Press Release: JMIR Publishes FHIR Testing Study

MITRE, AEGIS and ONC Author Study on Tools to Support FHIR Compliance, Health Data Interoperability Testing

BEDFORD, Mass. and ROCKVILLE, Md., Nov. 13, 2018 /PRNewswire/ — Frequent and thorough software testing has clear positive implications for health data interoperability according to a study published in the Journal of Medical Internet Research (JMIR) Medical Informatics.

The study, authored by the MITRE Corporation,, and the Office of the National Coordinator for Health IT (ONC) within the U.S. Department of Health and Human Services (HHS) focuses on tools that support testing of the Fast Healthcare Interoperability Resources (FHIR) standard from Health Level 7 International (HL7). Although there is wide recognition that the lack of health data interoperability has significant impacts, health data standards are complex. As such, test-driven methods play an important role in achieving interoperability. FHIR may be a technical solution that aligns with health information sharing policy, but systems need to be validated and tested.

As the operator of the CMS Alliance to Modernize Healthcare (CAMH) federally funded research and development center (FFRDC), MITRE is dedicated to ensuring the success of health IT priorities, such as interoperability.

“MITRE’s experience and history with health standards has taught us that testing implementations is critical to ensuring operational success,” said Jason Walonoski, health policy simulation, software engineer at MITRE. “In this paper, we present the data from Crucible and Touchstone that verifies our experience holds true with FHIR. The HL7 FHIR API will be critical to achieving health interoperability in the United States and globally.”

The study used two independent validation and testing tools, Crucible and Touchstone, and analyzed the usage and result data to determine their impact on server compliance with the HL7 FHIR specification. The use of such tools is strongly correlated with increased compliance with and conformance to the FHIR standard. Validation and testing tools can aid in the transition to an interoperable health care infrastructure. Developers that use testing and validation tools tend to produce more compliant FHIR implementations. The study demonstrates that when it comes to health data interoperability, “practice makes perfect.”

Michael Callihan, President of, said, “The JMIR study offers tangible evidence of the value of software testing in helping to achieve interoperability across EHR systems. We hope it leads to more use of standards-based testing in health information exchange as we pursue the national and global goals for true interoperability in healthcare.”

About The MITRE Corporation
MITRE’s mission-driven teams are dedicated to solving problems for a safer world. Through our federally funded R&D centers and public-private partnerships, we work across government to tackle challenges to the safety, stability, and well-being of our nation. Learn more at

About AEGIS, Inc. is a CMMI Maturity Level 3 appraised provider of data standards implementation, Healthcare Solutions, and Information Technology consulting services to Federal Civilian, Defense and Commercial sector clients. AEGIS is recognized as a leader in innovation of Health IT interoperability, testing, analytics, and informatics. Learn more at


Related Links

Leave a Reply

Your email address will not be published. Required fields are marked *