IHE cross-enterprise document sharing for imaging: interoperability testing software

In this paper we describe a software that is used to test systems that are involved in sharing medical images within the EHR. Our software is used as part of the Integrating the Healthcare Enterprise (IHE) testing process to test the Cross Enterprise Document Sharing for imaging (XDS-I) integration profile. We describe its architecture and functionalities; we also expose the challenges encountered and discuss the elected design solutions.EHR is being deployed in several countries. The EHR infrastructure will be continuously evolving to embrace advances in the information technology domain. Our software is built on a web framework to allow for an easy evolution with web technology. The testing software is publicly available; it can be used by system implementers to test their implementations. It can also be used by site integrators to verify and test the interoperability of systems, or by developers to understand specifications ambiguities, or to resolve implementations difficulties.The Electronic Health Record (EHR) enables access to relevant diagnostic information in order to assist in health decisions; and this, independently from the geographic location of the point of access or the institution where the information was initially gathered. However, EHR is not a single system that can be provided by a single manufacturer. It is a virtual system that results from the cooperation of several heterogeneous distributed systems. Interoperability is therefore essential. Achieving interoperability requires the use of communication standards; it also requires common vocabularies, common semantics, as well as process flows that are agreed on. Therefore, ensuring interoperability requires various types of testing: testing peers' ability to communicate and exchange data; testing peers' ability to parse and extract information from the successfully exchanged messages; and testing peers' ability to react to the extracted information by changing information in their systems or b