The Testing Program
Didi Davis, Testing Program Director
Matt Blackmon, Testing Analyst
July 7, 2015
An initiative of
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Copyright © 2015 The Sequoia Project. All rights reserved.
Healtheway rebrands
to reflect expanding
mission for health IT
interoperability, including:
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• Increasing number of collaborative initiatives
• Enhancing interoperability education
• Promoting industry-wide best practices
Why “The Sequoia Project”?
•
•
Sequoia trees are among the most enduring, massive living things.
An interconnected root system allows individual trees to support each
other, making the entire system stronger.
A thriving health IT community requires interconnected
organizations working together for the benefit of all.
Connected We Stand.
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Copyright © 2015 The Sequoia Project. All rights reserved.
Continued Support for
Carequality and eHealth Exchange
• The Sequoia Project will continue to serve
as the steward of its independent initiatives.
• The initiatives will continue to be governed
independently by its respective members.
• The Sequoia Project will be actively pursuing additional
interoperability initiatives that will aid in making secure
data exchange a reality in the U.S. More information will
be forthcoming within the year.
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Copyright © 2015 The Sequoia Project. All rights reserved.
Disclaimer
This webinar is a brief program description of the eHealth Exchange Testing
Programs. It does not constitute the full program policies and procedures of
the eHealth Exchange Testing Program. Those policies and procedures are
contained within the validation plan and the applicant agreement.
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Copyright © 2015 The Sequoia Project. All rights reserved.
Agenda
1.
2.
3.
4.
5.
6.
7.
History and Overview of the eHealth Exchange
Introduction to the eHealth Exchange Testing Program and 2010/2011
Specifications
The Validation Testing Programs Documentation
Conformance Testing Checklists
Automated Testing: The Developers Integration Lab (DIL)
Getting Started in the Testing Program and How to Join the eHealth
Exchange
The Testing Workgroup
This conference was recorded and posted.
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Copyright © 2015 The Sequoia Project. All rights reserved.
History and Overview of the eHealth Exchange
An initiative of
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Largest Health Information Exchange Network in the U.S.
Now in 2015, the eHealth Exchange connects:
17,000+ medical groups
All 50 states
1000+ dialysis centers
Four federal agencies
(DoD, VA, HHS including
CMS, and SSA)
30% of U.S. hospitals
8,200 pharmacies
Supporting more than
100 million patients
2015 Assumptions:
•
Totals include organizations that have completed the application process and are in the onboarding queue.
•
Data from non-participants was self-reported from the application or based on published data.
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eHealth Exchange Overview
eHealth Exchange Provides
– Legal Agreement and Governing Committee
– Operating Policies and Procedures
– Program Support (via Healtheway)
Technical Services
– UDDI (phone book of other network Participants)
– Security (x.509 Managed CA)
– Automated testing using Aegis platform
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eHealth Exchange Query Workflow
eHealth
Exchange
Patient Discovery
(IHE XCPD)
Retrieve Documents
(IHE XCA)
Query for Documents
(IHE XCA)
Participant
Gateway
(Acting as an
Initiator)
Found
patient
Lists zero or more
found documents
Returns zero or
more documents
eHealth
Exchange
Participant
Gateway
(Acting as a
Responder)
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Searches for
patients
Copyright © 2015 The Sequoia Project. All rights reserved.
Searches for
Document(s)
Transmits
Document(s)
eHealth Exchange: Benefits
Benefit
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How eHealth Exchange Achieves Benefit
Reducing
Costs
Using common standards, legal agreements and governance enables
participants to reduce legal fees and avoid building custom interfaces
with trading partners.
Improving
Clinical and
Business
Decisions
Access to a nationwide data sharing network provides secure access to
the comprehensive health data that healthcare providers, pharmacies
and payers require to improve clinical decision making, patient safety,
process improvement and fair payment.
Exchanging
Data with
Government
Agencies
Federal participation in the eHealth Exchange supports data sharing
among all participants and with agencies such as Centers for Medicare &
Medicaid Services, the Department of Defense, the Social Security
Administration and the Department of Veterans Affairs.
Planning for
the Future
Because the eHealth Exchange is governed by a representative set of
participants, its multi-purpose interoperability platform has the ability to
evolve and incorporate new use cases, standards, etc.
Copyright © 2015 The Sequoia Project. All rights reserved.
