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Certification and Conformance Approaches for Canada’s EHR Elaine Sawatsky, Senior Management Consultant, Privacy & Security, Canada

Certification and Conformance Approaches for Canada’s EHR

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Certification and Conformance Approaches for Canada’s EHR. Elaine Sawatsky, Senior Management Consultant, Privacy & Security, Canada. Conformance: Canada’s EHR. Infoway Conformance Services in Canada Supporting the Implementation of pan-Canadian Standards Provincial/Territorial work - PowerPoint PPT Presentation

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Page 1: Certification and Conformance Approaches for Canada’s EHR

Certification and Conformance Approaches for

Canada’s EHR

Elaine Sawatsky, Senior Management Consultant, Privacy

& Security, Canada

Page 2: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

• Infoway Conformance Services in Canada

• Supporting the Implementation of pan-Canadian Standards

• Provincial/Territorial work

• On the ground experiences

Page 3: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

• Sharing information requires a quality assessment of products to ensure interoperability, to reduce risk to patients, purchasers and the ‘system’.

• Standards support sharing data and bringing it together

• Improves comparability and harmonisation between products.

• Certification: “a process of validation of products in a given context against specific validation criteria.”

• Certification criteria are – even regarding the same functionality – up to a certain degree similar but also different between jurisdictions in:

» The way they are formulated & validated» The importance given to each of them

• Certification should be unambiguous, fair and trustworthy

Page 4: Certification and Conformance Approaches for Canada’s EHR

Conformance Services Vision

• To support the successful implementation of pan-Canadian Standards within projects through the provision of conformance testing artefacts and tooling.– To improve the consistent implementation of

pan-Canadian Standards– To reduce the effort required to implement pan-

Canadian Standards– To reduce the cost of implementing pan-

Canadian Standards• Strategic Intent of Conformance Services:

– Ensure that there is a national service to support the vendor conformance and certification of iEHR, public health and EMR solutions.

Page 5: Certification and Conformance Approaches for Canada’s EHR

SK EHR Blueprint and Concepts

Provincial Infostructure

Point-of-Service (POS) Infostructure

Registries Data & Services

Data WarehouseEHR Data & ServicesAncillary Data & Services

Client Registry (SCI)

Provider Registry (PRS)

Location Registry

LRS

Outbreak Management

Shared Health Record

Drug Information

PIP

Diagnostic Reports &

Imaging PACS

Lab Repository

SLRR

PHS Reporting

Health Information

Surgical Care Registry

POS Infostructure will continue to evolve as future needs are identified

BusinessRules

MessageStructures

EHRIndex

Modified: October 2, 2006

HIAL

User Registry

SecurityManagement Data

PrivacyData

ConsentIntegrationSecurity

TerminologyServices

IndexNormalizationOrchestration

CANADA

V3.1

Organizational Infrastructure Access Systems

SK Cancer Agency

Clinical Management

Service (Varian)

Prov Lab

Lab (LIMS)

Registry(Varian)

Regional Systems

Drug (WinPharm, RxTFC, PCSI)

Lab (TriWin, SCC)

Clinical Information System (SCM)

Regional ADT(WinCIS, Enovation)

Health Records (WinRecs, 3M)

Transcription (WinCIS,

HealthSuite,...)

Radiology (RIS)

RHA Integration Hub (Cloverleaf)

Clinical Viewer (SCM) Provincial

Medication Profile Provincial PACS Provincial Lab

Results

Vendor PoS

Community Pharmacies Medication Profile

Clinical EMR’s Primary Health Care

(PHC) LAB Medication Profile Shared Health Record

(SHR)

eHealth Portal

EHR Desktop Lab Results (SLRR) Medication Profile (PIP) DI Image & Reports Shared Health Record (SHR) Public Health Surveillance

(PHS) Client Id. (SCI) Health Insurance (PHRS) Provider Id. (PRS) Wait List (Surgical Care)

Individual Viewers

Client ID Viewer (SCI)

Health Insurance Viewer (PHRS)

Medication Profile (PIP)

Diagnostic Imaging Viewer (PACS)

...

