Archived source code for the Inferno Testing Tool and the Program Edition set of tests. No longer maintained.
Home Page: https://inferno.healthit.gov/
License: Apache License 2.0
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Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
Describe your issue here.
Hello,
When running Single Patient API test (whether I point to Inferno Reference Server or my FHIR server), after executing all the tests, the results are not displayed. I am getting a 504 Gateway Time-out
nginx/1.19.6
Thanks. (I am not sure if this is the right place to report the error).
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
Include:
Expected behavior
Tell us what should happen.
Actual behavior
Tell us what happens instead. Include screenshots if possible.
I have had consistent issues running Inferno. I continue to get a 504 response. I'm using an open endpoint and specifically only running the tests on the Single Patient API tab with one patient ID. I'm using Chrome. Any guidance is greatly appreciated.
Subject of the issue
USCP-02 The server doesn't support the search parameters: identifier
The error seems to indicate 'identifier' is not supported. but _id is? I'm not sure what I'm not including to pass this test.
{
"type":"Patient",
"interaction":[
{
"code":"read"
},
{
"code":"search-type"
}
],
"profile":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
"searchParam":[
{
"name":"_id",
"type":"token"
},
{
"name":"identifier",
"type":"token"
},
{
"name":"name",
"type":"string"
},
....
]
},
Your environment
Steps to reproduce
Capability Statment: https://www.medentmobiletest.com/fhir/R4/metadata/index.php?medent_practice_id=savcw235
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
When the source system does not have data for a Must Support data element such as Procedure.performed[x], a data absent reason is not passing the scenario per the general guidance.
https://www.hl7.org/fhir/us/core/general-guidance.html#must-support
Your environment
Steps to reproduce
Patient with a procedure that is missing performed[x] that is populated with a data-absent-reason extension
Include:
Expected behavior
Returning Procedure.performed[x] with data-absent-reason extension should pass
"_performedDateTime": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode": "unknown"
}
]
},
Is there something wrong with how the data-absent-reason is populated?
Actual behavior
Tell us what happens instead. Include screenshots if possible.
Returning Procedures.performed[x] with data-absent-reason extension is failing USCPROC-09
Subject of the issue
Describe your issue here.
In trying to run individual rake commands on the Inferno program source code's directory, we are met with some errors that seem to be internal to the source code itself (inferno-program-130P)
Whenever we build out our command to execute_batch (as dictated in https://github.com/onc-healthit/inferno-program#running-automated-command-line-interface-scripts ) we are consistently hit with this error:
rake aborted!
NoMethodError: undefined method fhir_version' for nil:NilClass /var/www/inferno/lib/app/models/testing_instance.rb:171:in fhir_version'
Here is a screenshot of where it is failing in the source code:
It seems that the "module" class is "nil" as of now - how can I work around this bug?
Your environment
Expected behavior
Tell us what should happen.
Actual behavior
Tell us what happens instead. Include screenshots if possible.
Subject: First Device Test Failing but it appears to be correct
Description:
From what I can tell, the two responses are identical. Is there an issue with this test?
Your environment
Steps to reproduce
Enter open-endpoint, patient ID and device type code - Execute tests
Include:
Expected behavior
The test should pass because both requests result in identical responses:
GET 200 https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Device?patient=12644044
GET 200 https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Device?patient=Patient/12644044
Actual behavior
Very first tests fails and it notes that it expects the same response from both.
As per HL7 document above mentioned resources are not included for separate bulk data test; But inferno takes it as individual test. we don't have patient's id listed in those resources.
Thanks,
Subject of the issue
When testing "name" searching for Patient, it appears that Inferno grabs the first name listed in Patient.name, pulls the text property, then issues a search Patient?name=. It looks like the search is escaped in the actual query. For example:
https://vs-icx.epic.com/Interconnect-CDE/api/FHIR/R4/Patient?name=Fhir%5C,%20Auto
However, when validating the search result against the expected name value, it seems to be comparing a partial escaped value.
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
Validate a patient "name" search where the first listed name has a comma.
Include:
Expected behavior
Tell us what should happen.
I'm not 100% sure. Validating name searching is tricky. A sufficient solution for us is just resolving what I think is an escaping issue.
Also, it looks like USCP-03 is just picking the first name, regardless of whether it is an "old", "usual", or "official" name. This seems fine, and would work for us if we just fix the escaping, but do you want to validate usual names instead? old name are part of USCDI, but it seems like the more common real-world use case is usual names, so making sure those work seems more useful. Or maybe check that searching both old and usual names?
Actual behavior
Tell us what happens instead. Include screenshots if possible.
Here is the FHIR searchset Bundle with the full patient resource that was causing the issue:
fhirpatientsearch.json.txt
name in Patient/e5ZHnklVuYuT85PnDVOepOg3 ([#<FHIR::HumanName:0x00007f09943bb100 @id=nil, @extension=[], @use="old", @text="Fhir, Auto", @family=nil, @given=[], @prefix=[], @suffix=[], @period=nil, @source_hash={"use"=>"old", "text"=>"Fhir, Auto"}>, #<FHIR::HumanName:0x00007f09943ba9a8 @id=nil, @extension=[], @use="old", @text="FHIR,AUTOMATION", @family=nil, @given=[], @prefix=[], @suffix=[], @period=nil, @source_hash={"use"=>"old", "text"=>"FHIR,AUTOMATION"}>, #<FHIR::HumanName:0x00007f09943ba2a0 @id=nil, @extension=[], @use="old", @text="FHIR,AUTOMATION SR.", @family=nil, @given=[], @prefix=[], @suffix=[], @period=nil, @source_hash={"use"=>"old", "text"=>"FHIR,AUTOMATION SR."}>, #<FHIR::HumanName:0x00007f09943b9b48 @id=nil, @extension=[], @use="official", @text="Automation FHIR Sr.", @family="FHIR", @given=["Automation"], @prefix=[], @suffix=["SR."], @period=nil, @source_hash={"use"=>"official", "text"=>"Automation FHIR Sr.", "family"=>"FHIR", "given"=>["Automation"], "suffix"=>["SR."]}>, #<FHIR::HumanName:0x00007f09943b8ef0 @id=nil, @extension=[], @use="usual", @text="Automation FHIR Sr.", @family="FHIR", @given=["Automation"], @prefix=[], @suffix=["SR."], @period=nil, @source_hash={"use"=>"usual", "text"=>"Automation FHIR Sr.", "family"=>"FHIR", "given"=>["Automation"], "suffix"=>["SR."]}>]) does not match name requested (Fhir\, Auto)
Example capabilitystatement: https://www.medentmobiletest.com/fhir/R4/metadata/index.php?medent_practice_id=savcw235
For test USCCAP-05: Capability Statement lists support for required US Core Profiles
There are multiple Observation profiles, but the R4 CapabilityStatement does not allow multiple "profile" elements: http://hl7.org/fhir/R4/capabilitystatement.html
Does Inferno recognize the "supportedProfile" elements for this test? Or is there another way to express this?
