1. www.albertawellnet.org Interoperability Conformance Testing Bela Berci/Denise Bagnell/Phil Robson October 03, 2003

2. Page 2 System to System Conformance Functional Conformance vFacilitate Vendor success in linking with EHR services vCommunications between Vendor/End User Systems and EHR are compatible vConforms to HL7 standards vInformation in End User Systems displayed correctly vEnd User Systems meet functionality rules established by EHR services vFlexible Implementation Mechanism vIncludes Change Management Protocols vSelf Administering Testing Protocols Interoperability Conformance Testing Strategic Objectives

3. Page 3 Interoperability Conformance Testing Strategy / Process and Requirements Relationship

4. Page 4 Conformance Testing Stages

5. Page 5 Acceptance vs. Conformance vAcceptance Acceptance applies to applications that utilize either the Parameter Based Browser Launch as an interface, and use integrated messaging for enquiry purposes only. Acceptance allows a vendor to access information maintained by the EHR, but not to update information. When an ISV attains “acceptance”, they will be given access to the EHR to view data only. vConformance Conformance is applied to an ISV’s application that has integrated a full set of messaging, enquiry and update, for a specific application in the EHR (ie: PIN, LTRH, PD, and other applications as they become available). Where an ISV has attained “conformance” they will be given access to the full functionality within an EHR Service.

6. Page 6 VCUR/Interoperability Conformance/Functional Testing VCUR Requirement 6.5.1.2 Must support coupling of knowledge to clinical observations by highlighting potential drug-drub interaction sin patient medication lists. VCUR Conformance Test Case 9.23 Procedure: Describe and demonstrate how the application meets this requirement Expected Result: Must support coupling of knowledge to clinical observations by highlighting potential drug-drug interaction in patient medication lists Interoperability Requirement Is data available from PIN included in medication list and drug-drug interactions assessment? Interoperability PIN Functional Requirement Check for drug-drug, drug-allergy, drug-intolerance, drug-indications, dosage, dosage-age, duplicate therapy….Contraindications Real time information for prescribing and dispensing Subscribe to accepted data source Automatic distribution of updates Assist in managing limited value alerts Manage duplicate alerts across multiple systems Capability to proceed past alerts Capability to capture reason for proceeding past alerts Capability to flag medication in the active medication list that have contraindications

7. Page 7 Conformance Testing Business Areas

8. Page 8 EHR Transaction Group Dependency

9. Page 9 Transactions by Transaction Group

10. Page 10 Interoperability Conformance Testing Process Steps

11. Page 11 Interoperability Conformance Testing - Responsibilities vISV Initiates and Runs Testing from their site Provides Verification Letter vWellnet Conformance Testing Coordination Schedules Testing Provide Test Scripts Monitor and Support Testing Review Test Results Provides Conflict Resolution Issues Conformance Letter

12. Page 12 Interoperability Conformance Testing Related Policies To support Interoperability Conformance Testing a number of policies need to be in place. The following have been identified to date:  Privacy and Security  Protect Proprietary Information of Vendors  Protect Proprietary Information of Alberta Health/Wellnet  Registration  Tracking who has applied for and what level of conformance they have achieved  Conformance  Based on Functionality a vendor requests conformance for  Vendor assumes responsibility for full testing, notification of changes, version management to end users  Final Conformance Based on Results of Testing

13. Page 13 Interoperability Conformance Testing Related Policies (Cont.)  Version Control  Software/Hardware Release Management  Requirement for Notification and Self Reporting  Audit based on identifiable issues  Cost of Testing  Vendor bears own costs, costs of retests, and tests resulting from more than 2 Vendor Software Changes/Releases per year  Wellnet bears cost of ongoing support/maintenance of Testing Infrastructure

14. Page 14 Conformance Testing to Rollout Conformance Testing Complete EHR Rollout Campaigns EHR Training Pilot Full Rollout

15. Page 15 Questions