ELR testing questions -(forwarded from Hans J. Buitendijk M.Sc.,Siemens Healthcare)

[Eric Haas, DVM, MS Consultant]

· The ELR guide does not specify whether to use SN or NM, which would mean that a numeric field that does not need any of the suffix/prefixes should be able to use NM. However, the data for Age at time of specimen collection is using SN, while an NM could work as well. E.g., if age is “23”, then OBX-2=”NM” and OBX-5=”23” is the same as OBX-2=”SN” and OBX-5=“=^23^^” or even OBX-5=”^23^^”. The test fails the NM variant. Would we just explain to our certifying agency that the NIST tool is limited in its capabilities and this is acceptable per the standard? Or is there an upcoming version that this will be fixed? If so, when?

· PID-10, OBX-3, OBX-8, SPM-4, and SPM-5 are sensitive to having the codes being evaluated in the first triplet, while the ELR guide is not specific about which triplet to use and the standard does not enforce sequencing of triplets. In fact, the ELR IG is even very specific on OBX-3 that “When populating this field with values, this guide does not give preference to the triplet in which the standard (LOINC) code should appear. “ Sending the information in the second triplet will yield a fail. Would we just explain to our certifying agency that the NIST tool is limited in its capabilities and this is acceptable per the standard? Or is there an upcoming version that this will be fixed? If so, when?

· OBR-49 fails when one sends a value formatted as a CWE. The field is optional, so the tool would validate against the base standard: V2.5.1. However, pre-adoption is allowed, so the V2.7/2.7.1 definition of CWE is valid, including any values used, whether in Table 0507 or not as it is user defined. The tool should not fail this transaction. Would we just explain to our certifying agency that the NIST tool is limited in its capabilities and this is acceptable per the standard? Or is there an upcoming version that this will be fixed? If so, when?

[taylor...@bah.com]

Hi Hans,

· The first issue is known to NIST. In certain Context-based Validation test cases, the Test Tool will check for a specific data type for OBX.2 in order to meet certification testing requirements. Context-free Validation does not require SN versus NM, but does require that the data type support the result value/format.

· For the second issue: The recommended workaround for this issue is for the Tester/EHR technology vendor to use the ELR Context-free Validation Test Tool to validate the message; the message should pass validation without generating an error regardless of how the triplets are sequenced. The ATL can then inspect the Context-free message for specific content. Please Note: If the user does not enter the data in the sequence indicated in the Message Content specification, a content validation error will be generated (a false negative) in the Context-based Validation. Through the design of the validator, NIST tries to test some capabilities for certification testing with the Context-based Validation, but the flexibility built into the standard can make this objective difficult to achieve.

· For the third issue: By default the NIST Validation Test Tool checks all optional elements against the version of the base standard indicated in MSH.12. If an EHR technology vendor “pre-adopts” for optional elements, associated error messages for optional elements should be ignored.

Thank you for your questions.

Sheryl

[Donna Featherston]

Would you be able to tell us how to use the ELR Context Free Validation in respect to how to pick the testing scenario?  It does not seem to allow you to pick those to validate??

Thanks,

Donna Featherston

[Taylor, Sheryl L. (Fed)]

Hi Donna,

 

The ELR Context-free Validation does not provide testing scenarios (i.e., Test Cases). Using the NIST ELR Testing Tool at this url https://hl7v2-elr-testing.nist.gov/mu-elr/ , the Context-based Validation provides a set of Test Cases with various testing scenarios.

If you require assistance in using the Context-based Validation feature, the Quick Reference Guide and the Tool Tutorial found on the Documentation page provide step-by-step instructions.

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