This page is part of the electronic Long-Term Services and Supports Implementation Guide (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Testing FHIR

Testing server capabilities through Implementation Guides (IGs) is a crucial aspect of Fast Healthcare Interoperability Resources (FHIR). Various methods can be employed to leverage the IG effectively.

A primary application of IG is the validation of data instances. This validation can be conducted using standalone tools, as referenced on the official FHIR validation page here, or by submitting the data instance to a server familiar with the desired profile for validation.

Validation processes can also be carried out manually. In all instances, computable StructureDefinitions play a pivotal role in evaluating data instances, with features such as cardinality, invariants, and terminology bindings being integral aspects of the specification guiding the validation process.

Furthermore, the Must Support (MS) and CapabilityStatement articulate specific requirements for servers and clients in terms of behavior. As implementation progresses, it becomes evident that MS and CapabilityStatement serve as guardrails rather than burdens, ensuring that the requisite behavior is available to fulfill the intended use case. The development of IGs involves rigorous testing and collaboration with data senders and receivers.

While the provided examples of data instances in this guide serve as development aids, they do not encompass the full spectrum of possibilities. Generally, these examples focus on populating MS data elements, which constitutes a significant component of conformance testing.

Beyond FHIR validation and computable conformance, ensuring adherence to necessary business rules is imperative. This includes verifying that data is not withheld arbitrarily or ignored as a means of support, aligning with the specifications allowing for the absence of a data element.

Several tools can enhance the utilization of IGs for testing purposes:

• Inferno’s Test Kits and Validator: Available at https://inferno.healthit.gov/
• Touchstone’s TestScript Implementation and Testing Services: Accessible through https://touchstone.aegis.net/touchstone/
• Crucible Mitre Test Service: Explore at https://projectcrucible.org/

The FHIR TestScript specification introduces intriguing possibilities for scripted interactions, enabling comprehensive testing of data support. For instance, the ability to send a data instance to a system with a FHIR server, retrieve it, modify it in the receiving system, and subsequently retrieve the changed data provides valuable insights into system capabilities, accommodating diverse testing workflows.