Long Term Care (MDS)

Home Care(Procura)

Surgical (SIS)

Public Health Immunization Public Health

Surveillance

Primary Health CareChronic Disease Mgmt.

(CDM)

Page 6: Certification and Conformance Approaches for Canada’s EHR

The need: Bridging The Gap

The challenge is to bridge the gap that exists between the health informatician (modeler) and the clinical integration specialist (solution developer).

EHR in

OperationEHR in

Operation

Health InformaticsModeler

Integration Specialist

Modeling Culture• Delivering

Specifications

Project and Product Culture• Delivers Production

Solutions

Standards DevelopmentStandards Implementation,

Conformance & Maintenance

Need Need Options Options Develop Develop SFU SFU

Authoring Vocabulary

Profiles Assessment Certification

Release Change Helpdesk

Tooling

6

Page 7: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Page 8: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Approach• There is recognition that there is a need for

conformance testing to ensure alignment• The approach is founded on international standards

• Prototype & Learn – conformance testing is not well understood yet

• Build Methods & Processes with stakeholder input • Build tooling & leverage : • Standards – HL7 v3, LOINC, SNOMED, XDSI

• Tooling• Component model – integration is key!• Sharing of testing artefacts – huge value to

stakeholders

Page 9: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Key Messages

• There is recognition that we all need to do end to end and integrated testing

• We are committed to leveraging work of others

• We are making good progress in developing processes and tooling to assist our jurisdictions in implementing “Conformant” solutions

Page 10: Certification and Conformance Approaches for Canada’s EHR

Conformance Continuum

Semantic testing

Most value / Difficult

Functional testing

Easier / Little value

Messaging

Messaging, Vocabulary

Messaging, Vocabulary, Sequencing

Workflow, Conformance Statements, Business Processes

Ex: an ‘add client’ message cannot be sent until a ‘client query’ message has been sent

Conformance Continuum(Scope of ‘Conformance’)

Conformance includes:– Message content and structure– Vocabulary and terminology– Interoperability profiles and

message sequencing– Sending and receiving

applications and intermediaries

Conformance Testing includes:– Functionality of application– Basic privacy and security

services related to the functionality

– Workflow (to an optimal level determined by conformance continuum)

10

Page 11: Certification and Conformance Approaches for Canada’s EHR

Our Approach

• First, develop Profiles for all pan-Canadian standards• Develop a process & mechanisms linking the pan-

Canadian Profiles through to conformance test • Develop, deploy, continuously improve “quick-hit”

tools• Provide business and technical support for Investment

Projects to set up and execute conformance testing• Document & refine requirements for long-term solution• Harvest artefacts for sharing with other jurisdictions• Rationalize jurisdiction artefacts to create pan-

Canadian versions• Establish a pan-Canadian Working Group of early

participant jurisdictions and their vendor partners to provide guidance and assistance in the development of Conformance Testing artefacts

Page 12: Certification and Conformance Approaches for Canada’s EHR

Options Research

and Analysis

Standards Development

Needs Identification

& Business Definition

Maintenance

TrainingEducation

Conformance

Implementation

Test Pilot

Pan-Canadian Standards

Pan-Canadian Standards

EvaluationEvaluation

AdoptionStrategiesAdoptionStrategies

Tools andTemplatesTools andTemplates

StandardsKnowledge

Management

StandardsKnowledge

Management

LiaisonLiaison

Promotion & CommunicationPromotion &

Communication

LicensesLicenses

Change Management

Change Management

Standards Selection Strategy

Stable for Use

Final Approval

Scope of Part 4

Our Approach

Page 13: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Benefits:• Financial savings through reduced duplication of efforts in

test authoring• Provinces leverage other provinces’ Business Rules

• Financial savings though tools based test message development

• Provinces use Infoway tools and other provinces’ messages

• Breadth of testing improved through increased quantity and quality of test cases

• Provinces are committed to sharing test artefacts.