Subject of the issue
When I try to Spot Check the Terminology Files I run the command bundle exec rake "terminology:check_code[91935009,http://snomed.info/sct, http://hl7.org/fhir/us/core/ValueSet/us-core-allergy-substance]" the rake is aborted.
The same happens when I run the command: bundle exec rake "terminology:check_code[91935009,http://snomed.info/sct]"
Your environment
Steps to reproduce
I simply followed your instructions here https://github.com/onc-healthit/inferno-program step-by-step, locally. From Docker, to creating a UMLS account.
I ran the terminology creation task with docker-compose -f terminology_compose.yml up. Which gave the following: MetamorphoSys run failed. See screenshot below:
I did NOT do the cleanup step.
I then tried to proceed with Spot Checking the Terminology Files and encountered the errors below.
Actual behavior
For the command bundle exec rake "terminology:check_code[91935009,http://snomed.info/sct]"
chruby: unknown Ruby: 2.5.6
INFO | Inferno | Environment: development
/.gem/ruby/2.7.2/gems/json_pure-1.8.6/lib/json/common.rb:155: warning: Using the last argument as keyword parameters is deprecated
**rake aborted!**
Inferno::Terminology::UnknownValueSetException: Unknown ValueSet: http://hl7.org/fhir/us/core/ValueSet/us-core-allergy-substance
/Repos/inferno-program-1.3.0P/lib/app/utils/terminology.rb:241:in `validate_code'
lib/tasks/tasks.rake:1127:in `block (2 levels) in <top (required)>'
/.rubies/ruby-2.7.2/bin/bundle:23:in `load'
/.rubies/ruby-2.7.2/bin/bundle:23:in `<main>'
Tasks: TOP => terminology:check_code
(See full trace by running task with --trace)
For the command bundle exec rake "terminology:check_code[91935009,http://snomed.info/sct]"
chruby: unknown Ruby: 2.5.6
INFO | Inferno | Environment: development
/.gem/ruby/2.7.2/gems/json_pure-1.8.6/lib/json/common.rb:155: warning: Using the last argument as keyword parameters is deprecated
**rake aborted!**
Inferno::Terminology::ValueSet::UnknownCodeSystemException: Unknown Code System: http://snomed.info/sct
/Repos/inferno-program-1.3.0P/lib/app/utils/terminology.rb:244:in `validate_code'
lib/tasks/tasks.rake:1127:in `block (2 levels) in <top (required)>'
/.rubies/ruby-2.7.2/bin/bundle:23:in `load'
/.rubies/ruby-2.7.2/bin/bundle:23:in `<main>'
Tasks: TOP => terminology:check_code
(See full trace by running task with --trace)
Any thoughts on this? Thanks.
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
_revinclude=Provenance:target test is skipped
When running Patient tests I found that this very test is scipped with the following message:
USCP-11: Server returns Provenance resources from Patient search by _id + _revIncludes: Provenance:target
The server doesn't support the revinclude 'Provenance:target' for the Patient resource
Though, when I perform GET to /Patient?_id=352&_revinclude=Provenance:target I successfully receive Patient and Provenance resources.
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
https://inferno.kollab.link/edifecs/fhir/R4 - is our address
Client: inferno_confidential
Secret: 78876427-0279-45aa-9475-ce8a7acde51c
user: [email protected]/password
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
"FluentPath expression evaluates to false for USCoreGoalProfile invariant rule gol-1: Goal.target.measure is required if Goal.target.detail is populated." However, Goal.target.detail is not populated. Sample JSON below.
Also, " Goal.lifecycleStatus: unable to evaluate FluentPath expression against JSON for USCoreGoalProfile invariant rule ele-1: All FHIR elements must have a @value or children". Though lifecycleStatus appears to be in order.
{
"resourceType": "Goal",
"id": "2CF8017665E94ED49499D848BD6BFDC4.NRS.30274",
"meta": {
"lastUpdated": "2020-11-24T18:01:27-05:00"
},
"lifecycleStatus": "active",
"subject": {
"reference": "Patient/2CF8017665E94ED49499D848BD6BFDC4",
"display": "Mcallister,Sathees Ron"
},
"target": [
{
"dueDate": "2021-11-04"
}
]
}
Your environment
Steps to reproduce
Single Patient API Test suite > Test for Goal resource
Include resource which does not have Goal.target.detail populated
Consider if Goal.target.dueDate is causing the rule to be invoked??
Include resource which does have Goal.lifecycleStatus populated
Include:
Expected behavior
Invariant rule should not be checked; should not fail test.
Actual behavior
Invariant rule fails test; see issue description
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
The Encounter Tests are skipped because they are unable to find Encounter references in prior searches.
Your environment
Steps to reproduce
Include:
Expected behavior
We would expect any Encounter reference from any other Test would qualify and be able to be tested in the Encounter Tests.
Actual behavior
All Encounter Tests are skipped.
Subject of the issue
In the USCCAP-02 test, the capability statement validation indicates that the values 'introspect' and 'revoke' are not defined by the extension http://fhir-registry.smarthealthit.org/StructureDefinition/oauth-uris. However, if we go to the URL where this extension is defined, http://www.hl7.org/fhir/smart-app-launch/StructureDefinition-oauth-uris.html, we can see that the 'introspect' and 'revoke' values are indeed defined.
Your environment
Steps to reproduce
Run USCCAP-02 with any fhir server that supports the "http://fhir-registry.smarthealthit.org/StructureDefinition/oauth-uris" extension and has 'introspect' and 'revoke' as url values. You can view our server's metadata by going to: https://fhir-staging.bluebuttonpro.com/inferno-certification/metadata
After getting the response from URL "/metadata", the tool is throwing the following error:
Invalid CapabilityStatement: CapabilityStatement.rest[0].operation[6].definition: Canonical URLs must be absolute URLs if they are not fragment references (OperationDefinition/-is-expunge).
Please help me with this.
