What to test before a FHIR exchange goes live
A practical guide to testing data exchange across electronic health records, from patient matching to incomplete records.
Start with one workflow
Choose a workflow with an identifiable recipient and a clear definition of success. For a referral, follow the record from the sending system to the receiving clinician's queue. Record which details the receiver needs, which system owns each field, and what happens when a value is absent.
Test how the recipient sees the data
Use synthetic patient records. Include differences in names and identifiers, missing units, amended results and records with unexpected codes. Have the receiving team confirm that the data lands in the right chart, appears in the expected view, and can be traced back to its source.
Treat transport and interpretation as separate checks
The HL7 FHIR US Core guide describes profiles and requirements intended to support exchange across U.S. healthcare systems. A successful response is only one part of acceptance. Also compare the meaning and units of the information as displayed, and test retry behavior so an interrupted exchange does not create duplicate work.
Set an owner for exceptions
Document where failed exchanges appear, how support staff can reproduce them without patient data, and which team resolves them. Keep these examples as regression cases for future EHR and interface upgrades.
Sources
ASTP/ONC eCQI Resource Center — HL7 FHIR US Core Implementation Guide