1. Oct. 10, 20081 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

2. 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

3. 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

4. Oct. 10, 2008 IHIC 08, Crete, Greece 4 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

5. Oct. 10, 2008 IHIC 08, Crete, Greece 5 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

6. Oct. 10, 2008 IHIC 08, Crete, Greece 6 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)

7. Oct. 10, 2008 IHIC 08, Crete, Greece 7 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

8. Oct. 10, 2008 IHIC 08, Crete, Greece 8 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

9. Oct. 10, 2008 IHIC 08, Crete, Greece 9 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

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

11. Oct. 10, 2008 IHIC 08, Crete, Greece 11 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/TestExecuti onGUI.html

12. Oct. 10, 2008 IHIC 08, Crete, Greece 12 TestBATN Architecture Test Scenario Design //hl7:examination//hl7:encounter//hl7:diagnosis/@code = $diagnosisCode Schematron Validator Schematron Validator Regular Expr. Validator Regular Expr. Validator HCRSCod e Validator HCRSCod e Validator.......................... ebXML Adaptor TCP Adaptor UDP Adaptor SMTP Adaptor MLLP Adaptor SOAP Adaptor HTTP Adaptor NHIS Sample Value Provider srdc:formatXSDDate(String date) srdc:insertAfter(XML source, XML node, String xpath) Party 1 Party 2 SendMessage ListenMessage TestAssertion ReceiveMessage XSD Validator XSD Validator Variable Declarations Variable Declarations XPATH Validator XPATH Validator Exit Configuration Management Handle Preliminary Data TestBATN Framework x: String y: XML z:... srdc:generateUUID() x= Variable Assignment Expressions Party3 Business Process Party2Party1Party3Party1 <InitiateValue valueInitiator=“NHISSampleValueProvider" valueID=“diagnosisCode” /> HTTPHeader SOAPHeader SOAPBody $y Source (XML) XPath (Expr.) $y Test Scenario Execution srdc:generateUUID()

13. Oct. 10, 2008 IHIC 08, Crete, Greece 13 Demonstration Thank you for your attention...