Dr. Sungkee Lee Dr. Il-kon Kim Todd Cooper Daegu Connectathon Daegu Connectathon – 15 Report to IHE International

2 Daegu Connectathon 2011

3 Computer Science Kyungpook National University!

Overview:  Managers / Monitors:  Dr. Sunkgkee Lee  Dr. Il Kon Kim  Todd Cooper  Dates: – (5 full days)  Companies & Systems  9 Participating Companies  17 Different Systems / Software Applications  2010: 4 Companies & 7 Systems - > 100% increase! 4 IHE-Korea Daegu 2011 General Review

PHD Devices PHD Manager u-Health Server EMR/HIS ISO/IEEE PHD PCD-01 PHMR Home/ Mobile WAN (DEC) WAN (XDS.b) XDS-MS Note: Out-of-Scope for Testing IHE-Korea Daegu 2011 General Review

Overview:  Profiles:  2 nd Year: CT, DEC “WAN”  1 st Year: XDS-MS & XDS.b (R’s only) – Very High Mountain to Climb!  Additional CDA documents:  Personal Health Monitoring Report (PHRM) – not an IHE profile … yet  Planned but … next year!  ATNA 6 IHE-Korea Daegu 2011 General Review

General IHE-K 2011 Connectathon ftp://ftp.ihe.net/International/Korea/2011_Connectathon/ Test …/2011_Connectathon/Connectathon/TestResults Validated CDA …/2011_Connectathon/Connectathon/CDA_Samples _Validated Validated message …/2011_Connectathon/Connectathon/DEC or /XDS.b 7 IHE-Korea Daegu 2011 General Review

8 IHE-Korea Daegu 2011 PCD “DEC” / WAN Samsung Electronics INFINITT UCareSoft Samsung Electronics SKTelecom SoftNet PHD Specializations: Blood Pressure Glucose Monitor Weighing Scale Data Observation Consumer (DOC) Device Observation Consumer (DOC)

9 IHE-Korea Daegu 2011 PCD “DEC” / WAN Testing overview:  NIST Tools:  Static message validation for all exchanges  Incorporated IHE-K OIDs & Patient Demographics  Incorporated support for Personal Health Device (PHD) specializations  Added support for SOAP envelope “stripping” & XML escape sequence translation in HL7 v2 messages  Note: Disconnect test not used for WAN testing

10 IHE-Korea Daegu 2011 DEC PCD-01 Results PCD DEC profile testing … 100% successful!

11 Daegu Connectathon 2011 Serious “meeting of the minds” … Dr. Lee Hyoungho Do

12 Daegu Connectathon 2011 Happy group upon completion of PCD DEC testing!

13 IHE-Korea Daegu 2011 PCD “DEC” / WAN Testing overview:  Issue – WS-Addressing:  Used xdstools2 “Message Validator” to check SOAP envelope ( )  Showed that WS-Addressing soapenv:Header missing  Participants said that this is a difference between IHE ITI & PCD Web Services specification & Continua Health Alliance’s specification … under investigation  Problem said to be primarily in implementation platform differences between Java EE / Linux & Microsoft.NET

14 IHE-Korea Daegu 2011 CDA: XDS-MS & PHMR Testing overview:  Participating Companies:  Content Creators: 5  Content Consumers: 5 (View option only)  CDA Profiles  XDS-MS (Discharge): Cross-Enterprise Document Sharing – Medical Summary – Discharge Summary Option Document  PHMR: Personal Health Monitoring Report Document

15 IHE-Korea Daegu 2011 CDA: XDS-MS & PHMR Testing overview:  NIST Tools:  Used “CDA Guideline Validation”  Supports CDA R2 + IHE XDS-MS profile validation  Added support for Personal Health Monitoring Report (PHMR) validation – not currently an IHE profile  Content Validation  Content specified by IHE Korea & Validated by Inspection

16 IHE-Korea Daegu 2011 XDS.b Testing UCareSoft [NIST Korea] ezCaretech GNSK INFINITT Insung Medical Standard Only Integrated Repository ezCaretech GNSK INFINITT Insung Medical Standard 2012

