Automated Interoperability Testing of Healthcare Information Systems

Over the last two decades, the number of healthcare services at the edge of the traditional medical care and computer technologies has increased dramatically, making eHealth infrastructure-related services ubiquitous. The obvious outcome is that many of the traditional medical care activities and practices were partially or completely replaced by the newest and more efficient ones based on Internet or using advances in the information technology. Services such as telemedicine, telehealth, Electronic Health Record (EHR) systems, automated retrieval, or update of the electronically stored patient data are common terms and practices in the actual medical care sector. Irrespective of the way the information is stored, either in the form of paper-based patient records or electronically, for example in the form of EHRs, the healthcare field is very data intensive, i.e., the information is huge and very complex. This is a characteristic of the healthcare domain that will not change, even if the movement from traditional Healthcare Information System (HIS) to electronic HIS is taking place. Among other important pieces of information in the healthcare systems, the patient record is a key one. The development of EHR solutions represents the base of the information systems in the IT medical industry. Many vendors provide solutions that are rather provider-centred approaches (i.e., proprietary protocols and message formats), but interoperability is not concerned. Obviously, automated test systems can help vendors of those eHealth solutions to validate the conformance to specifications. The major problem of HIS solutions is the lack of product interoperability. The publication of standards such as Health Level Seven Messaging Standard (HL7) for defining a common message structuring scheme for message exchange between medical information systems, or the adoption of the Integrating the Healthcare Enterprise (IHE) integration profiles for specifying the use cases that implementers should follow, is an important step in enabling interoperable HISs. These standards and recommendations are the basis for the interoperability testing. This extended chapter proposes an interoperability testing methodology and its realization concepts to cope with the aforementioned issues in HISs. The main problem addressed in this work is how to design a test system that can deal with very data-intensive systems and, at the same time, is capable of emulating the interacting parties. The challenge in this approach is how to automatically customize and configure the test platform to simulate an interoperability scenario by instantiating test components programmed in advance to simulate the behavior of particular interacting entities.