Introduction to the eHealth Exchange Testing Program
And the 2010/2011 Specifications
An initiative of
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What is the Testing Program of the eHealth Exchange?
•
•
•
•
•
•
•
•
•
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Developed to test compliance for Health Information Exchange (HIE) standards
as required by the eHealth Exchange Coordinating Committee
Purpose is to enable organizations that wish to participate to validate the
compliance of their Health Information Technology (HIT) with the eHealth
Exchange Performance and Service Specifications.
Designed to ensure interoperability and assure specification compliance and
minimal implementation
eHealth Exchange staff developed and operate validation programs to
implement testing in groupings of service sets, test scenarios and test cases
Implementation-hardened by years of operations
Evolves as new interoperability issues arise (The Specification Factory)
Intends to publish a multi-year roadmap (Testing Workgroup)
The community has developed a large body of test cases, testing data, and
conformity assessment tools including negative testing
The testing programs leverage AEGIS test lab Developers Integration Lab (DIL)
Copyright © 2015 The Sequoia Project. All rights reserved.
Who can leverage the Testing Program?
The eHealth Exchange Testing program supports:
– Applicants who wish to join the eHealth Exchange as Participants;
– Existing eHealth Exchange Participants who wish to test new capabilities or
retest as a condition of continued participation in the eHealth Exchange;
and
– Developers of systems who wish to have their product validated as eHealth
Exchange compliant.
The eHealth Exchange Testing program verifies that a System Under Test (SUT):
– Complies with the eHealth Exchange Specifications;
– Has the ability to interoperate with other eHealth Exchange Participant
Systems; and
– Has implemented key security features as demonstrated by negative testing.
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eHealth Exchange Architectural Layers/Specifications
Profiles
Employing exchange patterns to enable clinical data enabled workflows
Care Summary Exchange
Quality / Admin Data Push
Claims Eligibility
Information Exchange
Employing lower-level layers to enable basic message exchange patterns
Patient
Discovery
Query for
Documents
Retrieve
Documents
Patient
Consent
Push
Publish /
Subscribe
Discovery, Message Security and Privacy
Message security, privacy, and interoperable healthcare data exchange
Web Services Discovery (UDDI)
Message Platform
Authorization Framework
Operational Infrastructure
Runtime systems supporting the eHealth Exchange
Security Infrastructure
(Managed PKI)
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Web Services Discovery (UDDI)
IHE Mappings to eHealth Exchange Architecture
C32
IHE PCC
Profiles
Employing exchange patterns
to enable clinical data enabled workflows
Content
Care Summary Exchange
Quality / Admin Data Push
IHE XCPD
Information
ExchangeIHE XCA
IHE XCA
IHE BPPC
Employing lower-level layers to enable basic message exchange patterns
Patient
Discovery
Query for
Documents
Retrieve
Documents
Patient
Consent
Claims Eligibility
IHE
XDR/XDM
Push
IHE XUA
Discovery, Message Security and Privacy
Message security, privacy, and interoperable healthcare data exchange
Web Services Discovery (UDDI)
Message Platform
Authorization Framework
Operational Infrastructure
IHE ATNA
Runtime systems supporting the eHealth Exchange
Security Infrastructure
(Managed PKI)
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Publish /
Subscribe
Web Services Discovery (UDDI)
2010 Initial Product Specifications
These production specifications are in effect now, and are currently being
used by the majority of existing production Participants but they are being
sunset at a date to be determined by the eHealth Exchange Coordinating
Committee.
•
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•
•
•
•
•
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Access Consent Policies Production Specification – v1.0 [PDF – 154 KB]
Administrative Distribution Production Specification – v2.0 [PDF – 157 KB]
Document Submission Production Specification v2.0 [PDF – 192 KB]
Health Information Event Messaging Production Specification v2.0 [PDF – 133
KB]
Messaging Platform Production Specification v2.0 [PDF – 189 KB]
Patient Discovery Production Specification v1.0 [PDF – 199 KB]
Query for Documents Production Specification v2.0 [PDF – 178 KB]
Retrieve Documents Production Specification v2.0 [PDF – 150 KB]
Web Services Registry Production Specification v2.0 [PDF – 359 KB]
Copyright © 2015 The Sequoia Project. All rights reserved.
