PS-CA Testing Approach
The 2025 Projectathon is dedicated to supporting Patient Summary implementation projects across Canada. Testing will focus on validating that the vendor systems have the capabilities needed to securely exchange well-formed Patient Summary information with other systems. Vendors will have an opportunity to test and demonstrate these capabilities in two distinct areas of the PS-CA specification:
- PS-CA Document format and content – ensuring that the Patient Summary document is structured in the expected format and that it contains the required information using the correct data types and valuesets, where specific valuesets are defined as required in the pan-Canadian Patient Summary specifications (PS-CA v2.0.0 DFT-Ballot).
- PS-CA Secure, exchange transactions - ensuring that the system(s) can securely exchange Patient Summary information using the recommended secure exchange methods of the FHIR summary document as presented in the Reference Architecture (RA v0.2.0 DFT-Ballot), referenced by the PS-CA and CA:FeX specifications.
1. PS-CA Document Format and Content
There will be a set of test cases focused on ensuring that the Patient Summary document is structured in the expected format and that it contains the required information using the correct data types and valuesets, where specific valuesets are defined as required in the PS-CA.
In addition to testing the PS-CA, test cases will validate the harmonized provincial Patient Summary specifications from Ontario (PS-ON) and Alberta (PS-AB) which are very closely aligned to the PS-CA, and from New Brunswick (PS-CA:NB) and British Columbia (PS-CA:BC) which have adopted the PS-CA FHIR profiles. All should be supported by minimal configuration of capability in the vendor systems. The test cases will ensure that the Patient Summary is formatted and contains the required content according to the respective Jurisdiction Implementation Guide (IG), where applicable. Vendors will need to prepare to validate PT data against both PS-CA and the applicable PT Implementation Guide. Refer to the Test Cases for Document Format and Content table below for details about each PT implementation guide.
The test cases will highlight where configuration is needed and test that the configuration is applied properly, based on claimed vendor conformance.
Testing the Document Format and Content
Testing supports for the Patient Summary document format and content validation will be provided using a combination of test cases, test data sets, and tools (see table Test Cases for Document Format and Content below for more information). While test cases reside in Gazelle, they may refer to data sets which will be available on the Test Data Sets page. The data sets will be available in an Excel spreadsheet format.
2. PS-CA Secure, Exchange Transactions
This area of testing will focus on validating the recommended secure exchange methods of the FHIR summary document as presented in the Reference Architecture (RA v0.2.0 DFT-Ballot), referenced by the PS-CA and CA:FeX specifications. Under ideal conditions, depending on the number of participating vendors and their system capabilities, tests will offer a high degree of coverage for all profiles.
There are two categories of integration profiles (see table Test Cases for Secure, Exchange Transactions for more information):
- Core integration profiles: CA:FeX , MHD and CA:SHL
- Supporting integration profiles: CA:Sec, CA:Aud (Canadian implementation guidance for ATNA), CT, and IUA
Implementation patterns of these integration profiles may differ from jurisdiction to jurisdiction and information exchange channels may vary in terms of their security footprint. Therefore, the Projectathon test cases have been organized into two categories:
- Category 1: Test cases that test individual actor capabilities in isolation. E.g., how a system can handle encrypted transactions, how a system can handle a CA:FeX transaction, how a system can handle an OAuth 2 token exchange, etc.
- Category 2: Complex test cases that group individual actor capabilities with other relevant actor capabilities to simulate real world scenarios. E.g., how a patient summary creator system can submit the document to a repository by using an OAuth 2 integration, etc.
Testing the Secure, Exchange Transactions
Testing supports for the Patient Summary secure, exchange transactions will be provided using a combination of test cases and tools (see Table Test Cases for Secure, Exchange Transactions below for more information).
Test Cases Overview
The purpose of this overview is to provide an understanding of:
- What will be tested:
- integration profiles included in the test cases
- descriptions and purpose of test cases
- actors and transactions involved in the test cases
- types of test cases and supporting tools
- Where to find the test cases
- When to run the test cases
What will be Tested (Implementation Guides & IHE Profiles)
The following table describes Implementation Guides being tested, purpose of each, profiles involved and types of tests and supporting tools. To learn more about the IHE Profiles, be sure to watch the information videos included in the Description sections.
