Development of Electronic Laboratory Report Test Plans for HL7 Messages

BACKGROUND:   HL7 is an organization that develops Interoperability Standards for exchanging information within the healthcare domain including Electronic Laboratory Reporting (ELR) to public health. Some laboratory reporting scenarios are particularly problematic for both message sender and receiver applications, either because of their informational complexity or because the issue is dynamic in nature and cannot be tested with one ELR message. These situations require assessing the reaction of the sender and receiver applications over a course of several messages. Primary examples of these are parent-child linkages and snapshot processing for ELR messages.  An important challenge for on-boarding of eligible trading partners is the validation of messages containing these issues. The objective is to create a specific systematic process of validating and evaluating the ability of the sender and receiver to accommodate snapshot processing and parent–child relationships by using sample test scenarios in accordance with a standardized test plan.

METHODS: Adequate knowledge of HL7 ELR messages and testing scenarios was gained by researching and testing various ELR messages from eligible trading partners. A series of case scenarios were created for common parent-child relationships such as drug susceptibilities and reflex testing. These scenarios were developed to test the complexity commonly seen in relating multiple order observation groups. Different preliminary and follow up snapshot scenarios are in development for testing the ability of the sender and the receiver to handle snapshot processing mode.

RESULTS:   A systematic series of step-by-step ELR message structure and content validation protocols are in development based on these two complex scenarios that can plague public health consumption and usage of message data. These test plans would therefore alleviate the problem of evaluating parent-child relationships and snapshot message processing.

CONCLUSIONS: The complexity and dynamic nature of ELR messages such as parent-child relationships and snapshot processing are challenging. Structural validation tools that currently exist provide limited validation for these complex scenarios. These test plans will therefore aid in speeding up the on-boarding process by allowing sender and receiver to test their handling of different complex case scenarios for ELR. This will in turn enhance the public health authorities’ ability to better test and process ELR messages.