2011 Current Specifications (Production Eff. Date 3/1/12)
These specification were approved for production use for the eHealth Exchange Coordinating
Committee on 2012-03-01 and should be used by new eHealth Exchange Participants. Note that
Participants should consult with their key Exchange partners to coordinate their adoption of 2010
vs. 2011 specifications.
• CAQH CORE X12 Document Submission Service Interface Specification v 1.0 3/6/2012 [PDF –
390 KB]
• Electronic Submission of Medical Documentation (esMD) X12 Profile v 1.0 3/6/2012 [PDF –
783 KB]
• Web Services Registry Web Service Interface Specification v 3.1 3/6/2012 [PDF – 405 KB]
• Messaging Platform v3.0 approved by NTCon 6/27/2011 [PDF – 232 KB]
• Patient Discovery v2.0 approved by NTCon 6/27/2011 [PDF – 234 KB]
• Query for Documents v3.0 approved by NTCon 6/27/2011 [PDF – 201 KB]
• Retrieve Documents v3.0 approved by NTCon 6/27/2011 [PDF – 153 KB]
• Authorization Framework v3.0 approved by NTCon 7/25/2011 [PDF – 226 KB]
• Web Services Registry v3.0 approved by NTCon 7/25/2011 [PDF – 376 KB]
• Electronic Submission of Medical Documentation (esMD) XDR Production Specification
v1.0 [PDF – 324 KB]
• Administrative Distribution Production Specification v2.0 [PDF – 144 KB]
• Document Submission Production Specification v2.0 [PDF – 192 KB]
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Copyright © 2015 The Sequoia Project. All rights reserved.
What Specifications are Tested Today?
There are six eHealth Exchange specifications tested as part of the participant
and product testing program.
 Authorization Framework
 Messaging Platform
 Patient Discovery
 Query for Documents
 Retrieval of Documents
 Access Consent Policy (added June 2015)
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Copyright © 2015 The Sequoia Project. All rights reserved.
The Validation Testing Programs Documentation
Testing for Participants and HIT Product Vendors
An initiative of
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eHealth Exchange Validation Programs
Participant Testing Program
– Enables organizations wishing to participate in the eHealth Exchange
network to validate the compliance of their implemented HIT with the
eHealth Exchange Performance and Service Specifications
Product Testing Program
– Focus on compliance and interoperability testing
– Reduces cost and burden for participants to onboard by approximately
50%
– Minimizes the level of vendor / developer support of providers / HIOs
onboarding
– Reduces risk of interoperability issues being introduced into production,
including the cost and burden of fixing interoperability issues and
deploying patches
http://sequoiaproject.org/ehealth-exchange/testing-overview/
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Copyright © 2015 The Sequoia Project. All rights reserved.
eHealth Exchange Participant & Product Testing Fees
Participation Validation Testing:
Smoke Tests (Essential
2010 Specs
2011 Specs
No charge
$11,000
N/A
$8,000
tests to verify connectivity
and core functionality)
Security Tests
Content (Basic C32, Bridge C32, C-CDA)1
Notes:
1Optional Content testing: 1) Basic C32; 2) Bridge C32 and 3) C-CDA. Content testing is
waived if Applicant uses a product that was certified for the 2011 or 2014 edition of
EHR certification for Stage 1 or Stage 2 meaningful use. ($3,000 for each type of content
to be tested.)
Applicants using an eHealth Exchange Validated Product ONLY complete Smoke Testing.
Product Validation Testing $34,000
Smoke Test Cases, Security Test Cases (Required and Provisional)
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Copyright © 2015 The Sequoia Project. All rights reserved.
Product Testing Program
Vendors conduct rigorous set of
tests to validate:
• Conformance to underlying
standards and specifications
• Systems are free from known
interoperability issues transport, security,
transactions and content (if
not MU certified)
• Configured and operate
securely (negative security
tests)
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Copyright © 2015 The Sequoia Project. All rights reserved.