Test Cases for Document Format and Content | |||
By IG | IG Description and Purpose of Test Cases | IHE Profiles Involved | Test Case Peer Type & Supporting Tools* |
PS-CA | The Projectathon 2025 will focus on interoperability demonstrations based on the pan-Canadian Patient Summary (PS-CA v2.0.0 DFT-Ballot) and the associated pan-Canadian FHIR Exchange (CA:FeX v2.1.0 DFT-Ballot) specifications. The PS-CA specification defines the building blocks to create and share patient summaries. The purpose of the test cases for the PS-CA will ensure that the Patient Summary is formatted and contains the required content according to the PS-CA Implementation Guide. A PS-CA clinical data set will be provided to support these test cases. Refer to the Test Data Sets for more details. To read more about the PS-CA, go here. |
| No-Peer (PS-CA Renderer, FHIR Validator, CA:FeX Simulators, and MHD Simulators) Peer-to-Peer (Gazelle platform) |
PS-CA:BC | The PS-CA: BC Patient Summary Project has been endorsed by Canada Health Infoway and BC Provincial Digital Health as a key strategy to support patient information sharing across care settings. PS-CA: BC Implementation Guide leverages foundational artifacts from PS-CA, including BC-specific guidance tailored to provincial healthcare needs. For Release 1, national artifacts are utilized, with the potential to build on PS-CA profiles for BC-specific needs in future releases. Since the PS-CA is based on the IPS, provinces and territories can configure their building blocks to address variances and ensure alignment with the IPS specification. British Columbia has committed to aligning as close as possible with the Patient Summary sharing work with the PS-CA. The BC Patient Summary Project has focused on an initial Release that meets the minimum requirements as outlined by clinicians. BC Providers in community/clinic settings have not historically shared information digitally outside of their settings. As a result, the BC requirements are expected to evolve as clinicians become more comfortable with sharing of information and of the clinician requirements of a Patient Summary. To read more about the PS-CA:BC, go here. |
| No-Peer (PS-CA Renderer, FHIR Validator, CA:FeX Simulators, and MHD Simulators) Peer-to-Peer (Gazelle platform) |
PS-ON | The Ontario Patient Summary is based on the International Patient Summary standard and was developed in collaboration with Canada Health Infoway and other jurisdictions and with preliminary input from primary care clinicians and solution vendors. The Ontario Patient Summary (PS-ON) Standard aligns, where applicable, to the International Patient Summary (IPS) HL7 FHIR standard, the Pan-Canadian Patient Summary (PS-CA) Standard (under concurrent development), and the Canadian Baseline (CA-Baseline). To read more about the PS-ON, go here. |
| No-Peer (PS-CA Renderer, FHIR Validator, CA:FeX Simulators, and MHD Simulators) Peer-to-Peer (Gazelle platform) |
PS-CA:NB | The PS-CA:NB implementation has adopted the PS-CA FHIR profiles without creating a separate implementation guide. The initial NB Patient Summary release focuses on requirements outlined by NB clinicians, a subset of data from MyHealth Records, and the Patient Mediated Access use case using the CA:SHL profile. To read more about the PS-CA:NB implementation, go here |
| TBD |
PS-AB | The Alberta Patient Summary (PS-AB) is based on the the Pan-Canadian Patient Summary (PS-CA) Standard, and the Canadian Baseline (CA-Baseline). It was developed in collaboration with Canada Health Infoway and with input from Alberta clinicians and solution vendors. The PS-AB attempts to profile in a way that allows the patient summary instances to be conformant to PS-CA, and CA-Baseline without having to formally derive from the profiles in these specifications. To read more about the PS-AB, go here. |
| No-Peer (PS-CA Renderer, FHIR Validator, CA:FeX Simulators, and MHD Simulators) Peer-to-Peer (Gazelle platform) |
*To learn more about the Supporting Tools, go here.
The table below describes the integration profiles being tested, purpose of each, actors involved and types of tests and supporting tools.
The Test Cases for Secure Exchange Transactions are designed to validate the interoperability capabilities of the system under test in securely exchanging a Patient Summary. Each test case typically defines a specific transaction or action that must be validated between two systems or actors. It includes detailed prerequisites, involved actors, step-by-step instructions, and any supporting tools required for testing. To explore and execute these test cases, please access Gazelle, where you can find the full set of test cases categorized by interoperability profile, actor, and transaction.
