While self-testing serves as a crucial step in the development of standards and implementation guides, it may not fully equip vendors and users for the swift and effective adoption of complex multi-party HL7® Fast Healthcare Interoperability Resource (FHIR®) based use cases such as Payer to Payer (P2P) data exchange or electronic Prior Authorization (ePA). Drawing from Drummond’s extensive experience in a related industry—supply chain software interoperability standards testing—it’s become evident that a more comprehensive approach is necessary. Without it, the progress of FHIR-based process innovation in healthcare will risks unnecessary delays and frustration among stakeholders as healthcare organizations struggle to fix multi-party FHIR interoperability issues in their real-life production environments.
Fortunately, Drummond offers FHIRplace, a proven group testing approach built off the same platform used to successfully facilitate full-matrix interoperability testing for supply chain clients for over 25 years. FHIRplace offers proactive healthcare organizations the opportunity to facilitate multi-party interoperability testing in their pre-production environments prior to going live, so they can accelerate their trajectory to seamless FHIR adoption.
Saying that, let’s explore the two primary types of users intended for FHIRplace and what FHIR strategy they should implement to maximize the platform’s benefits.
Who Should Participate in Full-Matrix Interoperability Testing?
The first type is commercial software developers offering products for FHIR use cases or self-developers of such software. Developers typically offer standalone FHIR platforms, EHRs with integrated FHIR technology, or large organizations with self-developed FHIR technology. These developer organizations would bring their pre-release software to a round of full-matrix interoperability testing to get their products certified for a specific test event—a super Connectathon of sorts, but more rigorous, with more participants and strict rules for successful testing, leading to certification.
In Drummond’s experience, commercial software developers typically begin to align their product release plans so that a round of Drummond full-matrix testing fits near the end of their release cycle. Certified software that has passed full-matrix testing then provides a user (a customer looking to upgrade to a new version of the software or prospective customer) assurance that the product is not only compliance tested but has passed the additional rigor of full-matrix interoperability testing.
The second group of potential full-matrix testing participants are end-user organizations, such as provider or payer organizations, that would bring their pre-production implementations to a round of interoperability testing. End-user organizations would typically deploy a FHIR-enabled EHR or commercial FHIR platform to support the FHIR use case being tested but their system could also be broader. For example, a provider could deploy an EHR, a third-party FHIR platform, and or an integrated legacy application. The primary benefit of this kind of group testing would be to provide an organization with credentialing to streamline their onboarding processes and to certify an entire integrated system.
For a given payer organization, partners would be provider organizations and other payers. For provider organizations, partners would focus on their payer network and other providers. When a provider starts to roll out its ePA program to its payer network, for example, it could come to the Drummond testing platform, discover which payers are already certified, and invite those payers to onboard, thereby streamlining the onboarding effort. Similarly, since a given payer organization will have to connect to several provider organizations, being certified for Drummond full-matrix interoperability testing will, in turn, streamline their onboarding efforts to multiple providers as well.
In short, whether it’s software developers or end-users there are numerous benefits to participating in full-matrix interoperability testing. However, the best way to maximize these benefits is to incorporate FHIRplace’s testing protocol into one’s due diligence process so that they can experience the value of repeated testing.
Ongoing Full-Matrix Testing for Maintaining Interoperability
FHIR is a dynamic and evolving technology (as are related emerging and evolving use cases and IG’s, etc.) which adds to the complexity of assuring that real-world systems continue to be interoperable. As a result, interoperability test rounds must be periodically repeated to verify that as products are updated (new versions, or releases) they remain compatible with one another. Therefore, it’s important to note that the relevance of a full-matrix test round certification within real-world deployments will eventually diminish over time as new products enter the market, and existing products change with revisions and updates.
Given such changes in the product test group, an interoperability certification has an expiration date, and products must participate in new testing events to maintain certification. This is especially relevant for maintaining the core idea of full-matrix testing because even if a software code base has not changed, other participating code bases may have; and new participants will impact interoperability. For this reason, FHIRplace testing should be incorporated into one’s routine, so long-term plans are not made based on the false pretense that one’s data-exchange system is still interoperable.
Conclusion
To wrap up, self-testing alone is ultimately not enough to equip vendors and users for the intricate demands of multi-party FHIR based applications. Through FHIRplace, Drummond offers software developers and end users a proven group testing platform, empowering proactive organizations to accelerate interoperability testing and streamline their transition to FHIR integration. That said, sustaining interoperability requires ongoing vigilance. This is because as FHIR evolves, continuous full-matrix testing remains imperative to uphold interoperability standards and safeguard seamless integrations within healthcare’s multiple ecosystems.