Content Testing Documentation
• The Basic C32 (ONC 2011 Edition)
• The Bridge C32
• The Consolidated CDA (C-CDA) (ONC 2014 Edition)
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Test Case Hierarchy
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Smoke Tests Summary
Smoke Tests Summary
The Smoke Tests Service Sets, Test Scenarios and Test Cases can be summarized as below for the
Participant and Product Testing Programs:
2010 Service set
2010 Scenario
2010 Test Case
Participant
X
SS: PRL-0000.0-2010 TS: PRL-I-0000.0-2010
TC: PD-I-0000.0-2010
X
SS: PRL-0000.0-2010 TS: PRL-I-0000.0-2010
TC: QD-I-0000.0-2010
X
SS: PRL-0000.0-2010 TS: PRL-I-0000.0-2010
TC: RD-I-0000.0-2010
X
SS: PRL-0000.0-2010 TS: PRL-R-0000.0-2010 TC: PD-R-0000.0-2010
X
SS: PRL-0000.0-2010 TS: PRL-R-0000.0-2010 TC: QD-R-0000.0-2010
X
SS: PRL-0000.0-2010 TS: PRL-R-0000.0-2010 TC: RD-R-0000.0-2010
Product
Peer to Peer
Peer to Peer
Peer to Peer
Peer to Peer
Peer to Peer
Peer to Peer
2011 Service set
2011 Scenario
2011 Test Case
Product
X
X
X
X
X
X
Participant
X
SS: PRL-0000.0-2011 TS: PRL-I-0000.0-2011
TC: PD-I-0000.0-2011
X
SS: PRL-0000.0-2011 TS: PRL-I-0000.0-2011
TC: QD-I-0000.0-2011
X
SS: PRL-0000.0-2011 TS: PRL-I-0000.0-2011
TC: RD-I-0000.0-2011
X
SS: PRL-0000.0-2011 TS: PRL-R-0000.0-2011 TC: PD-R-0000.0-2011
X
SS: PRL-0000.0-2011 TS: PRL-R-0000.0-2011 TC: QD-R-0000.0-2011
X
SS: PRL-0000.0-2011 TS: PRL-R-0000.0-2011 TC: RD-R-0000.0-2011
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Copyright © 2015 The Sequoia Project. All rights reserved.
eHealth Exchange Test Case Documentation
2010 Specifications for Participants & Product Vendors
•
2010 Smoke Test Cases (6 required)
2011 Specifications for Participants
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2011 Smoke Test Cases (6 required)
Security Test Cases (19 required for Participants)
Provisional Security Test Cases applicable to Product Testing ONLY (52 provisional)
2011 Specifications for Product Vendors
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2011 Smoke Test Cases (6 required)
Security Test Cases (35 required for Product Vendors)
Provisional Security Test Cases applicable to Product Testing ONLY (52 provisional)
Copyright © 2015 The Sequoia Project. All rights reserved.
eHealth Exchange Service Set Documentation
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eHealth Exchange Test Scenario Documentation
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eHealth Exchange Test Case Documentation
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ACP Test Cases and checklists – Approved by CC June 2015
• A pilot was facilitated under the direction of the CC, with three
organizations (IOD, Mirth and MRO). IOD and MRO represent two
releases of information (ROI) companies who manage medical records
releases for their provider customers. Mirth is an HIE vendor. All three
pilot participants provide gateways that can be leveraged for the eHealth
Exchange requirements.
• The three pilot participants agreed to complete the existing eHealth
Exchange Smoke Tests and Security Tests and then pilot the newly
developed ACP-SSA set of test cases.
• The Spec factory approved moving the ACP-SSA testing program
documentation and testing tools from pilot to production. The P&T Task
Group reviewed the documentation and had no additions / objections.
• The testing documentation has been posted for public comment here:
– http://ehealthexchange.wikispaces.com/Documents+Posted+for+30+Day+Comment+Period
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Copyright © 2015 The Sequoia Project. All rights reserved.
Fast Track Testing Process for Applicants/Participants Using a
Qualified Technology Solution – Approved by CC June 2015
•
Qualified Technology Solution is a system that satisfies the following:
–
–
–
–
–
•
•
•
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Is an eHealth Exchange validated solution;
Has a standardized production-level configuration that complies with the eHealth Exchange Performance and Service
Specifications;
Has a minimum of four (4) production Participants in the eHealth Exchange network who have successfully completed
testing without any issues. Those production Participants may not have any outstanding technical issues which
impede their ability to exchange information with other eHealth Exchange participants; and
Has a history of demonstrating reproducible compliance with the Performance and Service Specifications as
previously validated under the participant testing program.
Only Applicants or Participants who use Qualified Technology Solutions may utilize the Qualified Technology Solution
Testing Process.