Test Cases for Secure, Exchange Transactions | |||
|---|---|---|---|
By Interoperability Profile | Profile Description and Purpose of Test Cases | Actors Involved | Test Case Peer Type & Supporting Tools* |
CA:FeX | The pan-Canadian FHIR Exchange (CA:FeX) is an implementable, testable interoperability specification based on HL7 FHIR Implementation Guides, that defines building blocks to enable creating, consuming and sharing clinical data via FHIR RESTful exchange patterns. The purpose of testing CA:FeX is to ensure systems have the ability to create, search and retrieve FHIR documents (e.g., Patient Summary) over the internet in a secure manner. Test cases for CA:FeX will include groupings with other profiles to ensure that patient information is shared securely over the internet (CA:Sec), meets audit requirements (CA:Aud), contains a consistent time (CT) with a median error less than 1 second and is accessed only by authorized users (IUA). To learn more about CA:FeX, you may watch this short video and review the presentation material here: CA:FeX Profile Information Video (mp4), CA:FeX Profile Information Presentation Deck (PDF) To read more technical information about CA:FeX, go here. |
| No-Peer (CA:FeX Client & Server Simulator) Peer-to-Peer (Gazelle platform) |
MHD | The Mobile Access to Health Documents (MHD) Profile defines one standardized interface to health document sharing. This profile is applicable to systems where needs are simple, such as pulling the latest summary for display. The purpose of testing MHD is to ensure systems have the ability to publish and access (i.e. query/retrieve) FHIR documents (e.g., Patient Summary) over the internet in a secure manner. Test cases for MHD will include groupings with other profiles to ensure that patient information is shared securely over the internet (CA:Sec), meets audit requirements (CA:Aud), contains a consistent time (CT) with a median error less than 1 second and is accessed only by authorized users (IUA). To learn more about MHD, you may watch this short video and review the presentation material here: MHD Profile Information Video (mp4), MHD Profile Information Presentation Deck (PDF) To read more technical information about MHD, go here. |
| No-Peer (MHD Client & Server Simulator) Peer-to-Peer (Gazelle platform) |
IUA | The Internet User Authorization (IUA) is an interoperability profile that provides an authorization profile for the HTTP RESTful transactions. Being authorized means that the user, patient, or provider has legitimate access to this HTTP RESTful service. The authorization includes identifying the user and the application that is making the request to the HTTP RESTful server, so that the server can make further access control decisions. The purpose of testing IUA in these test cases is to ensure that the person (e.g., patient, provider, etc. ) and application requesting access to the FHIR document (e.g., Patient Summary) are authorized to have access. To learn more about IUA, you may watch this short video and review the presentation material here: IUA Profile Information Video (mp4), IUA Profile Information Presentation Deck (PDF) To learn more about IUA, go here. |
| No-Peer (IUA Simulator) |
CA:Sec | The CA:Sec (Canadian Network Security) Implementation Guidance specifies the foundational elements needed to securely execute transactions between two systems. It is based on the ATNA profile and aims to bring improvements via loose coupling, and high cohesion, with focus on secure communication. The purpose of testing CA:Sec in these test cases is to ensure that the systems exchanging FHIR documents are able to meet the requirements of secure exchange between systems. To learn more about CA:Sec, you may watch this short video and review the presentation material here: CA:Sec Profile Information Video (mp4), CA:Sec Profile Information Presentation Deck (PDF) To read more technical information about CA:Sec, go here. |
| No-Peer (Gazelle Security Suite, TLS Server and Client Simulators) |
CA:Aud | The CA:Aud (Canadian Audit Trail) Implementation Guidance specifies the foundational elements needed to perform event logging for auditing purposes. It is based on the ATNA profile and aims to bring improvements via loose coupling, and high cohesion, with focus on auditing using modern formats and technologies. CA:Aud defines capabilities to record, store and retrieve audit messages in FHIR format using RESTful operations and other (IHE or non-IHE) methods. The purpose of testing CA:Aud in these test cases is to ensure that the systems exchanging FHIR documents (e.g., Patient Summary) are able to meet the requirements of recording, storing and retrieving audit messages. To learn more about CA:Aud, you may watch this short video and review the presentation material here: CA:Aud Profile Information Video (mp4), CA:Aud Profile Information Presentation Deck (PDF) To read more technical information about CA:Aud, go here. |
| No-Peer (Tested as part of CA:FeX and MHD) |
CT | The Consistent Time Integration Profile (CT) provides a means to ensure that the system clocks and time stamps of the many computers in a network are well synchronized. The purpose of testing CT in these use cases is to ensure the systems exchanging FHIR documents (e.g., Patient Summary) are synchronized with a median error less than 1 second. This provides systems with the ability to properly manage the information and provides clarity for users on the timeline of when the information was recorded. To learn more about CT, you may watch this short video and review the presentation material here: CT Profile Information Video (mp4), CT Profile Information Presentation Deck (PDF) To read more technical information about CT, go here. |
| No-Peer (Scripts provided within the test cases) |
CA:SHL | The pan-Canadian Shareable Health Links (CA:SHL) based on the HL7 Health Links Specification and part of the PMA initiative, defines building blocks enabling patients to generate shareable links that encode their health data such as patient summaries or immunization records. These shareable links can often be downloaded onto their devices and converted in a QR code format, facilitating patient-mediated data sharing and interoperability within the healthcare ecosystem. Currently, the CA:SHL includes minimal information, as the profile is in the process of being contributed to IHE (Integrating the Healthcare Enterprise) with the aim of becoming an internationally recognized Integration Profile. Until the international integration profile is available, the initial content for CA:SHL is published within the Reference Architecture release. This approach serves as a temporary measure until the final profile is established. To read more technical information about CA:SHL, go here |
| TBD |
*To learn more about the Supporting Tools, go here.