Using the Installer Wizard to create a foundation production and namespace provides you with a base production with all the mappings needed for a healthcare interoperability production. It saves you the time and effort of creating your own namespace and production needed for healthcare interoperability. You do not always have to start with a foundation production; if you are comfortable creating your own namespace and production, you can do so. As a side note, when you create an HL7 production, you are creating a foundation production.
The Ens.Activity.Operation.Local operation is used for activity monitoring. It is not required by the foundation production. For more about activity monitoring, see https://docs.intersystems.com/healthconnect20191/csp/docbook/DocBook.UI.Page.cls?KEY=EMONITOR_activity
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