An organization using a Qualified Technology Solution will be able to move directly into
production testing. This will accelerate the testing process, and reduce the level of effort and
cost to onboard.
The risk for production interoperability issues is expected to be minimal. Partner testing will
help verify that configurations of a Qualified Technology Solution are interoperable in a
production environment. The current testing process verifies the configurations in a test
environment. As a result, it does not detect configurations in a production environment.
The draft eHealth Exchange Testing Option has been posted for public comment effective
6/19/2015 at:
– http://ehealthexchange.wikispaces.com/Documents+Posted+for+30+Day+Comment+Pe
riod
Copyright © 2015 The Sequoia Project. All rights reserved.
Formal Change Process Milestones
Approval Milestones
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Fast Track Testing ACP Test Cases
Policy Target
Target
Approval
Approval
Present to CC for Approval (Draft):
6/8
April
Participant Input (Post draft to eHealth
Exchange Wiki):
6/18
May
Participant Input (Webinar to review
updates):
6/19
6/19
eHealth Exchange Informational Call
7/7
7/7
CC Approval:
6/30
6/16
Public Comment notice to participants:
7/2
7/7 (extended
from 6/20
Objection Period Ends:
7/31
8/6
Target Effective Date:
8/1
8/7
Copyright © 2015 The Sequoia Project. All rights reserved.
Conformance Testing Checklists
An initiative of
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Copyright © 2015 The Sequoia Project. All rights reserved.
Conformance Checklists
Test Cases Testing Documentation (Test Steps)
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The Test Steps field contains a list of steps that should be executed for the Test Case.
Each step has information that relates to the activity that is being accomplished. Within
these test steps there is a call out to the checklists that are also part of the overall testing
programs for the eHealth Exchange.
The CL: MA SOAP Request and CL: MA SOAP Response checklists specifically validate
conformance to the Messaging Platform (M) and Authorization Framework (A) Specifications,
see sample excerpt below:
Copyright © 2015 The Sequoia Project. All rights reserved.
Overall format…too small to read in this view
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Prefix
Example: “PD”
In this example,
“Patient
Discovery”
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ID
Example: “200”
“ID” identifies the Checklist
Test Item Number
In this example, Item 200
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Field being verified
Example: “S:Envelope”
“Field” identifies which node is under
examination.
In this example, it is the SOAP envelope.
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Field Level
Example: “0”
“Field level” identifies the level of
subordination of the node.
In this example, it is “0”, or top level.
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Copyright © 2015 The Sequoia Project. All rights reserved.
Verify Presence
Example: “R”
“Verify Presence” indicates whether the
field is Required, Optional, or Conditional.
In this example, it is “R” for Required.
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Copyright © 2015 The Sequoia Project. All rights reserved.
Multiple Possible
Example: “ “ [blank]
“Multiple Possible” indicates if there can be
more than one instance of this node.
In this example, it is blank, meaning no.
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Copyright © 2015 The Sequoia Project. All rights reserved.
Additional Verification, Description, example
Example: Verify: using the Messaging & Authorization SOAP Request
Checklist, verify the entire SOAP envelope.
This field provides the direct checklist instructions
In this example, it directs the user to another checklist for verification.
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Copyright © 2015 The Sequoia Project. All rights reserved.
Column H
Exchange Spec Reference
Example: “PD v2.0”
This field provides the reference to the relevant eHealth Exchange
Specification.
In this example, it refers to Patient Discovery, version 2.0 (2011)
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Copyright © 2015 The Sequoia Project. All rights reserved.
Column I
Underlying Specification
Example: “XCPD Section 3.55.4.1.2.1”
This field provides the reference to the underlying specification section.
In this example, it refers to the IHE Cross-Community Patient Discovery
(XCPD), section 3.55.4.1.2.1
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Copyright © 2015 The Sequoia Project. All rights reserved.
Column J
2nd Underlying Spec
Example: “HL7 v3 Domain: Transmission Infrastructure, Section 1.2”
PRPA_IN201305UV02.MCCI_MT000100UV01.Message
This field provides the reference to any underlying secondary
specification(s) section(s).
In this example, it refers to the HL7® version 3 specification
“Domain: Transmission Infrastructure” Section 1.2
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Copyright © 2015 The Sequoia Project. All rights reserved.