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
Two of the transitive dependencies of data_mapper pull in json for ruby which has a known security vulnerability -
data_mapper:1.2.0
dm-serializer:1.2.2
json_pure:1.8.6dm-types:1.2.2
json:1.8.6The vulnerability - https://cve.mitre.org/cgi-bin/cvename.cgi?name=CVE-2020-10663
The JSON gem through 2.2.0 for Ruby, as used in Ruby 2.4 through 2.4.9, 2.5 through 2.5.7, and 2.6 through 2.6.5, has an Unsafe Object Creation Vulnerability. This is quite similar to CVE-2013-0269, but does not rely on poor garbage-collection behavior within Ruby. Specifically, use of JSON parsing methods can lead to creation of a malicious object within the interpreter, with adverse effects that are application-dependent.
Your environment
Expected behavior
The gem being used - data_mapper is almost a decade old and is no longer being maintained. Replacing the dependency with another mapper implementation is recommended.
I am working on replacing the dependency with Ruby Object Mapper as it replaced data_mapper in 2012. I am not a ruby developer though, so I'm logging this issue to see if someone from the community can help with the migration.
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
For FHIR search interactions return a Bundle that has both the relevant resource (e.g. Immunization) and an OperationOutcome, Inferno tries to validate must-support properties for AllergyIntolerance on the OperationOutcome. In our case, we return informational OperationOutcomes, which should be allowed.
Your environment
Steps to reproduce
Run the Single Patient API tests against a server that returns OperationOutcomes in the searchset Bundle alongside the actual search results. Unfortunately I don't have a public server for you to use for testing :(. I did include some example Bundle responses so maybe you can load those into a reference server and use for testing?
Include:
Expected behavior
must-support validation logic should only run on a resource in a bundle if that resource is of the type that has the must support requirements. If a search interaction returns a mix of the requested resource (e.g. Immunization) and OperationOutcome, the must-support requirements for Immunization should only be checked on the Immunization resources.
Actual behavior
The test fails, due looking for must-support elements on the OperationOutcome.
Example Bundle responses are attached.
example_immunization_bundle.xml.txt
example_immunization_bundle.json.txt
Example errors:
USCI-01: Server returns valid results for Immunization search by patient. results...
Fatal Error: undefined method `patient' for #<FHIR::OperationOutcome:0x00007fe403771ca0 @id=nil, @meta=nil, @implicitRules=nil, @language=nil, @text=nil, @contained=[], @extension=[], @modifierExtension=[], @issue=[#<FHIR::OperationOutcome::Issue:0x00007fe4037716b0 @id=nil, @extension=[], @modifierExtension=[], @Severity="warning", @code="processing", @details=#<FHIR::CodeableConcept:0x00007fe403770f58 @id=nil, @extension=[], @coding=[#<FHIR::Coding:0x00007fe403770c10 @id=nil, @extension=[], @System="urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", @Version=nil, @code="4119", @display="This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system.", @userSelected=nil, @source_hash={"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}>], @text="This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system.", @source_hash={"coding"=>[{"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}], "text"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}>, @diagnostics=nil, @location=[], @expression=[], @source_hash={"severity"=>"warning", "code"=>"processing", "details"=>{"coding"=>[{"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}], "text"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}}>], @source_hash={"resourceType"=>"OperationOutcome", "issue"=>[{"severity"=>"warning", "code"=>"processing", "details"=>{"coding"=>[{"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}], "text"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}}]}>
USCI-08: Immunization resources returned from previous search conform to the US Core Immunization Profile. results...
Fatal Error: undefined method `status' for #<FHIR::OperationOutcome:0x00007fe403771ca0 @id=nil, @meta=nil, @implicitRules=nil, @language=nil, @text=nil, @contained=[], @extension=[], @modifierExtension=[], @issue=[#<FHIR::OperationOutcome::Issue:0x00007fe4037716b0 @id=nil, @extension=[], @modifierExtension=[], @Severity="warning", @code="processing", @details=#<FHIR::CodeableConcept:0x00007fe403770f58 @id=nil, @extension=[], @coding=[#<FHIR::Coding:0x00007fe403770c10 @id=nil, @extension=[], @System="urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", @Version=nil, @code="4119", @display="This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system.", @userSelected=nil, @source_hash={"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}>], @text="This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system.", @source_hash={"coding"=>[{"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}], "text"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}>, @diagnostics=nil, @location=[], @expression=[], @source_hash={"severity"=>"warning", "code"=>"processing", "details"=>{"coding"=>[{"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}], "text"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}}>], @source_hash={"resourceType"=>"OperationOutcome", "issue"=>[{"severity"=>"warning", "code"=>"processing", "details"=>{"coding"=>[{"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}], "text"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}}]}>
USCI-09: All must support elements are provided in the Immunization resources returned. results...
Fatal Error: undefined method `statusReason' for #<FHIR::OperationOutcome:0x00007fe403771ca0 @id=nil, @meta=nil, @implicitRules=nil, @language=nil, @text=nil, @contained=[], @extension=[], @modifierExtension=[], @issue=[#<FHIR::OperationOutcome::Issue:0x00007fe4037716b0 @id=nil, @extension=[], @modifierExtension=[], @Severity="warning", @code="processing", @details=#<FHIR::CodeableConcept:0x00007fe403770f58 @id=nil, @extension=[], @coding=[#<FHIR::Coding:0x00007fe403770c10 @id=nil, @extension=[], @System="urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", @Version=nil, @code="4119", @display="This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system.", @userSelected=nil, @source_hash={"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}>], @text="This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system.", @source_hash={"coding"=>[{"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}], "text"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}>, @diagnostics=nil, @location=[], @expression=[], @source_hash={"severity"=>"warning", "code"=>"processing", "details"=>{"coding"=>[{"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}], "text"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}}>], @source_hash={"resourceType"=>"OperationOutcome", "issue"=>[{"severity"=>"warning", "code"=>"processing", "details"=>{"coding"=>[{"system"=>"urn:oid:1.2.840.114350.1.13.5325.1.7.2.657369", "code"=>"4119", "display"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}], "text"=>"This response includes information available to the authorized user at the time of the request. It may not contain the entire record available in the system."}}]}>
Subject of the issue
Currently there is a test specific to referencing Medication within MedicationRequest. According to the clarification in the v3.2 US Core profile: The server systems are not required to support both a code and a reference, but SHALL support at least one of these methods. The test is ‘omitted’ but I wanted to confirm its relevancy and ensure we will not be dinged for only supporting medicationCodeableConcept. The test name references US Core v3.1.1 but I wanted to see if the test would be removed with the Must Support clarification.