Page 14: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Benefits:• Depth of testing improved through consistent test rules

and tooling• Provinces’ use of tooling has improved UAT testing Too early to

accrue benefits

• Quality and consistency of conformance testing improved between Investment Projects

• Too early to accrue benefits

• Improved consistency in Investment Project implementations of pan-Canadian standards

• Too early to accrue benefits

Page 15: Certification and Conformance Approaches for Canada’s EHR

Benefits

Providing Implementation support for the development of Test Authoring and Test Execution will enable jurisdictions to leverage and share Conformance Profiles and testing artefacts, leading to:

– Improved quality of testing– Financial savings through reduced duplication of efforts– Breadth of testing improved through increased quantity

and quality of test cases – Improved quality and consistency of conformance testing – Financial savings though tools based test message

development– Depth of testing improved through consistent test rules

and tooling– Improved consistency in implementations of pan-

Canadian standards

Page 16: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Conformance Services Overview• Main elements influencing content of test

criteria:Legal, national, cultural (business and social)• Sophistication of the industry area• Environment• Certification is the process• Conformance is the result• Must be good enough, not best or everyone

will fail• Area subject matter experts – what will the

medical professional need?

Page 17: Certification and Conformance Approaches for Canada’s EHR

Stakeholder Engagement• Governance

• Collaboration on Test Authoring components• Collaboration on supporting tools development and implementation

• Registry of vendor systems & certification status • Registry of implementation projects• Ongoing liaison/communication with jurisdictions and vendors

• Promotion and Education around Conformance Services

Overview of Conformance Services

Test Authoring Services• Business Rule Management• Conformance Profile Management• Vocabulary Maintenance• Test Case Authoring• Test Data Management• Message Instance Authoring

Test Execution Services•Conformance self assessment & evaluation•Conformance independent verification & validation•Conformance certification

Technology• Test Execution Tools

Conformance ValidationTest Case ValidationSelf-test, monitoring

• Web presence for jurisdictions and vendorsRegistration, artifacts library, test results

• Test Authoring ToolsRepository, remote user accessshared authentication

17

Page 18: Certification and Conformance Approaches for Canada’s EHR

Strategic Direction Analysis Project

• Project Objective:– Develop a preferred option for the future delivery of Conformance

Services. • Define and identify existing conformance services models;• Develop a shared vision for the delivery of Conformance Services for

the Canadian healthcare sector• Develop conformance services delivery options for the Canadian

healthcare sector; and detail the preferred option.

• Defined Strategic Intent of Conformance Services:– “Ensure that there is a national service to support the vendor

conformance and certification of iEHR, public health and EMR solutions.”

RFP Release February 15 ‘08

Project Start March 15 ‘08

Draft recommendations June 30 ‘08

Final Recommendations Available August 30 ‘08

18

Page 19: Certification and Conformance Approaches for Canada’s EHR

Investment Project Support Overview

• Project Objective:– Provide immediate Standards Implementation Support for Test

Authoring & Test Execution to key Infoway Investment projects• Project Approach:

– Develop a process & mechanisms linking the pan-Canadian Profiles through to conformance test

– Develop, deploy, continuously improve “quick-hit” tools– Rollout to qualified projects (if proof of concept successful)– Harvest artefacts for sharing with other jurisdictions– Provide lessons learned and input into CS Strategic Direction Project– Provide transition and support to recommended Strategic Direction

Project Kick-off November 1 ‘07

Proof of concept (2-3 projects) March 31 ’08

Proposed Project Extension:

Limited rollout (4-6 projects) September ‘08

19

Page 20: Certification and Conformance Approaches for Canada’s EHR

Investment Project Support Activities

• The specific services that Infoway is offering to assist projects

• Assistance in developing test strategies– Sort out overlap between conformance testing vs. UAT

• Education on development of business rules & test cases• Technical education on development of message

instances and test data• Sharing of testing artefacts• Quality review of artefacts developed by investment

projects• Full set of tools to assist getting to Conformance Testing • Assistance to jurisdiction in rationalizing and integrating

their testing tools with Infoway conformance tools• Harvesting of testing artefacts for sharing with

jurisdictions• Sharing of Lessons Learned• Facilitating inter-jurisdiction collaboration on conformance

testing

20

Page 21: Certification and Conformance Approaches for Canada’s EHR

Quality Review Harvest artefacts

(2-3 days)

