bundles**: FHIR bundle metadata\n- **bundleEntries**: Bundle entry information\n- **patients**: Patient demographics\n- **practitioners**: Healthcare provider information\n- **organizations**: Healthcare organizations\n- **encounters**: Healthcare encounters\n- **conditions**: Medical conditions and diagnoses\n- **observations**: Clinical measurements and findings\n- **medicationRequests**: Medication prescriptions\n- **procedures**: Medical procedures performed\n- **immunizations**: Vaccination records\n- **allergyIntolerances**: Allergy and intolerance information\n- **diagnosticReports**: Diagnostic test reports\n- **locations**: Healthcare facility information\n- **appointments**: Scheduled appointments\n- **careTeams**: Care team compositions\n- **carePlans**: Patient care plans\n\n### Relationship and Detail Tables\n- **patientIdentifiers**: Patient identifier systems\n- **patientNames**: Patient name variations\n- **patientContacts**: Emergency/family contacts\n- **practitionerQualifications**: Provider credentials\n- **organizationTypes**: Organization classifications\n- **encounterParticipants**: Encounter participants\n- **observationComponents**: Multi-component observations\n- **medicationDosages**: Medication dosing instructions\n- **procedurePerformers**: Procedure performers\n- **allergyReactions**: Allergic reactions\n- **allergyManifestations**: Reaction manifestations\n- **diagnosticReportResults**: Report result references\n- **appointmentParticipants**: Appointment participants\n- **careTeamParticipants**: Care team member details\n- **carePlanActivities**: Care plan activity details\n\n### Common Data Type Tables\n- **addresses**: Physical addresses (deduplicated)\n- **telecoms**: Contact points (phone, email, etc.)\n- **codeableConcepts**: Coded concepts with text\n- **codings**: Individual coding systems\n- **notes**: Annotations and comments\n- **attachments**: Binary attachments and documents\n- **references**: Resource references and relationships\n\n## Key Features\n\n### FHIR Compliance\n- Full FHIR R4 resource support\n- Proper handling of FHIR data types (CodeableConcept, Reference, etc.)\n- Preservation of clinical terminology and coding systems\n- Support for complex nested structures\n\n### Data Integrity\n- Referential integrity through normalized foreign keys\n- Unique constraint handling for identifiers\n- Proper temporal data handling (effective periods, timestamps)\n- Clinical status and verification status preservation\n\n### Healthcare-Specific Patterns\n- Support for multiple identifier systems per resource\n- Proper handling of clinical hierarchies (conditions, observations)\n- Care team and care plan relationship modeling\n- Medication dosing and administration patterns\n- Allergy and adverse reaction tracking\n\n### Performance Optimized\n- Efficient deduplication of common entities (addresses, codings)\n- Bulk insert-friendly table structures\n- Indexed foreign key relationships\n- Minimal data redundancy\n\n## Testing\n\nThe library includes comprehensive tests covering:\n- Complete FHIR bundle normalization\n- Individual resource type processing\n- Complex nested structure handling\n- Reference relationship preservation\n- Edge cases and error conditions\n\nRun tests with:\n```bash\nnx test lib-isomorphic-fhir\n```\n\n## FHIR Standards Compliance\n\nThis library is designed to work with FHIR R4 resources and follows HL7 FHIR standards for:\n- Resource structure and cardinality\n- Data type handling and validation\n- Reference resolution and integrity\n- Clinical terminology bindings\n- Healthcare workflow patterns\n\n## Use Cases\n\nPerfect for:\n- **EHR Data Warehousing**: Normalize FHIR data for analytics\n- **Clinical Data Lakes**: Store FHIR resources in relational format\n- **Interoperability Solutions**: Transform FHIR for legacy systems\n- **Healthcare Analytics**: Enable SQL-based analysis of clinical data\n- **Compliance Reporting**: Structure data for regulatory requirements\n- **Research Databases**: Prepare clinical data for research queries\n\n## License\n\nThis library is licensed under the MIT License. See the LICENSE file in this package for details.","readmeFilename":"README.md"}