17 IHE-Korea Daegu 2011 XDS.b Testing Testing overview:  Overview  Actors: Consumer, Registry & Integrated Repository  TLS used for all transactions (ITI-18, -42 & -43)  PIX/PDQ Manager for 2012  NIST Tools:  Used special configuration of xdstools2 for  NIST Registry used as 2 nd actor instance  NIST PIDs generated using “xdstools” allocate service

18 IHE-Korea Daegu 2011 XDS.b Testing Testing overview:  Testing process:  All systems passed static Message Validator testing  All systems showed TLS link (via logs)  Transactions tested: ITI-42, ITI-18 & ITI-43  Validated CDAs registered & retrieved  Tests not performed:  homeCommunityID not supported (2012)  Error handling tests not performed (also only partial could be supported given Integregated Repository)

19 Daegu Connectathon 2011 XDS.b group … after working through the night, smiles well deserved! Drs. Kim & Lee

20 IHE-Korea Daegu 2011 XDS.b Results Repository RegistryezCareTechGNSKInfinittInsungInfoMedicalStandard NIST Registry TLS UCareSoftTLS Repository GNSKInfinittMedicalStandard Consumer NIST RegistryUCareSoft NIST RegistryUCareSoft NIST RegistryUCareSoft ezCareTech TLS GNSK TLS Infinitt TLS InsungInfo TLS MedicalStandard TLS

21 IHE-Korea Daegu 2011 XDS.b Testing Testing overview:  TLS Certificate issues  Generating & installing to enable NIST TLS links  Converting for use on both Java EE & Microsoft.NET  Conversion tool: OpenSSL (from  Patient Identifier issues:  UCareSoft Registry used same PIDs as CDA & PCD DEC  NIST PIDs had to be generated using xdstools service  No PIX/PDQ Manager support made initial NIST Registry configuration difficult

22 IHE-Korea Daegu 2011 XDS.b Testing Testing overview:  Profile Validation Test Requirements Issue:  Test requirements embedded in Gazelle Connectathon tool – Not used in Korea due to small size & training  Tool hard to use – e.g., interaction is slow, printing test definitions works sometimes … not other times  Process for validating validation test suite not well defined  Tool troubleshooting issues:  Should have set up remote tool (xdstools) access – would have saved time that could have been used for testing!

IHE-Korea Daegu 2011 Showcase Plan IHE Korea Showcase opportunities … KOSMI (Korean Society of Medical Informatics) Fall Conference  Oct Korea Health Congress 2011  KHA (Korean Hospital Association)  Nov KITHA (Korean Information Technology of Hospital Association) Fall Conference  Nov. 2011

IHE-Korea Daegu 2011 Use Case Scenarios Target Use Case Scenarios Meets needs of end users + participants  National u-Health Project  Personal Health Focus u-Health Services:  Diabetes (primary target for 2011)  PHM glucose monitor reading to u-Health Server  Report sent to primary care physician  Physician creates and publishes health summary (a.k.a. CCD)  COPD (anticipated 2012 or later)  Cancer (anticipated 2012 or later)

25 IHE-Korea 2012 Connectathon? Under Consideration for 2012 Connectathon:  Enhanced tools:  Open source implementations (e.g., from Open Health Tools, Microsoft, etc)  Local copies & implementation of NIST XDS tools  Possible use of Gazelle for Connectathon management  CDA Documents:  Add Referral Option? Add Korea-Specific Documents?  Support for more Consumer Actor “Import” Options

26 IHE-Korea 2012 Connectathon? Under Consideration for 2012 Connectathon:  XDS.b & Related Services:  ATNA (Audit Trail / Node Authentication) Security Profile  Document Repository & Consumer options to support full Registry validation (e.g., document replacement and folder management)  Document Source – as a separate actor?  Patient Identity Source (e.g., PIX/PDQ Manager)?  Imaging Support Profiles (e.g., XDS-I)  Patient privacy, Cross Community Access + Discovery

27 IHE-Korea Daegu 2011 Special Thanks Special thanks to those who made the 2012 IHE Korea Connectathon a success!  U.S. Expert Support:  John Garguilo & Julian Deshayes (NIST) – PCD tooling  Bill Majurski (NIST) – XDS.b testing support (incl. xdstools2K – Public version for Korea!)  Andrew McCaffrey (NIST) – CDA PHMR Test Tools  Steve Moore (WUSTL) - Testing req’s + CA certificates  Daegu Support:  Hyoungho Do (KNU) – Worked through the night!

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