V2 Testing Toolkit
Rob Snelick (email@example.com)
The Health Level Seven (HL7) standard is a specification for moving
clinical and administrative information between healthcare applications.
This ability to share relevant information among diverse healthcare
systems and provide consistent data across applications helps improve
the quality of care as well as improved patient safety and a reduction
in the cost of healthcare. The HL7 standard is used by 90% of the
hospitals in the U.S. Its adoption in other care settings such as
outpatient, long-term care, and telemedicine is necessary to ensure
the benefits of widespread electronic communication. However the
cost-restrictive nature of managing an HL7 system to achieve interoperability
is a concern for widespread adoption in these other settings.
Need Addressed: When originally developed, HL7 was designed
to accommodate the many diverse processes that exist in the healthcare
industry. This universal design was necessary to gain broad industry
support. However, this resulted in a standard that could not be
sufficiently constrained to provide a single and consistent interpretation--prohibiting
plug and play installations. As a consequence, systems are difficult
to implement and debug resulting in undue costs. To help alleviate
this shortcoming the concept of message profiles were introduced.
A message profile is a proper subset of the HL7 messaging standard
that constricts the definition of a message in a manner that specifically
states the optional constructs and processing rules of a message.
However, if the profile rules are not followed then interoperability
problems will still persist. Conformance testing is essential. NIST
is developing testing tools to ensure that message profiles are
applied as intended to fulfill the promise of interoperable healthcare
Approach: The introduction of message profiles to the HL7 standard
provides a path to conformance and interoperability testing. NIST
is building a tool kit that supports the testing of HL7 message
interfaces based on the concept of message profiles. The foundation
of the tool kit is a set of Java APIs that supports testing activities
such as automated message generation and message validation. The
APIs can be used to build tools, web services, or they can be incorporated
into 3rd party applications and testing environments. Using the
APIs, NIST has developed Message Maker, a tool that
creates a suite of test message instances for any given profile.
NIST is also developing a testing framework and a message validation
tool to administer and analyze the results of the tests. Future
plans include tools for profile validation and an HL7 data repository.
Delivery of the tools will be standalone applications, web services,
and web applications.
There is strong consensus that standards-based messaging, using
the HL7 standards, is key for the US to reap the benefits of and
electronic healthcare infrastructure. However achieving true interoperability,
by implementing HL7 within all of the healthcare sectors (e.g.,
outpatient, ambulatory, and long-term care) may prove cost prohibitive.
Having a strong set of conformance tests and tools, as well as dynamically
generated test messages tailored to interoperability will reduce
the cost of achieving interoperability.