1 copyright © 2015 the sequoia project. all rights reserved. an initiative of the testing program...
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1 Copyright © 2015 The Sequoia Project. All rights reserved.
An initiative of
The Testing ProgramDidi Davis, Testing Program Director
Matt Blackmon, Testing AnalystJuly 7, 2015
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Healtheway rebrands to reflect expanding mission for health IT interoperability, including:
• Increasing number of collaborative initiatives• Enhancing interoperability education• Promoting industry-wide best practices
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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 interconnectedorganizations working together for the benefit of all.
Connected We Stand.
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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.
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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Agenda
1. History and Overview of the eHealth Exchange 2. Introduction to the eHealth Exchange Testing Program and 2010/2011
Specifications3. The Validation Testing Programs Documentation4. Conformance Testing Checklists5. Automated Testing: The Developers Integration Lab (DIL)6. Getting Started in the Testing Program and How to Join the eHealth
Exchange7. The Testing Workgroup
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This conference was recorded and posted.
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An initiative of
History and Overview of the eHealth Exchange
17,000+ medical groups
1000+ dialysis centers
8,200 pharmacies
Supporting more than 100 million patients
Largest Health Information Exchange Network in the U.S.Now in 2015, the eHealth Exchange connects:
All 50 states
Four federal agencies(DoD, VA, HHS including
CMS, and SSA)
30% of U.S. hospitals
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
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(Acting as an Initiator)
(Acting as a Responder)
Patient Discovery(IHE XCPD)
Query for Documents (IHE XCA)
Searches for patients
Found patient
Retrieve Documents (IHE XCA)
Searches for Document(s)
Lists zero or more found documents
Transmits Document(s)
Returns zero or more documents
eHealth Exchange
Participant Gateway
eHealth Exchange
Participant Gateway
eHealth Exchange: BenefitsBenefit 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.
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An initiative of
Introduction to the eHealth Exchange Testing Program And the 2010/2011 Specifications
What is the Testing Program of the eHealth Exchange?• 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)
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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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Operational Infrastructure
Discovery, Message Security and Privacy
Information Exchange
Profiles
Security Infrastructure(Managed PKI) Web Services Discovery (UDDI)
Web Services Discovery (UDDI) Message Platform Authorization Framework
Patient Discovery
Query for Documents
Retrieve Documents
Patient Consent Push Publish /
Subscribe
Care Summary Exchange Quality / Admin Data Push Claims Eligibility
Runtime systems supporting the eHealth Exchange
Message security, privacy, and interoperable healthcare data exchange
Employing lower-level layers to enable basic message exchange patterns
Employing exchange patterns to enable clinical data enabled workflows
eHealth Exchange Architectural Layers/Specifications
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IHE Mappings to eHealth Exchange Architecture
Operational Infrastructure
Discovery, Message Security and Privacy
Information Exchange
Profiles
Security Infrastructure(Managed PKI) Web Services Discovery (UDDI)
Web Services Discovery (UDDI) Message Platform Authorization Framework
Patient Discovery
Query for Documents
Retrieve Documents
Patient Consent Push Publish /
Subscribe
Care Summary Exchange Quality / Admin Data Push Claims Eligibility
Runtime systems supporting the eHealth Exchange
Message security, privacy, and interoperable healthcare data exchange
Employing lower-level layers to enable basic message exchange patterns
Employing exchange patterns to enable clinical data enabled workflows
C32IHE PCC Content
IHE XCPD IHE XCA IHE XCA IHE BPPC IHE XDR/XDM
IHE XUA
IHE ATNA
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.• 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]
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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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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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An initiative of
The Validation Testing Programs DocumentationTesting for Participants and HIT Product Vendors
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
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http://sequoiaproject.org/ehealth-exchange/testing-overview/
eHealth Exchange Participant & Product Testing Fees
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 $34,000Smoke Test Cases, Security Test Cases (Required and Provisional)
2010 Specs 2011 Specs
Smoke Tests (Essential tests to verify connectivity and core functionality)
No charge $11,000
Security Tests N/A $8,000
Content (Basic C32, Bridge C32, C-CDA)1
Participation Validation Testing:
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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)
Product Testing Program
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
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eHealth Exchange Test Case Documentation
2010 Specifications for Participants & Product Vendors • 2010 Smoke Test Cases (6 required)
2011 Specifications for Participants • 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 • 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)
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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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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:– 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+Period
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33
Formal Change Process MilestonesApproval Milestones Fast Track Testing
Policy Target Approval
ACP Test Cases Target
ApprovalPresent 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
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An initiative of
Conformance Testing Checklists
Conformance ChecklistsTest Cases Testing Documentation (Test Steps) • 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:
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Overall format…too small to read in this view
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Prefix
Example: “PD”
In this example, “Patient
Discovery”38 Copyright © 2015 The Sequoia Project. All rights reserved.
ID
Example: “200”
“ID” identifies the Checklist Test Item Number
In this example, Item 20039 Copyright © 2015 The Sequoia Project. All rights reserved.
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.
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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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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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.44 Copyright © 2015 The Sequoia Project. All rights reserved.
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)
Column H
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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
Column I
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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
Column J
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An initiative of
Automated Testing The Developers Integration Lab (DIL)
http://dil.aegis.net
What is the DIL?
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SUT Adapter
SUT Adapter
SUT Adapter
How does the DIL work?
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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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An initiative of
Getting Started in the Testing Programand How to Join the eHealth Exchange
Preparing for eHealth Exchange TestingParticipant 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-readiness-checklist_2014-04-03.zip (You may need to enlist your vendor's help to complete this checklist)
• Apply to the Product Testing Program• Submit Product Testing Application• Submit Signed Testing Services Agreement• Complete DIL Setup Checklist• Pay Testing Fees
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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Onboarding & Testing Process
Staff Reviews
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An initiative of
The Testing Workgroup
Call for Participation – Testing Workgroup• 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
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An initiative of
Questions and AnswersFor further questions, please contact
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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