Sequoia Project Content Testing Program Overview · Industry-wide Content Pain Points Terminology:...

1 Copyright©2016TheSequoiaProject.Allrightsreserved.

Aninitiativeof

SequoiaProjectContentTestingProgramOverview

DidiDavisDirectorTestingPrograms

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Agenda• Background

– eHealthExchangeContentTestingEvolution– TestingWorkgroup(TWG)Background&Overview– Industry-wideContentPainPoints

• NewContentTestingProgramDetails– EnhancedContentTestingDocumentationPackage– ContentTestingProcess– ContentTestingToolingUnderConsideration– EnhancedContentTesting– Milestones/Timeline

• InformationandHowtoJointheTestingWorkgroup• GeneraleHealthExchangeUpdates• QuestionsandDiscussion


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


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


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


ProcessforCreatingConsistent&RobustHL7C-CDAs

ContentPriorities••Clinicians••BusinessOffice••Others

DataMapping••SDORequirements••Vendorspecificdatamodeloverlay

••SemanticInteroperabilityTransformation

C-CDACreation••IdentifySources••SystemConfiguration

••Value Sets••Internal/Externaltransformation


ContentTestingProcess


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


EnhancedContentTesting- Milestones

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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


Aninitiativeof

InformationandHowtoJointheTestingWorkgroup

SequoiaProjectTestingWorkgroupCallforParticipation

JoinNow:https://ehealth-exchange-testing.wikispaces.com/Communications+%26+Calendar


DeveloptestingrequirementstotestandvalidateHealthITModules

Createreviewandapprovetestingdocumentation,checklistsandUseCases

Determineinteroperabilitytestingrequirementstoenablerobusttestingofinformationexchangeamongparticipants

GeneraleHealthExchangeUpdates

• TheGeneralPerformanceandServiceSpecificationsAddendumwentintoeffecton11/19/16.

• TheHL7®FHIR-basedproviderdirectoryisnowliveandreadyfor‘pre-alpha’testingbyeHealthExchangeParticipantsand/ortheirVendors.– Ifyouareinterestedinhelpingtestthenewdirectory,please

sendane-mailto:[email protected]• StaytunedforupcomingwebinarstoreviewtheupdatedeHealth

ExchangeValidationPlanandnewusecases


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

Sequoia Project Content Testing Program Overview · Industry-wide Content Pain Points Terminology:...

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