Your environment
Edition of inferno (Community or Program): ONC Program Edition
Version of inferno: 1.4.1
Which browser and version(s) is the bug present on?: Chrome Version 87.0.4280.141
Steps to reproduce
Select Program Edition>Enter endpointSelect>Select Single Patient API tab>Run Tests>Add a patient id
Include:
The selected test suite: Single Patient API tab
The URL of the FHIR server being tested: https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d
The Test ID, if it's a problem with a specific test: USCMR-11: Medication resources returned conform to US Core v3.1.1 profiles
Expected behavior
We would not expect to be tested for a reference to Medication
Actual behavior
There is an omitted test for not having a reference to Medication
The NLM has changed the method for logging in, and now the content is not automatically loaded for INFERNO. Can this be fixed to work with the new login method?
-----Original Message-----
From: UMLS Notification [email protected] On Behalf Of NLM Customer Service
Sent: Monday, November 16, 2020 7:20 AM
To: [email protected]
Subject: UTS Login Changes and UMLS 2020 Annual Report
Dear UMLS Licensee,
UTS Login Changes
The UMLS Terminology Services (UTS) is moving from a username/password login to a service that allows you to sign in to the UTS using Google, Microsoft, Login.gov, or another identity provider of your choice.
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
When running test data from uscore-testing-data-03-05-2020.zip through a FHIR validator, I'm seeing validation errors on DocumentReference.identifier that say, "if identifier.system is ''urn:ietf:rfc:3986'', then the identifier.value must be a full URI (e.g. start with a scheme)". This error appears to be present in every DocumentReference.identifier.
Here's a brief example using Abigail677_Zieme486_621338a9-01f4-49d4-b852-14507a8bf8c7.json as input.
{
"severity": "error",
"code": "processing",
"diagnostics": "if identifier.system is ''urn:ietf:rfc:3986'', then the identifier.value must be a full URI (e.g. start with a scheme)",
"location": [
"Parameters.parameter[0].resource.ofType(Bundle).entry[9].resource.ofType(DocumentReference).identifier[0]",
"Line 1, Col 24010"
]
}
The Bundle.entry[9] DocumentReference.identifier looks like this:
{
"system": "urn:ietf:rfc:3986",
"value": "445d4eab-7da3-45cf-aa65-272344c8da08"
}
The identifier.value looks like a UUID, so presumably "urn:uuid:" should be prepended to it.
Your environment
I'm using only the uscore-testing-data (not a full Inferno edition).
https://github.com/inferno-community/uscore-data-sets
Steps to reproduce
Extract one of the JSON bundles from the zip file and send it to the Bundle/$validate endpoint of a FHIR server which supports validation.
E.g. ...
{
"resourceType": "Parameters",
"parameter": [ {
"name": "resource",
"resource":
<<< content of Abigail677_Zieme486_621338a9-01f4-49d4-b852-14507a8bf8c7.json >>>
} ]
}
cat Abigail677_Zieme486_621338a9-01f4-49d4-b852-14507a8bf8c7_parameters.json | curl --data @- --silent --verbose --request POST --url 'http://localhost:8080/r4/Bundle/$validate' --header 'content-type: application/fhir+json' --header 'accept: application/fhir+json' > Abigail677_Zieme486_621338a9-01f4-49d4-b852-14507a8bf8c7_validation-result-1.json
Expected behavior
The DocumentReference.identifier values should not trigger validation errors.
Actual behavior
DocumentReference.identifier values are invalid.
Is your feature request related to a problem? Please describe it.
Describe the problem you are trying to solve.
Our EHR requires Internet Explorer 11. When we run the INFERNO test for EHR Launch, INFERNO fails with a message that it does not support Internet Explorer (see attachment 1). When we click on OK, and then click on the Run Tests button, nothing happens (see attachment 2). I asked about this during the monthly call (Feb 10 @1 PM EST), and Rob Scanlon asked me to log this request.
Describe the solution you'd like to see implemented
Allow EHR Launch from IE 11.
The retirement date announced by Microsoft is the same as Windows 10 retirement, which is 10/24/2025. See https://docs.microsoft.com/en-us/lifecycle/faq/internet-explorer-microsoft-edge and https://docs.microsoft.com/en-us/lifecycle/products/windows-10-home-and-pro.
Describe alternatives you've considered
Describe any alternative solutions or features you have considered.
We have considered support for additional browsers, but will be certifying our EHR before supporting additional browsers.
How can we run the US Core Profiles tests with the capability statement failing? Can we run Patient individually?
Capability Statement only failing on test USCCAP-02 for CapabilityStatement.meta.versionId error parsing primitive value must be a string.
We would like to be able to run Patient Test and unable to run / execute. The tests are just skipped for the remaining US Core Profile tests.
When launching a test for the EHR Practitioner App, the following pops up:
Inferno will now redirect you to an external website for user authorization. For this test sequence to complete successfully, you will need to select a patient and authorize the Inferno client to access their data. Once you authorize the Inferno client to access patient data, you should be redirected back to Inferno. If something goes wrong, you can always return to Inferno at https://inferno.healthit.gov/inferno/4ksRXaHZSRO.
Is an external website required for testing?
For example, if an EHR User selects a patient before launching the app, then the launch token can be linked internally to a patient. We don't see the need to have the user log in a second time and/or re-select a patient.
If an EHR launches the app outside of a patient context, I can see the need for optionally supplying patient selection later in the flow.
If the app is launched outside of the EHR, where the user needs to log in, it seems like it would be a Standalone Launch sequence, as opposed to the EHR Launch we're testing here?
Is your feature request related to a problem? Please describe it.
Describe the problem you are trying to solve.
Is there a way to disable authorization requirement for bulk-api testing using Inferno? Our authorization server is not yet ready with full support for the backend authorization specification and our bulk-api export APIs are ready for testing. We’d like to run Inferno tests to identify any gap in our implementation. Any suggestion on how we can achieve this?
Describe the solution you'd like to see implemented
Things you can put in this section include (but aren't limited to):
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
The sites certificate has expired
https://packages.fhir.org/
If I hit that site and bypass the expired certificate it looks like they have moved the content to https://simplifier.net/packages. So my guess is they have not update the Inferno code to point to the new site.
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
Include:
Expected behavior
Tell us what should happen.
Actual behavior
Tell us what happens instead. Include screenshots if possible.
I am facing issue : For the observation resource, must support elements are status, code, subject, issued and valueCodeableConcept .
But the test fails with message : Could not verify presence for profile http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus of the following must support elements: status, code, subject, issued.
However, the application contains all the mandatory elements.
Thanks!
