Health Information Exchange Standards Compliance via Integration Testing…

Peter Jordan, Solution
Architect
Andrew Terris,...
Introduction
HISO 10040 Health Information Exchange

10040.1
R-CDRs
XDS

10040.2
CCR
SNOMED CT
Archetypes

10040.3
Documen...
HIE Integration Testing
New Zealand Solution
• Maturing CDA Landscape

• NZ CDA Toolkit – Specifications, but not standards
• HISO Standards – Sim...
Certification & Integration
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Patients First – Evaluate Primary Care
PMS Review – Clinicians & Technologists
Re...
Integration Test Platform
• ITP Services

• Validation Tool – tests messages & documents
• Downloads – sample test instanc...
Practical Discussion
Will the Integration as a Service approach succeed?
• Feedback – Generally positive
– PMS vendors (GP...
Summary & Conclusions
• Progress
- All CDA types used in national projects
- Adding clinical coding analysis

• Going Forw...
Reference Sources
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•
•
•
•
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•
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W3C. Extensible Markup Language (XML). http://www.w3.org/XML/...
Questions & Suggestions
• Additions to the Integration Test Platform?

• Thanks for attending!
peter.jordan@patientsfirst....
Health Information Exchange Standards  -  Compliance via Integration Testing
Health Information Exchange Standards  -  Compliance via Integration Testing
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Health Information Exchange Standards - Compliance via Integration Testing

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Solution Architect, Patients First

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Health Information Exchange Standards - Compliance via Integration Testing

  1. 1. Health Information Exchange Standards Compliance via Integration Testing… Peter Jordan, Solution Architect Andrew Terris, CEO HINZ Conference 2013 Paper Presentation 28 November 2013 1
  2. 2. Introduction HISO 10040 Health Information Exchange 10040.1 R-CDRs XDS 10040.2 CCR SNOMED CT Archetypes 10040.3 Documents CDA • Testing HIE Standards – CDA compliance • NZ Solution – Integration as a Service & certification • Discussion & Conclusions - meeting the challenges
  3. 3. HIE Integration Testing
  4. 4. New Zealand Solution • Maturing CDA Landscape • NZ CDA Toolkit – Specifications, but not standards • HISO Standards – Simplified CDA Templates • Vendor Products – Native CDA Capability • Integration as a Service • Certification and Integration – NHITB Strategy • Integration Test Platform – Web Site & Web Service
  5. 5. Certification & Integration • • • • • • Patients First – Evaluate Primary Care PMS Review – Clinicians & Technologists Regime – Structured & Standards-Based Analysis – 75% objective, 25% subjective Initial Focus – Interoperability Standards Plug & Play – Vendor & User Confidence
  6. 6. Integration Test Platform • ITP Services • Validation Tool – tests messages & documents • Downloads – sample test instances • Reporting – test results by application & version • ITP Interfaces • Web Site – additional rendering examples & links • Web Service – RESTful business functionality • ITP Validation Levels • Message Transport – CDA document wrappers • Document Formatting – Structural & Document Template • Data Content – Header, Section, Entry & Item Templates
  7. 7. Practical Discussion Will the Integration as a Service approach succeed? • Feedback – Generally positive – PMS vendors (GP2GP v2) & DHB CIOs • Operational Principles – Broad consensus: – HISO as certifying authority, Patients First the endorsed test agency – ITP as enabler, rather than enforcer, of standards – educative feedback • Usage – UAT moving into production for InterRAI & GP2GP v2 • HISO Standards – Simplified CDA Templates – Hierarchical Descriptions - (c/f XML Schematron –arcane conformance statements) – Human-understandable error and warning messages – Richer validation provided by OO languages • Service-Oriented – Web Form and RESTful interfaces – Centrally hosted and targeted testing – persists beyond project lives – No silo-based testing of entire product suite deployments
  8. 8. Summary & Conclusions • Progress - All CDA types used in national projects - Adding clinical coding analysis • Going Forward - Compliance testing as part of product certification - Objective criteria for informed purchasing decisions • Acknowledgements - Alastair Kenworthy & Dr. Peter Sergent. - HL7 NZ and various HIT/PMS software vendors! “Interoperability is not a boat race. One team can’t win by rowing better than another. We are all rowing the same boat.”
  9. 9. Reference Sources • • • • • • • • • • • • • • • • • • • • • W3C. Extensible Markup Language (XML). http://www.w3.org/XML/ HL7. Clinical Document Architecture Release 2. http://www.hl7.org/implement/standards/index.cfm Atalag K, Hay D, Kenworthy A, Le Maitre A. Interoperability Reference Architecture. Version 1.0 December 2011 HISO 10040.3. Health Information Exchange: Structured Documents. Version 1.0 April 2012 http://www.ithealthboard.health.nz/sites/all/files/HISO%2010040.3%20HIE%20Structured%20Documents%20v1.pdf HISO 10043. CDA Common Templates. Draft 10 April 2013 http://www.ithealthboard.health.nz/sites/all/files/vPC%20CDA%20Common%20Templates.pdf HISO 10047. Comprehensive Clinical Assessments for Older People. Draft 10 April 2013 http://www.ithealthboard.health.nz/sites/all/files/VPC%20Comprehensive%20Clinical%20Assessments%20for%20Older%20People.pdf Jordan P. Clinical Document Architecture Implementations - Lessons Learned To Date. HINZ Conference 2012 http://www.hinz.org.nz/uploads/file/2012conference/Papers/P9_Jordan.pdf Tech Target. Integration as a Service: Definition. http://searchcloudapplications.techtarget.com/definition/integration-as-a-service at June 2012 Wikipedia. Integration Testing: Definition. http://en.wikipedia.org/wiki/Integration_testing at 3 June2013 Rishel W. Gartner Blog Network. Health Interoperability January 9, 2013 http://blogs.gartner.com/wes_rishel/category/interoperability/ MSDN. Improving XML Document Validation With Schematron. http://msdn.microsoft.com/en-us/library/aa468554.aspx#schematron_topic4 HL7 Book. The Eclipse Instance Editor. http://hl7book.net/index.php?title=Eclipse_Instance_Editor Lantana Consulting Group. CDA Validator. https://www.lantanagroup.com/validator/ AHML. Australian Healthcare Messaging Laboratory. http://www.ahml.com.au/ NIST. Meaningful Use Test Methods. http://healthcare.nist.gov/use_testing/index.html Intelliware Software. e-Health Testing Platform. http://www.intelliware.com/case_study/e-health-testing-platform/ IHE. Integrating The Healthcare Enterprise. http://www.ihe.net/ PMS Requirements – final report http://174.142.164.230/~whmroot/_patientsfirst.org.nz/wp-content/uploads/2013/02/PMS-Requirements-Final-Report-v1-.1.pdf Commonwealth Fund – eMR adoption http://www.commonwealthfund.org/News/News-Releases/2012/Nov/International-Survey.aspx http://174.142.164.230/~whmroot/_patientsfirst.org.nz/wp-content/uploads/2013/02/PMS-Review-Findings-2011-Executive-Summary-Report-FINAL.pdf Wikipedia. Representational State Transfer: Definition. http://en.wikipedia.org/wiki/Representational_state_transfer
  10. 10. Questions & Suggestions • Additions to the Integration Test Platform? • Thanks for attending! peter.jordan@patientsfirst.org.nz andrew.terris@patientsfirst.org.nz

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