Quality Review Harvest artefacts

(2-3 days)

33

Introduction Workshop

Introduction Workshop

00

21

Engagement Process to Conformance

Introduction Workshop

Introduction Workshop

00

JurisdictionConformance Pilot

Testing, Quality ReviewHarvesting artefacts,

Lessons learned(3-5 days)

JurisdictionConformance Pilot

Testing, Quality ReviewHarvesting artefacts,

Lessons learned(3-5 days)

55JurisdictionEnd-to-End Test

Case Development(20-40 days)

JurisdictionEnd-to-End Test

Case Development(20-40 days)

44Quality Review Harvest artefacts

(2-3 days)

Quality Review Harvest artefacts

(2-3 days)

33

JurisdictionEnd-to-End Test

Case Development (10%) (15-20 days)

JurisdictionEnd-to-End Test

Case Development (10%) (15-20 days)

22Test case Examples

Harvestedartefacts

Test case Examples

Harvestedartefacts

End to EndTest AuthoringExamples

End to EndTest AuthoringExamples

Jurisdiction Test ArtefactsJurisdiction Test Artefacts

ToolsTools

End to EndTest ExecutionExamples

End to EndTest ExecutionExamples

Jurisdiction Test Authoring Artefacts

Jurisdiction Test Authoring Artefacts

Jurisdiction still needto complete, but ready to perform ConformanceTesting

Jurisdiction still needto complete, but ready to perform ConformanceTesting

Ongoing HarvestingOngoing Harvesting

End to EndConformance

Process Workshop(2-3 days)

End to EndConformance

Process Workshop(2-3 days)

11

Page 22: Certification and Conformance Approaches for Canada’s EHR

22

Conformance Constructs – End-to-End Process

JurisdictionInput

BestPractice

External Application

ConformanceProfiles

StandardsArtefacts

TestCases

HL7 TestHarness

Test CaseAuthoring

TestData

InstanceEditor

(Messages)

Vocabulary Data

- “Quick-hit” tools

- “Existing” tools

- HL7 V3

Business &Technical Rules

ImplementationGuides

Page 23: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Major Tooling Components• Business Rules Manager- Maintains Business Rules• Conformance Profile Manager - browse pan-Canadian

Conformance Profiles• Implementation Conformance Profile Manager - browse profiles

and create/maintain ICPs• Static Model Constraint Tool - captures changes to models,

and traceability information• Instance Editor - creates Conformance Test Scenario Files,

Message Fragments and Parameter Files as XML output. • Test Case Author - Maintains Test Cases• Test Authoring Manager - The main user interface• Test Execution Manager - links the Test Authoring Manager to

control the test execution• Test Authoring Reports Manager - run reports

Page 24: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Conformance Test Execution ScenariosThere are different ways to perform

Conformance Test Execution. This process uses the pCCT Test Execution manager and / or the HL7 Test Harness to allow the user to test both POS and iEHR systems as “real” or “simulated” applications under test.

1. Scenario 001 - Real POS with Simulated iEHR Application 2. Scenario 002 - Simulated POS with Simulated iEHR

Application 3. Scenario 003 - Simulated POS with Real iEHR Application 4. Scenario 004 - Real POS with Real iEHR Application

Page 25: Certification and Conformance Approaches for Canada’s EHR

Lessons Learned – Considerations for AB

• Testing artefact reuse is seen to be a big win• One province has 100 business rules & 300 test cases –

target is 500-700 test cases• Another target will be significantly higher (~2,500 test cases)• Others will leverage oand likely add more

• Toolset are not all or nothing• One province using blend of Infoway tools and home grown• Uses Infoway tools and processes first to perform testing

then conformance testing of PoS• One province using Infoway tools for go forward & PoS testing• Specific initiatives will likely use blend

• Infoway is investing in tools so jurisdictions don’t have to!

