Oct. 10, 2008 1

Conformance and Interoperability Testing of NHIS, Turkey: TestBATN Framework and NHIS Test Scenarios

http://www.srdc.com.tr/

TestBATN is supported by the Scientific and Technical Research Council of Turkey (TÜBİTAK), TEYDEP Project No: 7070191

Oct. 10, 2008 IHIC 08, Crete, Greece 2

Overview NHIS Overview NHIS Web Services Integration Profile TestBATN Framework Turkey NHIS Test Scenarios Conformance and Interoperability Testing Event,

Çeşme, İzmir Demonstration

Oct. 10, 2008 IHIC 08, Crete, Greece 3

NHIS Overview Turkey’s National Health Information System (NHIS)

aims to provide a nation-wide infrastructure for sharing Electronic Health Records (EHRs)

Currently, Minimum Health Data Sets, called the “Transmission Schemas”, from the Family Medicine Information Systems (FMIS) and the Hospital Information Systems (HIS) to the NHIS servers at the MoH premises

The implementation provides Twenty five HL7 v3 based Web Services Sixteen non-HL7 Web Services each of which is

specialized to a specific Minimum Health Data Set Transmission

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MHDS Web Services Integration Profile The integration profile is based on the following national

and international standards and specifications: The Transmission Schemas are HL7 v3 conformant messages

and localized according to the national requirements For transport protocol, HL7 Web Services Profile is used For security, WS-Security Username Token over SSL is required

for conformance Codes in the messages must be from the Health Coding

Reference Server (HCRS) The id numbers of the doctors in the messages should exist in

Doctor Data Bank The patient id numbers in the messages are required to exist and

be consistent with Turkey’s MERNIS (Central Demographics Management System)

For each Transmission Schema and MHDS, several semantic Business Rules are defined to provide consistency among the values used in the data elements

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TestBATN Framework A generic Web-based Conformance and Interoperability

Testing Framework for e-Business standarts and specifications HL7, Integrated Healthcare Enterprises (IHE), OASIS

UBL, OAGIS, GS1 eCOM, CIDX, RosettaNet, etc.

How the TestBATN can be used? Web-based testing service to support vendors to test

themselves for conformance and interoperability As a testing and monitoring tool in interoperability testing

events As a certification framework As tool for SDOs or interoperability consortiums

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TestBATN Features

A Test Execution Model consisting of high level test constructs

Provides functionalities to handle or simulate different parts or layers of the interoperability stack

Automate the whole testing process Messaging Capabilities (Sending, Receiving, Listening) Data Processing Capabilities Test Assertions Configuration Management User Interaction (set/show scenario requirements, test

questions, monitoring test execution)

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TestBATN Test Description Language A computer interpretable XML-based test

description language which provides Flexibility to design Modify Maintain and Extend the test functionality In contrast to a priori designed and hard coded test cases

Provides a graphical environment Where a test designer can assemble the reusable test

constructs to desing a test scenario

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Turkey NHIS Test Scenarios

Basic Conformance Test Cases: Tests the ability of the SUTs (HIS or FMIS systems) to send valid “Transmission Schemas” in terms of syntactic and structural constraints The ability of the systems to send HL7 Web Services Profile

conformant SOAP (Web Service) messages The ability of the systems to send WSSecurity Username-Token

Profile conformant SOAP (Web Service) messages The ability of the systems to use the username and the

password assigned to it correctly, as specified in the WS-Security Username-Token Profile in the corresponding SOAP header

Syntactic validations of “Transmission Schemas” sent by the systems against their corresponding XML schemas

Checking if the code systems and the codes used in the “Transmission Schemas” are valid

Validation of the “Transmission Schemas” according to the corresponding business rules

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Turkey NHIS Test Scenarios Interoperability Test Cases:

Functions as a proxy between the SUTs (FMISs and HISs) and the MoH NHIS Server

Internally stores all intercepted messages for further testing

Applies the same checks presented in basic conformance test cases and generates its own transmission response based on the profile constraints

As the final step, the transmission responses of the MoH Server are validated against the ones generated internally by the TestBATN framework

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Turkey NHIS Test Scenarios Functionality/Semantic Test Cases:

Tests whether the information in the transmissions accurately represents the intentional semantics of the FMIS or HIS users (e.g. doctors, family practitioners)

A real life scenario with some information requirements are provided to user or users are asked to specify the values

The information requirements are tested by semantic validations

Performed Tests: Basic Conformance Tests Testing whether the system provides all possible code values to its

user for selection, Checking whether the system accurately packs the value selected by

the user into the transmission, Testing whether the system (HIS or FMS) has the ability to render

this value to its users

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NHIS Conformance Testing Event, Izmir 2008 A conformance testing event(connect-a-thon like event), a

five-day workshop, is organized by MoH, Turkey in June 2008 in Cesme, İzmir. 200 Test Scenarios categorized under 25 testsuites

are developed for TestBATN During the workshop more than 5000 test scenarios

are executed through TestBATN by an avarage of 130 participants from 55 vendors

After the workshop TestBATN is also deployed to MoH Servers and are still publicly available from web for vendors to test their products for conformance 109 registered users https://212.175.169.50:8443/testexecution/

TestExecutionGUI.html

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TestBATN ArchitectureTest Scenario Design

//hl7:examination//hl7:encounter//hl7:diagnosis/@code = $diagnosisCode//hl7:examination//hl7:encounter//hl7:diagnosis/@code = $diagnosisCode

Schematron

Validator

Schematron

Validator

Regular Expr.

Validator

Regular Expr.

Validator

HCRSCode

Validator

HCRSCode

Validator

....

....<acknowledgement> <typeCode code="%$ackTypeCode%" /> <message> <id extension="%$messageID%" /> </message></acknowledgement>.........

ebXML Adapto

r

ebXML Adapto

r

TCP Adapto

r

TCP Adapto

r

UDP Adapto

r

UDP Adapto

r

SMTP Adapto

r

SMTP Adapto

r

MLLP Adapto

r

MLLP Adapto

r

SOAP Adapto

r

SOAP Adapto

r

HTTP Adapto

r

HTTP Adapto

r

NHIS Sample Value

Provider

NHIS Sample Value

Provider

srdc:formatXSDDate(String date)

srdc:insertAfter(XML source, XML node, String xpath)

SendMessage

ListenMessage

TestAssertion

ReceiveMessage

XSDValidato

r

XSDValidato

r

Variable Declarations

XPATHValidato

r

XPATHValidato

r

Exit

Configuration Management

Handle Preliminary

Data

x: Stringy: XMLz: ...

srdc:generateUUID()

x=

Variable Assignment

Expressions

Business Process

Party2Party1 Party3Party1

<InitiateValue valueInitiator=“NHISSampleValueProvider" valueID=“diagnosisCode” />

HTTPHeaderHTTPHeader

SOAPHeaderSOAPHeader

SOAPBodySOAPBody

$y

Source (XML)

XPath (Expr.)

$y

Test Scenario Execution

srdc:generateUUID()

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Demonstration

Thank you for your attention...