Automated Testing
The Developers Integration Lab (DIL)
http://dil.aegis.net
An initiative of
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Copyright © 2015 The Sequoia Project. All rights reserved.
What is the DIL?
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Copyright © 2015 The Sequoia Project. All rights reserved.
How does the DIL work?
SUT
Adapter
SUT
Adapter
SUT
Adapter
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Copyright © 2015 The Sequoia Project. All rights reserved.
Getting Started
•
•
•
•
•
OID and Assigning Authority ID
Health IT gateway
Patient Database
DIL UDDI Connection Information
Before executing any tests in the DIL, the following tasks need to be
completed:
– Registering in the DIL
– Publishing endpoints
– Downloading and Installing AEGIS certificates
– Finalizing UDDI configuration
• Paperwork/checklist process with Healtheway for customer support
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Copyright © 2015 The Sequoia Project. All rights reserved.
Getting Started in the Testing Program
and How to Join the eHealth Exchange
An initiative of
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Preparing for eHealth Exchange Testing
Participant Testing (New & Existing Participants)
Product Testing (For Vendors)
Apply to eHealth Exchange (New Applicants)
•
eHealth Exchange Application (New Applicants: The
Testing Services Agreement is included in the Application)
•
DURSA (Version September 30, 2014)
•
eHealth Exchange Participation Agreement
•
Testing Services Agreement
•
http://www.sequoiaproject.org/images/Content/Docume
nts/Application-Package/ehex-testing-readinesschecklist_2014-04-03.zip (You may need to enlist your
vendor's help to complete this checklist)
•
•
•
•
•
Coordinating Committee Approves Application for Participation
and Refers Applicant to Begin Practice Testing
N/A
Setup and Conduct Practice Testing in the DIL
Setup and Conduct Practice Testing in the DIL
Run Tests and Submit Results
Run Tests and Submit Results
Coordinating Committee Approves Applicant Test Results
The Sequoia Project Approves Applicant Test Results
Activate in Production Environment
N/A
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Copyright © 2015 The Sequoia Project. All rights reserved.
Apply to the Product Testing Program
Submit Product Testing Application
Submit Signed Testing Services Agreement
Complete DIL Setup Checklist
Pay Testing Fees
Onboarding & Testing Process
Staff Reviews
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Copyright © 2015 The Sequoia Project. All rights reserved.
The Testing Workgroup
An initiative of
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Call for Participation – Testing Workgroup
•
•
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•
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On behalf of the Coordinating Committee, the eHealth Exchange announces
an open call for participation in the new Testing Workgroup launching June
2015.
The Testing Workgroup will develop functional and conformance testing
requirements to test and validate Health IT Modules to the eHealth Exchange
criteria.
The Testing Workgroup will be responsible to create, review and approve
testing documentation, checklists and Use Cases.
The workgroup will determine interoperability testing requirements to enable
robust testing of information exchange among participants of the eHealth
Exchange for Coordinating Committee-approved use cases.
The Testing Workgroup shall focus on the broad industry needs by remaining
grounded in existing capabilities implemented in production as well as
identifying gaps or issues with information exchange among technology
platforms and architectures.
We invite your participation in the Testing Workgroup by signing up at
:http://goo.gl/forms/RfCOlfdM9p
Copyright © 2015 The Sequoia Project. All rights reserved.
Questions and Answers
For further questions, please contact
testing@sequoiaproject.org
An initiative of
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Content Testing Documentation
•
http://sequoiaproject.org/ehealth-exchange/testing-overview/testing-references-2/
•
The Basic C32 (ONC 2011 Edition)
– Basic C32 (ONC 2011 Edition) – Test Data Sets
– The Test Data Sets are found on pages 10-18 of Test Procedure for the ONC 2011 Edition
criteria: §170.306 (f) Exchange Clinical Information and Summary Record. For additional
information about the Data Notes, please refer to the Basic C32 test case
documentation
•
The Bridge C32
– Bridge C32 – Please use your own test data; no specific test data provided.
•
The Consolidated CDA (C-CDA) (ONC 2014 Edition)
–
Consolidated CDA (C-CDA) – Test Data Sets
–
The Test Data Sets are found in the ONC 2014 Edition criteria – §170.314(b)(2) –
Transitions of care – generate summary care records document. For additional
information about the Data Notes, please refer to the C-CDA test case documentation.
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