Page 26: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Tooling Vision• Create a suite of integrated Conformance Test tools based on

Open Source principles and accepted pan-Canadian standards that allows jurisdictions, and vendors to perform conformance testing

• Includes:– Well documented processes and procedures– A repository of structured conformance profiles, test cases,

test data and business rules that can be reused– A suite of re-usable conformance testing solution components

able to easily exchange structured data between each component and projects

– An Enhanced Web Based Presence to allow remote administration, self registration, shared resources management, self testing / monitoring and publication of results

Page 27: Certification and Conformance Approaches for Canada’s EHR

Lessons Learned – Considerations for AB

• Many jurisdiction projects have left UAT & Conformance Testing until very late in their project lifecycle

• There is not a clear understanding of the continuum of conformance testing

• Profile Business rules Test cases Messaging Conformance test

• Traceability is key to conformance test• Profile Business rules Test cases Messaging

Conformance test• Using Profiles to help them define user roles

• What does a physician do vs. project focus• Tools can and are providing immediate benefit to

jurisdiction projects for publishing• Consolidated view of all business rules• Publication of specification for vendor

27

Page 28: Certification and Conformance Approaches for Canada’s EHR

Conformance Profiles

Pan-CanadianConformance Profile (pCCP)

ImplementationConformance Profile (ICP)pCCP

Extension

Constraint

Example:BC ICP #84#84

BC ExtensionsBC

Constraint

LikelyInitial State

DesiredState

#47

#84

Library of Conformance Profiles

Sask

BC

Nfld

Sask

BC

Nfld

+

+

Page 29: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Tooling for Test Authoring Components (TAC)– Use prototyping methodology to conduct staged

development – Test with jurisdictional review and input – Document processes, requirements and changes– Garner feedback and experience to inform the refinement

of detailed specifications for long-term open source tooling development

– Address immediate jurisdictional needs & provide tangible benefits

• All test artefacts exportable• Work with jurisdictions to rationalize and integrate

tooling – Align test cases, business rules across jurisdictions– Promote early sharing and leveraging of work by

jurisdictions

Page 30: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Tooling for Test Execution– Leverage an existing open source test harness (previous Infoway

investment), adding ability for jurisdictions to easily configure to reflect local technology solutions such as transport and security

– Leverage Eclipse Instance Editor for message and vocabulary creation

– Use data exported from test authoring tools• Key is to ensure tools export into a format that can be

consumed by HL7 Test Harness• Invest in documenting processes, requirements, integration

– Rationalize and integrate tools

– Develop guidelines for local Test Execution prototyping environments including a reference implementation

– Develop processes to ensure data integrity between different groups of users during prototyping phase

Page 31: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

It’s not easy:• In order to get to a conformance test, you need to

start with the Profile, know what the business rules are and create test data and message instances that will then test a scenario

• Once you have done this for every business and technical scenario, only then can you think about performing a conformance test

• By our simple calculations, this will be thousands and thousands of test cases!

Page 32: Certification and Conformance Approaches for Canada’s EHR

0 – Step 0 Engagement1 – Step 1 Workshop2 – Step 2 Activities3 – Step 3 Workshop4 – Step 4 Activities5 – Step 5 Workshop

0 – Step 0 Engagement1 – Step 1 Workshop2 – Step 2 Activities3 – Step 3 Workshop4 – Step 4 Activities5 – Step 5 Workshop

PlannedPlannedScheduled/UnderwayScheduled/UnderwayCompletedCompleted

PlannedPlannedScheduled/UnderwayScheduled/UnderwayCompletedCompleted

0,10,10,10,1 0000

00004,54,54,54,50,1,2,30,1,2,30,1,2,30,1,2,3

PanoramaPanorama

0000

0,0,0,0, 1111 0000

0,10,10,10,1

0000

32

13-Mar-08

Conformance Services Activity in Canada

Page 33: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

• Provinces have done functional Certification for EMRs specifically.

• Other certification means defining differences in function, scope, perspective (e.g. Social interaction between users, staff and patients),

• Legal requirements are different between provinces, policies are different: Infoway cannot set policy but provinces must

• Provinces must work in collaboration with Health Authorities and professional bodies.