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
" USCPO-10: Observation resources returned from previous search conform to the US Core Pulse Oximetry Profile. Observation.code.coding failed cardinality test (1..1) – found 2"
While Observation.code has a cardinality of 1..1, Observation.code.coding has a cardinality of 1..* per definition of CodeableConcept data type http://hl7.org/fhir/R4/datatypes.html#CodeableConcept
The example resource with US Core Pulse Oximetry profile in 3.1.1 demonstrates 2 codings (59480-5 and 2708-6). Link and snippet from US Core follow:
https://www.hl7.org/fhir/us/core/Observation-satO2-fiO2.json.html
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "2708-6",
"display" : "Oxygen saturation in Arterial blood"
},
{
"system" : "http://loinc.org",
"code" : "59408-5",
"display" : "Oxygen saturation in Arterial blood by Pulse oximetry"
},
{
"system" : "urn:iso:std:iso:11073:10101",
"code" : "150456",
"display" : "MDC_PULS_OXIM_SAT_O2"
}
]
},
Unsure if this happens with other *code.coding elements, Observation or otherwise.
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
Provide two or more code.coding values with Observation Pulse Ox resource
Include:
Expected behavior
Tell us what should happen.
Cardinality of code.coding is 1..* per definition of CodeableConcept data type
http://hl7.org/fhir/R4/datatypes.html#CodeableConcept
Actual behavior
Tell us what happens instead. Include screenshots if possible.
Hi,
For resources Location, PractitionerRole tests are getting skipped and giving error like "No prior search references found" While executing the tests on Inferno (inferno-2.10.0) pointing to our local FHIR server. I want to know why these are skipping or is there any dependencies for these type of resources to get tests executed.
NOTE: I executed test cases related to Practitioner before i run PractitionerRole tests.
Thanks in Advance.
Regards,
Dileep
Greetings,
My regrets if this is not the correct forum. I am new to Inferno and am just attempting to install the container on Windows 2016 for the first time. When attempting to build in docker the following error appears:
Step 1/16 : FROM ruby:2.5.6
2.5.6: Pulling from library/ruby
ERROR: Service 'ruby_server' failed to build: no matching manifest for windows/amd64 10.0.14393 in the manifest list entries
Thank you in advance for any leads on how to resolve this issue.
Jim
Tests that deny access due to insufficient scope needs to expect 403 instead of 401. This is an issue in AVR/AVU tests.
This is also explicit in the FHIR spec itself: https://www.hl7.org/fhir/security.html#AccessDenied
Subject of the issue
Patient.address[0].period: Object must have some content
Reading the Period definition[https://www.hl7.org/fhir/datatypes.html#Period], I see this:
If the start element is missing, the start of the period is not known. If the end element is missing, it means that the period is ongoing, or the start may be in the past, and the end date in the future, which means that period is expected/planned to end at the specified time
It seems if the Start is unknown, and the End is Ongoing, Period would be an empty object: "period": {}, Or is there another way to express this that the Inferno test is looking for?
Inferno Single Patient API Laboratory Result Observation test USCLRO-02 is failing when the coded data is not available. The system may allow to enter results manually on a patient, for example Glucose Random, without performing lookup on a LOINC code. See JSON below. According to HL7 FHIR® US Core Implementation Guide STU3 Release 3.1.1 , section 2.1.1.6 Missing Data
http://hl7.org/fhir/us/core/general-guidance.html#missing-data, “… if the source systems has text but no coded data, only the text element is used”.
Your environment
Edition of inferno (Community or Program): Program
Version of inferno: 1.4.1
Which browser and version(s) is the bug present on?: Chrome
Steps to reproduce
Tell us how to reproduce this issue.
Use a test patient that has text but no coded data for the Observation resource and run Single Patient API Laboratory Result Observation Tests, test USCLRO-02.
Include:
The selected test suite: Single Patient API
The URL of the FHIR server being tested: https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43 (not a public URL)
The Test ID, if it's a problem with a specific test.: USCLRO-02
Expected behavior
Tell us what should happen.
Inferno test USCLRO-02 should not fail when coded data is not available.
Body
{
"resourceType": "Bundle",
"id": "5a1699d8-f555-4039-ab77-db87cb7d53b1",
"type": "searchset",
"timestamp": "2021-02-25T15:40:51-05:00",
"entry": [
{
"fullUrl": "https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43/Observation/156EA49F96FB45F0AB1DB0B59053C8B4.RES.18218",
"resource": {
"resourceType": "Observation",
"id": "156EA49F96FB45F0AB1DB0B59053C8B4.RES.18218",
"status": "preliminary",
"meta": {
"lastUpdated": "2020-12-03T12:58:53-05:00"
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
]
}
],
"subject": {
"reference": "Patient/156EA49F96FB45F0AB1DB0B59053C8B4",
"display": "Ash,Renny-Obs-Nurs-Vitals Jean"
},
"encounter": {
"reference": "Encounter/156EA49F96FB45F0AB1DB0B59053C8B4.112261",
"display": "City General,Initial"
},
"effectiveDateTime": "2020-12-02T07:19:00-05:00",
"code": {
"text": "Glucose Random"
},
"valueString": "Blood Glucose Abnormal\r\n",
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">Observation
Patient:Ash,Renny-Obs-Nurs-Vitals Jean
Status:preliminary
Encounter:City General,Initial
Category:Laboratory
Effective Time:2020-12-02T07:19:00-05:00
Code:
Text:Glucose Random
Value:Blood Glucose Abnormal\r\n
"
}
}
},
{
"fullUrl": "https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43/Observation/156EA49F96FB45F0AB1DB0B59053C8B4.RES.12215",
"resource": {
"resourceType": "Observation",
"id": "156EA49F96FB45F0AB1DB0B59053C8B4.RES.12215",
"status": "preliminary",
"meta": {
"lastUpdated": "2020-11-21T13:20:11-05:00"
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
]
}
],
"subject": {
"reference": "Patient/156EA49F96FB45F0AB1DB0B59053C8B4",
"display": "Ash,Renny-Obs-Nurs-Vitals Jean"
},
"encounter": {
