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1 Copyright©2016TheSequoiaProject.Allrightsreserved.
Aninitiativeof
SequoiaProjectContentTestingProgramOverview
DidiDavisDirectorTestingPrograms
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2 ©CopyrightTheSequoiaProject.AllRightsReserved.
Agenda• Background
– eHealthExchangeContentTestingEvolution– TestingWorkgroup(TWG)Background&Overview– Industry-wideContentPainPoints
• NewContentTestingProgramDetails– EnhancedContentTestingDocumentationPackage– ContentTestingProcess– ContentTestingToolingUnderConsideration– EnhancedContentTesting– Milestones/Timeline
• InformationandHowtoJointheTestingWorkgroup• GeneraleHealthExchangeUpdates• QuestionsandDiscussion
3 Copyright©2016TheSequoiaProject.Allrightsreserved.
4 Copyright©2016TheSequoiaProject. Allrightsreserved.
eHealthExchangeContentTestingEvolution
HITSPC32
HITSPC62
MU2011
HL7C-CDAv1.1
MU2014
HL7C-CDAv2.0
HL7C-CDAv2.1
MU2015
• NoContentTestingRequired:IfParticipantorVendor’sarchitectureiscertifiedforMU2011editon,2014editionor2015edition• IfnotMUcertified:Requiredtotestoneormoreofthefollowing:• TheBasicC32(ONC2011Edition)• TheBridgeC32• TheConsolidatedCDA(C-CDA)(ONC2014Edition)
• InJune2015,CoordinatingCommitteeapproveslaunchofTestingWorkgroupwithinitialfocusonContentTesting
5 Copyright©2016TheSequoiaProject.Allrightsreserved.
TestingWorkgroup(TWG)Background&Overview
1. TestingWorkgroupapprovedbytheeHealthExchangeCoordinatingCommittee(CC)on6/16/2015
2. TestingWorkgroupLaunched6/30/2015– 2co-chairs3. TestingWorkgroupCharterApproved7/21/20154. ContentTestToolingResourcesInventory&Demonstrationcompletedby
10/31/20155. DraftEnhancedContentTestingDocumentationPublished11/5/20156. IndustryContentTestingToolsEvaluationandScoringCompleted1/5/20167. PublicCommentsresolvedandEnhancedContentTestingDocumentationRe-
PublishedApril11,20168. ContentTestingPilotApril– July2016
• https://ehealth-exchange-testing.wikispaces.com/eHealth+Exchange+Testing+Home#Home
Industry-wideContentPainPoints
Terminology:Inconsistentterminologyusage
Optionality:Morethanonewaytodothingsandinconsistentimplementationsacrossvendors
Complexity:TheC-CDAstandardisdifficulttounderstandandconsumeandislackinginclearlydocumentedexamples
SpecificationAmbiguity
7 Copyright©2016TheSequoiaProject.Allrightsreserved.
WhatistheEnhancedContentTestingProgram?• FocusedonHITSPC32/CCD,HL7ConsolidatedCDA(C-CDA)R1.1andR2.1
– Chapters1-4provideinformativeexcerptsforconformance• EnhancedTestableAssertions(Chapter5)• MeaningfulUse(MU)requirements/TransitionsofCare(Chapters6&7)• Enhancedtestcasesandprocedures(Chapter8)• Designedtoenableinteroperabilityandassurespecificationcompliance• Implementation-hardenedbyyearsofoperationsand
documentedpainpointsthatcontinuetobecoordinatedwithHL7forinclusioninfuturedocumentation:– HL7ImplementationGuides/CompanionGuides
• Chapter3– ImprovedScorecardRubrics
• (QuantitativeScoringCriteria)
– HL7C-CDACompanionGuideforMUGuidanceforR2.1– Relevant&PertinentDocumentationPublication– ExamplesTaskForceLibrary
EnhancedContentTestingDocumentationPackage
• https://ehealth-exchange-testing.wikispaces.com/Documentation+for+Comment• 2016_11_15_Sequoia_C-CDA_Content_Test_Cases.pdf
1. eHealth_Exchange_Content_Testing_Survey_Submission_Form_V2.0.pdf
2. 2017_eHEX_Content_Test_Data_CREATE.pdf3. RECEIVETestFiles
• MU_HITSP_C32C83_4Sections_RobustEntries_NoErrors.xml• 170.315_b5_ccds_amb_ccd_r11_sample2_v1.xml• 170.315_b5_ccds_amb_ccd_r21_sample1_v1.xml