• Conformance criteria will be different from one business environment to another.

Page 34: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

• Work is based on existing provincial models– Establish business rules to support policy set by

Ministries of Health, College of Physicians and Surgeons and College of Pharmacists

– Publish compliance specifications that include all the transactions needed at the point-of-service (e.g. pharmacy claims, pharmacy prescriptions, Client Registry, Provider Registry, Common, Lab, Immunization, etc.)

– Provide support to vendors during their development

– Conduct compliance testing of vendor software once they pass a pre-test

– Support change agents (chain stores, vendors, etc.) during their training and deployment activities

Page 35: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

POS Software Compliance Principles• POS systems

– Must enhance patient safety & Support clinician workflow– Must be secure and ensure privacy of patient medical records– Must support interoperability standards– Are integral in creating and maintaining quality data for use

throughout the health care system• POS vendors must be able to differentiate their products• Compliance documents

– Are referred to in some provinces legislation– Communicate what rules need to be followed, not how the rules

are implemented in vendor software– Provide one place to house Ministry policy, College rules and

application capabilities– Provide a level playing field for all vendors regardless of size

Page 36: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

POS Conformance Specifications• Define Business rules

– Based on existing business rules from compliance documents and input from Clinical Working Group

– Identify items that need further clarification• Develop Compliance specifications

– Based on existing compliance documents and published message specifications from Infoway

– Builds on Infoway Conformance Profile definitions– Leverage, where possible, work from other jurisdictions

• Materials include:– POS Software Vendor Compliance specifications;– Vendor registration and development support processes;– Compliance testing process;– Process for approving vendors with compliant software

• Stakeholders included in joint review of material prior to publishing

Page 37: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Compliance – Lessons Learned• It takes time for the vendors to develop code to the

level that warrants compliance testing• Vendors may present software that was not stable

enough to warrant compliance testing• Vendors can require multiple attempts at compliance

testing• Thorough compliance testing takes time, especially on

the very first test of new software or a major release change

• Good rules are needed on what constitutes an initial test and a follow-up test for each version of the vendor software

• Good rules are needed on when penalty and charges are applied to the test

Page 38: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

• Sample tests were provided for vendors• Focus needed to ensure that the vendors could prove they

ran the tests and the tests worked before scheduling a compliance testing

• Need mechanisms to ensure compliance team provided consistent responses to all vendors throughout the compliance support process

• Good rules are needed around mandatory training that a vendor must provide e.g. training plans, training outcomes, etc.

• Good test facilities are needed for vendors and for compliance testing

• Multiple training environments are needed for each vendor• Good tools are needed for the compliance testers that

assist them in developing the test cases and support them during the testing

Page 39: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

• Clinical guidance was critical during vendor development and compliance testing to clarify options and workflow– Requires ongoing clinical involvement

• Specifications, clinical guidance and support needs to include details

• Compliance team requires good communication and negotiation skills and need to be able to stand their ground under pressure

• Compliance documentation needs to be targeted to specific audiences and also clearly identify elements common across audiences

• A tool that enables easy linking and/or packaging of modules is highly desirable. Documents that are difficult to maintain don’t get maintained

• Business context for the compliance material is just as important as the rules themselves

Page 40: Certification and Conformance Approaches for Canada’s EHR

Conformance: Canada’s EHR

Conformance includes:– Message content and structure– Vocabulary and terminology– Interoperability profiles and message sequencing– Sending and receiving applications and

intermediaries

Conformance Testing includes:– Functionality of application– Basic privacy and security services related to the

functionality– Workflow (to an optimal level determined by

conformance continuum)

Page 41: Certification and Conformance Approaches for Canada’s EHR

Contact

Standards Collaborative Information Desk Bureau d'information de l'Unité

collaborative de normalisation d’Inforoute 1-877-595-3417 or [email protected] or

[email protected]

[email protected] and Security, SME

Page 42: Certification and Conformance Approaches for Canada’s EHR

Holding slide