"reference": "Encounter/156EA49F96FB45F0AB1DB0B59053C8B4.68248",
"display": "City General,Initial"
},
"effectiveDateTime": "2020-11-15T12:03:00-05:00",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "17969-7"
}
],
"text": "Culture, Urine"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "57768-4"
},
{
"system": "http://www.ama-assn.org/go/cpt",
"code": "86625"
}
],
"text": "Campylobacter Jejuni\r\n"
},
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">Observation
Patient:Ash,Renny-Obs-Nurs-Vitals Jean
Status:preliminary
Encounter:City General,Initial
Category:Laboratory
Effective Time:2020-11-15T12:03:00-05:00
Code:
System:http://loinc.org Code:17969-7 Text:Culture, Urine
Value:
System:http://loinc.org Code:57768-4 Text:Campylobacter Jejuni\r\n
System:http://www.ama-assn.org/go/cpt Code:86625 Text:Campylobacter Jejuni\r\n
"
}
}
},
{
"fullUrl": "https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43/Observation/156EA49F96FB45F0AB1DB0B59053C8B4.RES.12227",
"resource": {
"resourceType": "Observation",
"id": "156EA49F96FB45F0AB1DB0B59053C8B4.RES.12227",
"status": "preliminary",
"meta": {
"lastUpdated": "2020-11-21T17:25:16-05:00"
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
]
}
],
"subject": {
"reference": "Patient/156EA49F96FB45F0AB1DB0B59053C8B4",
"display": "Ash,Renny-Obs-Nurs-Vitals Jean"
},
"encounter": {
"reference": "Encounter/156EA49F96FB45F0AB1DB0B59053C8B4.112261",
"display": "City General,Initial"
},
"effectiveDateTime": "2020-11-15T09:10:00-05:00",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "6690-2"
}
],
"text": "WBC"
},
"valueRange": {
"low": {
"value": -130
},
"high": {
"value": -123
}
},
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">Observation
Patient:Ash,Renny-Obs-Nurs-Vitals Jean
Status:preliminary
Encounter:City General,Initial
Category:Laboratory
Effective Time:2020-11-15T09:10:00-05:00
Code:
System:http://loinc.org Code:6690-2 Text:WBC
Value:
Low:
Value:-130
High:
Value:-123
"
}
}
},
{
"fullUrl": "https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43/Observation/156EA49F96FB45F0AB1DB0B59053C8B4.RES.12218",
"resource": {
"resourceType": "Observation",
"id": "156EA49F96FB45F0AB1DB0B59053C8B4.RES.12218",
"status": "preliminary",
"meta": {
"lastUpdated": "2020-11-21T15:16:43-05:00"
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
]
}
],
"subject": {
"reference": "Patient/156EA49F96FB45F0AB1DB0B59053C8B4",
"display": "Ash,Renny-Obs-Nurs-Vitals Jean"
},
"encounter": {
"reference": "Encounter/156EA49F96FB45F0AB1DB0B59053C8B4.68248",
"display": "City General,Initial"
},
"effectiveDateTime": "2020-11-14T12:03:00-05:00",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "BLDC"
}
],
"text": "Culture, Blood"
},
"valueDateTime": "2020-12-13T00:00:00-05:00",
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">Observation
Patient:Ash,Renny-Obs-Nurs-Vitals Jean
Status:preliminary
Encounter:City General,Initial
Category:Laboratory
Effective Time:2020-11-14T12:03:00-05:00
Code:
System:http://loinc.org Code:BLDC Text:Culture, Blood
Value:2020-12-13T00:00:00-05:00
"
}
}
},
{
"fullUrl": "https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43/Observation/156EA49F96FB45F0AB1DB0B59053C8B4.RES.18416",
"resource": {
"resourceType": "Observation",
"id": "156EA49F96FB45F0AB1DB0B59053C8B4.RES.18416",
"status": "final",
"meta": {
"lastUpdated": "2020-12-03T12:24:38-05:00"
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
]
}
],
"subject": {
"reference": "Patient/156EA49F96FB45F0AB1DB0B59053C8B4",
"display": "Ash,Renny-Obs-Nurs-Vitals Jean"
},
"encounter": {
"reference": "Encounter/156EA49F96FB45F0AB1DB0B59053C8B4.112261",
"display": "City General,Initial"
},
"effectiveDateTime": "2020-12-03T12:22:00-05:00",
"code": {
"text": "RES_RESTRICTED"
},
"valueQuantity": {
"value": 101310,
"unit": "10.mBar.s/L"
},
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">Observation
Patient:Ash,Renny-Obs-Nurs-Vitals Jean
Status:final
Encounter:City General,Initial
Category:Laboratory
Effective Time:2020-12-03T12:22:00-05:00
Code:
Text:RES_RESTRICTED
Value:
Unit:10.mBar.s/L Value:101310
"
}
}
},
{
"fullUrl": "https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43/Observation/156EA49F96FB45F0AB1DB0B59053C8B4.RES.17224",
"resource": {
"resourceType": "Observation",
"id": "156EA49F96FB45F0AB1DB0B59053C8B4.RES.17224",
"status": "final",
"meta": {
"lastUpdated": "2020-12-02T19:29:46-05:00"
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
]
}
],
"subject": {
"reference": "Patient/156EA49F96FB45F0AB1DB0B59053C8B4",
"display": "Ash,Renny-Obs-Nurs-Vitals Jean"
},
"encounter": {
"reference": "Encounter/156EA49F96FB45F0AB1DB0B59053C8B4.112261",
"display": "City General,Initial"
},
"effectiveDateTime": "2020-12-02T08:59:00-05:00",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "17849-1"
}
],
"text": "RBC"
},
"valueInteger": 3333,
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">Observation
Patient:Ash,Renny-Obs-Nurs-Vitals Jean
Status:final
Encounter:City General,Initial
Category:Laboratory
Effective Time:2020-12-02T08:59:00-05:00
Code:
System:http://loinc.org Code:17849-1 Text:RBC
Value:3333
"
}
}
},
{
"fullUrl": "https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43/Observation/156EA49F96FB45F0AB1DB0B59053C8B4.RES.18219",
"resource": {
"resourceType": "Observation",
"id": "156EA49F96FB45F0AB1DB0B59053C8B4.RES.18219",
"status": "final",
"meta": {
"lastUpdated": "2020-12-03T13:09:59-05:00"
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
]
}
],
"subject": {
"reference": "Patient/156EA49F96FB45F0AB1DB0B59053C8B4",
"display": "Ash,Renny-Obs-Nurs-Vitals Jean"
},
"encounter": {
"reference": "Encounter/156EA49F96FB45F0AB1DB0B59053C8B4.74047",
"display": "City General,Initial"
},
"effectiveDateTime": "2020-12-01T12:08:00-05:00",
"code": {
"text": "Glucose Random"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "44877-9"
},
{
"system": "http://snomed.info/sct",
"code": "166922008"
}
],
"text": "Blood Glucose Abnormal\r\n"
},
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">Observation
Patient:Ash,Renny-Obs-Nurs-Vitals Jean
Status:final
Encounter:City General,Initial
Category:Laboratory
Effective Time:2020-12-01T12:08:00-05:00
Code:
Text:Glucose Random
