Da Vinci Payer Data Exchange (PDex) FHIR Implementation Guide.

The Da Vinci Payer Data Exchange (PDex) STU 2.0.0 Test Kit validates the conformance of systems to the PDex STU 2.0.0 FHIR IG. The test kit includes suites targeting the following actors from the specification:

• Payer Servers: Inferno will act as a client and make a series of requests to the server under test simulating a new payer's request to access member clinical data from an old payer using the payer to payer workflow.
• Payer Clients: Inferno will act as an old payer server that contains member information that the client under test would like to access using the payer to payer workflow. Inferno will wait for the client to make requests and respond appropriately to them.

In each case, content provided by the system under test will be checked individually for conformance and in aggregate to determine that the full set of features is supported.

This test kit is open source and freely available for use or adoption by the health IT community including EHR vendors, health app developers, and testing labs. It is built using the Inferno Framework. The Inferno Framework is designed for reuse and aims to make it easier to build test kits for any FHIR-based data exchange.

These tests are a DRAFT intended to allow PDex implementers to perform preliminary checks of their implementations against PDex IG requirements and provide feedback on the tests. Future versions of these tests may validate other requirements and may change how these are tested.

Neither the server nor client test suite included test the full scope of the PDex IG. This is because the PDex IG is under active development and the IG authors intend to change the approach to the workflows included within future versions of the IG. In particular

• The payer to payer workflow will move from a single-patient workflow to a multi-patient workflow.
• The payer to payer discovery and trust mechanisms will be updated.
• The payer to provider workflow will change to no longer use CDS Hooks.

Due to these expected changes, this test kit focuses on validating the high-level payer to payer workflow from both the client and server perspective under the expectation that the broad need of payers to exchange data will remain, but the details are expected to change.

Use either of the following methods to run the suites within this test kit. If you would like to try out the tests but don’t have a PDex implementation, the test home pages include instructions for trying out the tests, including

• For server testing: a public reference implementation (code on github)
• For client testing: a sample postman collection

Detailed instructions can be found in the suite descriptions when the tests are run or within this repository for the server and client.

You can run the PDex test kit via the ONC Inferno website by choosing the “Da Vinci Payer Data Exchange (PDex) Test Kit” test kit.

• Download the source code from this repository.
• Start or identify an Inferno Reference Server instance for Inferno to use for simulation (only needed if planning to run the Client test suite).
• Open a terminal in the directory containing the downloaded code.
• In the terminal, run setup.sh.
• In the terminal, run run.sh.
• Use a web browser to navigate to http:https://localhost.

The PDex client test suite needs to be able to return responses to FHIR read and search APIs. These responses can be complex and so the suite relies on a full FHIR server to provide responses for it to provide back to systems under test. The test kit was written to work with the Inferno Reference Server

• loaded with patient 999 and an associated group
• accepting bearer token SAMPLE_TOKEN for read access.

The test kit can be configured to point to either a local instance of the reference server or to a public instance. The location of the The following are valid configuration approaches:

1. Point to a public instance of the Inferno reference server at either https://inferno.healthit.gov/reference-server/r4/ or https://inferno-qa.healthit.gov/reference-server/r4/: update the FHIR_REFERENCE_SERVER environment variable in the appropriate environment file (.evn.production when running in docker as above, or env.development when running the test kit in Ruby).
2. Run a local instance of the Inferno Reference Server, either with docker or without docker (NOTE: this decision can be made independently from whether to run the test kit with docker or using Ruby).

A preset has been provided if you would like to run the test kits against each other. To do so:

1. Begin each test suite in separate windows.
2. Select the "PDex Payer Server Preset for Client Tests" preset in the Server Suite.
3. Select "Run All Tests" for both kits. Input the same access token for both, but do not click submit.
4. Begin the Client tests by clicking submit. It will now await a member-match to begin the workflow.
5. Begin the Server tests by clicking submit. It will send a member-match request to begin the workflow.
6. Once a member-match request is received, the client tests will begin awaiting clinical data requests. The server tests will automatically begin sending them. Once the Server tests have reached the second group, you may attest in the client that clinical data requests are over.
7. Let both test kits finish, attesting in client side that member-match's have all been received after Server group 2.1 completes. The tests are not expected to pass at this time.

Note that there is a currently a race condition that means that the client test may fail to respond to some server test suite requests. As a work-around, run the server test suite a second time while the client is waiting for clinical data requests during test 1.2.

We welcome feedback on the tests, including but not limited to the following areas:

• Validation logic, such as potential bugs, lax checks, and unexpected failures.
• Requirements coverage, such as requirements that have been missed and tests that necessitate features that the IG does not require.
• User experience, such as confusing or missing information in the test UI.

Please report any issues with this set of tests in the issues section of this repository.

To make updates and additions to this test kit, see the Inferno Framework Documentation, particularly the instructions on development with Ruby.

Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at

http:https://www.apache.org/licenses/LICENSE-2.0

Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.

HL7, FHIR and the FHIR [FLAME DESIGN] are the registered trademarks of Health Level Seven International and their use does not constitute endorsement by HL7.