8 Copyright©2016TheSequoiaProject.Allrightsreserved.
ProcessforCreatingConsistent&RobustHL7C-CDAs
ContentPriorities••Clinicians••BusinessOffice••Others
DataMapping••SDORequirements••Vendorspecificdatamodeloverlay
••SemanticInteroperabilityTransformation
C-CDACreation••IdentifySources••SystemConfiguration
••Value Sets••Internal/Externaltransformation
9 Copyright©2016TheSequoiaProject.Allrightsreserved.
ContentTestingProcess
10 Copyright©2016TheSequoiaProject.Allrightsreserved.
SubmitHL7C-CDACCDsample(s)andsubmissionform [email protected]
1.SystemUnderTest(SUT)createsC-CDAsubmissiondocument withappropriate
testdata
2.SUTself-validatesC-CDAsubmission(s)witheHealthExchangerequiredtoolingandmakesimprovements as
appropriatepriortosubmission
3.TheSUTemailsthesubmissionformandC-CDA
sample(s)[email protected]
4.TheTestingLabreviewscontenttesting
submission(s)andconfirmsreceipttoSUTpointof
contact
5.TheTestingLabschedulesamanualreviewforReceiveTestCaseasdescribedin
section8.1ofthedocumentation
6.TheTestingLabvalidatesC-CDAsubmission(s)withTestingToolsandprovidessummary reporttoSUT
ContentTestingToolingUnderConsiderationARTDÉCOR/GAZELLEOBJECTSCHECKER• HostedbyIHEServicesaspartoftheIHEInternationalSchemeTesting• ToolingwaspilotedinApril2015andisISO17025CompliantforConformityAssessment• CoversonlytheHITSPC32/CCD,HL7C-CDACCDR1.1andR2.1versions• Foundtoreportonwarningsanderrorsnotfoundbyothertestingtooling
DIAMETERHEALTH• FocusedonusingC-CDAdocuments• CCDAnalyzertoolhas280+rulesthatscoreC-CDAforsemanticandclinicalcompletenessandsyntax• Emphasisbeyondsimpleschema/schematron rulesavailableinintheNISTETTtool• ThistoolisproprietaryandONChasanopensourceScorecardoptionavailable
SITE:STANDARDSIMPLEMENTATION&TESTINGENVIRONMENT– C-CDASANDBOX• Acentralizedcollectionoftoolsandresources• AssiststhedevelopersandimplementersofHealthInformationTechnologystandardstoachieveinteroperability• ConsolidatedCDA(C-CDA)Sandboxwillbeevaluated• C-CDAScorecard
11 Copyright©2016TheSequoiaProject.Allrightsreserved.
EnhancedContentTesting- Milestones
12 Copyright©2016TheSequoiaProject.Allrightsreserved.12
MilestoneDescriptions TargetDate Status
PresenttoCCforReview/approval 11/15/16 Completed
ParticipantInput(PostdrafttoeHealthExchangeWiki)
11/15/16 Completed
Participant InputInformational Call(Reviewdocumentation)
12/02/16 InProcess
30daynoticetoParticipants 12/02/16 InProcess
30+dayObjectionPeriodEnds 01/09/17 NotStarted
TargetEffectiveDate 01/10/2017 NotStarted
eHealthExchangeToolingImplementation/Training January2017
NotStarted
TestingWorkgroupFeedback toHL7/ONC Ongoing Ongoing
ContentTestingFutureTimeline
©2016CopyrightTheSequoiaProject.Allrightsreserved.
• PublicCommentofUpdatedDocumentationthroughDecember2016
• TestingToolingtobechosenforProductionContentTestingbyJanuary2017
• ProductionContentTestingtobeginJanuary2017– AllNewparticipantswillberequiredtotestContent– ExistingProductionParticipantswillhave12monthstotest
content– ErrorsEncounteredwithInitialtestingwillhavetobecorrected
within18monthsofinitialtestingreport
14 Copyright©2016TheSequoiaProject.Allrightsreserved.
Aninitiativeof
InformationandHowtoJointheTestingWorkgroup
SequoiaProjectTestingWorkgroupCallforParticipation
JoinNow:https://ehealth-exchange-testing.wikispaces.com/Communications+%26+Calendar
15 Copyright©2016TheSequoiaProject.Allrightsreserved.
DeveloptestingrequirementstotestandvalidateHealthITModules
Createreviewandapprovetestingdocumentation,checklistsandUseCases
Determineinteroperabilitytestingrequirementstoenablerobusttestingofinformationexchangeamongparticipants
GeneraleHealthExchangeUpdates
• TheGeneralPerformanceandServiceSpecificationsAddendumwentintoeffecton11/19/16.
• TheHL7®FHIR-basedproviderdirectoryisnowliveandreadyfor‘pre-alpha’testingbyeHealthExchangeParticipantsand/ortheirVendors.– Ifyouareinterestedinhelpingtestthenewdirectory,please
sendane-mailto:[email protected]• StaytunedforupcomingwebinarstoreviewtheupdatedeHealth
ExchangeValidationPlanandnewusecases
16 Copyright©2016TheSequoiaProject.Allrightsreserved.
Survey
17 2016©CopyrightTheSequoiaProject.Allrightsreserved.
Pleaserespondtothesurveyquestions.
1. WhatUsecasedoesyourorganizationcurrentlysupportfortheexchangeofclinicalcontent?
a.Treatment/CareCoordinationb.Military/VeteranHealthc.SSA/DisabilityDeterminationd.CMS/QualityReportingforEndStageRenalDiseasePrograme.Otherf. Unknown
2.WhichversionofHL7Contentdoesyourorganizationcurrentlysupport?a.HITSPC32b.HL7C-CDARelease1.1c.HL7C-CDARelease2.1d.Unknown
18 2016©CopyrightTheSequoiaProject.Allrightsreserved.