Value:
System:http://loinc.org Code:44877-9 Text:Blood Glucose Abnormal\r\n
System:http://snomed.info/sct Code:166922008 Text:Blood Glucose Abnormal\r\n
"
}
}
},
{
"fullUrl": "https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43/Observation/156EA49F96FB45F0AB1DB0B59053C8B4.RES.18220",
"resource": {
"resourceType": "Observation",
"id": "156EA49F96FB45F0AB1DB0B59053C8B4.RES.18220",
"status": "final",
"meta": {
"lastUpdated": "2020-12-03T13:25:25-05:00"
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
]
}
],
"subject": {
"reference": "Patient/156EA49F96FB45F0AB1DB0B59053C8B4",
"display": "Ash,Renny-Obs-Nurs-Vitals Jean"
},
"encounter": {
"reference": "Encounter/156EA49F96FB45F0AB1DB0B59053C8B4.112261",
"display": "City General,Initial"
},
"effectiveDateTime": "2020-12-01T09:22:00-05:00",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "6690-2"
}
],
"text": "WBC"
},
"valueQuantity": {
"system": "http://unitsofmeasure.org",
"comparator": ">=",
"value": 100,
"code": "%"
},
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">Observation
Patient:Ash,Renny-Obs-Nurs-Vitals Jean
Status:final
Encounter:City General,Initial
Category:Laboratory
Effective Time:2020-12-01T09:22:00-05:00
Code:
System:http://loinc.org Code:6690-2 Text:WBC
Value:
System:http://unitsofmeasure.org Comparator:>= Code:% Value:100
"
}
}
},
{
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"subject": {
"reference": "Patient/156EA49F96FB45F0AB1DB0B59053C8B4",
"display": "Ash,Renny-Obs-Nurs-Vitals Jean"
},
"encounter": {
"reference": "Encounter/156EA49F96FB45F0AB1DB0B59053C8B4.74047",
"display": "City General,Initial"
},
"effectiveDateTime": "2020-12-01T08:19:00-05:00",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "2093-3"
}
],
"text": "Cholesterol, Total"
},
"valueString": "Specimen tested for Staphylococcus aureus/MRSA, Streptococcus pyogenes and Enter",
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">Observation
Patient:Ash,Renny-Obs-Nurs-Vitals Jean
Status:entered-in-error
Encounter:City General,Initial
Category:Laboratory
Effective Time:2020-12-01T08:19:00-05:00
Code:
System:http://loinc.org Code:2093-3 Text:Cholesterol, Total
Value:Specimen tested for Staphylococcus aureus/MRSA, Streptococcus pyogenes and Enter
"
}
}
},
{
"fullUrl": "https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43/Observation/156EA49F96FB45F0AB1DB0B59053C8B4.RES.17219",
"resource": {
"resourceType": "Observation",
"id": "156EA49F96FB45F0AB1DB0B59053C8B4.RES.17219",
"status": "entered-in-error",
"meta": {
"lastUpdated": "2020-12-02T18:46:14-05:00"
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory",
"display": "Laboratory"
}
]
}
],
"subject": {
"reference": "Patient/156EA49F96FB45F0AB1DB0B59053C8B4",
"display": "Ash,Renny-Obs-Nurs-Vitals Jean"
},
"encounter": {
"reference": "Encounter/156EA49F96FB45F0AB1DB0B59053C8B4.112261",
"display": "City General,Initial"
},
"effectiveDateTime": "2020-11-30T09:24:00-05:00",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "17849-1"
}
],
"text": "Glucose Random"
},
"valueInteger": 134,
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">Observation
Patient:Ash,Renny-Obs-Nurs-Vitals Jean
Status:entered-in-error
Encounter:City General,Initial
Category:Laboratory
Effective Time:2020-11-30T09:24:00-05:00
Code:
System:http://loinc.org Code:17849-1 Text:Glucose Random
Value:134
"
}
}
}
],
"link": [
{
"relation": "self",
"url": "https://fhir-myrecord-sc.stagingcerner.com/r4/3f2aca24-87f3-4eac-a6d7-1f75247e6b43/Observation?patient=156EA49F96FB45F0AB1DB0B59053C8B4&category=laboratory"
}
]
}
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
Request is encoded twice
Your environment
Steps to reproduce
Patient needed with identifier:
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR",
"display": "Medical Record Number"
}
],
"text": "Medical Record Number"
},
"system": "http://hospital.davinciproject.org",
"value": "123456"
}
Include:
inferno_confidential
cf57bebe-b85f-47d4-a2b3-48b8312466a6
Expected behavior
Dash in identifier=system|value must not be encoded twice
Real request must be the following
https://davinci.collablynk.com/emr/fhir/R4/Patient?identifier=http%3A%2F%2Fhospital.davinciproject.org%7C123456
Actual behavior
Second request with identifier=system|value is encoded twice
First - dash is encoded.
https://davinci.collablynk.com/emr/fhir/R4/Patient?identifier=http://hospital.davinciproject.org%7C123456
and actual invocation URL is
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
"USCMR-12: All must support elements are provided in the MedicationRequest resources returned. Could not find reported in the 2 provided MedicationRequest resource(s)."
Our implementation supports the reportedBoolean flag only. This failure came in Inferno 1.4.
Inferno is installed in-house, using the internal validator
US Core clarified with 3.2 the following:
"The MedicationRequest resource can represent that information is from a secondary source using either a boolean flag or reference in MedicationRequest.reportedBoolean, or a reference using MedicationRequest.reportedReference to Practitioner or other resource.
Although both are marked as must support, the server systems are not required to support both a boolean and a reference, but SHALL choose to support at least one of these elements.
The client application SHALL support both elements."
http://build.fhir.org/ig/HL7/US-Core/StructureDefinition-us-core-medicationrequest.html
We understood the Inferno 1.4 release to relax must-support in the same fashion but are failing on reported.
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
Support reportedBoolean flag
Do NOT support reportedReference
Include:
Expected behavior
Tell us what should happen.
Actual behavior
Tell us what happens instead. Include screenshots if possible.
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
When you fire up the docker container for the program edition without importing valuesets, you get a banner saying:
Inferno is missing files needed to validate codes in FHIR Resources. To see how to load these files, please visit This Inferno page
The "This Inferno page" is linking to the Unit Tests section, not the Terminology section.
You probably intend to link to
https://github.com/onc-healthit/inferno-program#terminology-support
Not:
https://github.com/onc-healthit/inferno#unit-tests
Looks like this is the file that has the incorrect link:
https://github.com/onc-healthit/inferno-program/blob/development/lib/app/views/missing_valuesets.erb
Your environment
Expected behavior
You probably intend to link to
https://github.com/onc-healthit/inferno-program#terminology-support
Not:
https://github.com/onc-healthit/inferno#unit-tests
Subject of the issue
Inferno Single Patient API Document Reference test USCDR-13 is failing because of criteria listed in the Must Support elements; it requires support of content.attachment.data and content.attachment.url (see Inferno output below)
According to HL7 FHIR® US Core Implementation Guide STU3 Release 3.1.1 , section 3.17.1.1 Mandatory and Must Support Data Elements each DocumentReference must have an address (e.g. url) where the document can be retrieved OR the content as inline base64 encoded data.
https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-documentreference.html
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
Use a test patient with the following charted Clinical Notes:
• Consultation Note (11488-4)
• Discharge Summary (18842-5)
• History & Physical Note (34117-2)
• Procedures Note (28570-0)
• Progress Note (11506-3)
The JSON output should contain content as inline base64 encoded data and not contain an address (e.g. url) in DocumentReference.content.attachment
Include:
Expected behavior
Tell us what should happen.
Inferno test USCDR-13 should not fail when Document Reference resource contains content as inline base 64 encoded data.
Actual behavior
Tell us what happens instead. Include screenshots if possible.
Test Result: Skip
×
USCDR-13: All must support elements are provided in the DocumentReference resources returned.
US Core Responders SHALL be capable of populating all data elements as part of the query results as specified by the US Core Server Capability Statement. This will look through the DocumentReference resources found previously for the following must support elements:
• author
• category
• content
• content.attachment
• content.attachment.contentType
• content.attachment.data
• content.attachment.url
• content.format
• context
• context.encounter
• context.period
• custodian
• date
• identifier
• status
• subject
• type
http://www.hl7.org/fhir/us/core/general-guidance.html#must-support
Message:
Could not find identifier, content.attachment.url in the 17 provided DocumentReference resource(s)
0 Requests
Subject of the issue
In the USCCAP-02 test, the result indicates that the group-export url does not resolve. Here is an image:
However, the URL this is resolvable. Here is the URL: http://hl7.org/fhir/uv/bulkdata/OperationDefinition/group-export. You can copy paste this to your browser window or postman and verify that the URL resolves.
Your environment
Steps to reproduce
Run USCCAP-02 with any fhir server that defines the "$export" operation. You can view our server's metadata by going to: https://fhir-staging.bluebuttonpro.com/inferno-certification/metadata
Subject of the issue
CapabilityStatement allows you to specify search parameters in two places:
Our server puts common parameters (_id, count, _revInclude, _include) at the system level since we support them for all resources. It does not appear that Inferno is checking that, and is failing us because we do not specify them in the resource-level searchParam.
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
Run the program validation on server that uses the server-level option for universally supported search params.
Include:
Expected behavior
Tell us what should happen.
For validating that the common search parameters (_id, _count, etc.) are supported on a resource, check for both the system-level params (CapabilityStatement.rest.searchParams) and the resource-level params (CapabilityStatement.rest.resource.searchParam)
Actual behavior
Tell us what happens instead. Include screenshots if possible.
Validation will fail for any parameters that are only listed at the system level (i.e. it only checks the resource level search params)
Example cap statements:
capstatement.json.txt
capstatement.xml.txt
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Subject of the issue
Inferno Single Patient API Care Team test USCCT-01 is issued an error message: Fatal Error undefined method ‘name’ for nil:NilClass due to Inferno is not supporting Related Person profile. According to HL7 FHIR Release 4, https://www.hl7.org/fhir/careteam-definitions.html#CareTeam.participant.member, CareTeam profile supports Related Person.
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
Patient needs to have a Related Person in the Care Team according to https://www.hl7.org/fhir/relatedperson.html
Run Single Patient API Care Team tests.
Include:
Expected behavior
Tell us what should happen.
The Care Team test USCCT-01 should not fail when the response contains Related Person
Actual behavior
Tell us what happens instead. Include screenshots if possible.
Care Team error.docx
I'm trying to understand this error. My well-known endpoint has all of the fields required, and the two messages seem to be saying that this requires RSA SHA256 signing, but also does not support it?
Is this the same error? onc-healthit/inferno-community#377
Thanks!
The README currently explains that you must have 10gb of reserved memory to build the terminologies which is useful info, but currently says nothing about free disk space required.
I just ran the terminologies script while only having about 15gb free disk space and had to frantically start deleting things off my disk faster than it could import data / build sql indexes.
Thank you for reporting a possible bug in Inferno! Please fill in as much of the template below as you can.
Many Patient tests are erroring because a Patient.contact is repeated.
I'm not sure why Inferno is testing for duplicate Patient.contacts. There are plenty of workflows where one given related person may be added to the patient's record using different relationships: guardian, authorized representative and mother could all be associated to a given contact.
Error:
Patient.contact[3].name: Duplicate id value 'CI-12742541-0' * Patient.contact[2].name: Duplicate id value 'CI-12743963-0'
Tests Impacted:
USCP-01: Server returns valid results for Patient search by _id.
USCP-03: Server returns valid results for Patient search by name.
USCP-04: Server returns valid results for Patient search by birthdate+name.
USCP-12: Patient resources returned from previous search conform to the US Core Patient Profile.
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
REQUEST:
GET 200 https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Patient?_id=12744437
RESPONSE:
Request
Headers
User-Agent: Ruby FHIR Client
Accept-Charset: utf-8
Accept: application/fhir+json
Authorization: Bearer
Response
Headers
content-type: application/fhir+json; charset=utf-8
transfer-encoding: chunked
connection: keep-alive
date: Tue, 16 Mar 2021 18:40:04 GMT
cache-control: no-cache
etag: W/"8d9b943a3dfd7427e5a6394d3894b6f6"
server-response-time: 1056.192052
vary: Origin
x-request-id: e6c4157a-5d29-494e-8579-1ff0f4edfc1d
x-runtime: 1.056078
x-cache: Miss from cloudfront
via: 1.1 9724c58d66570574c4bf5a2b0c0f3038.cloudfront.net (CloudFront)
x-amz-cf-pop: IAD79-C3
x-amz-cf-id: 9z9_-LoMZ-Z8aDb4x6UoCPafvc8WjJ8wa9vZAL_AQM7JquVIHaANlw==
Body
{
"resourceType": "Bundle",
"id": "cda2d440-72ab-4b7a-b781-23503b494a22",
"type": "searchset",
"total": 1,
"link": [
{
"relation": "self",
"url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Patient?_id=12744437"
}
],
"entry": [
{
"fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Patient/12744437",
"resource": {
"resourceType": "Patient",
"id": "12744437",
"meta": {
"versionId": "13",
"lastUpdated": "2021-03-03T05:55:41.000Z"
},
"text": {
"status": "extensions",
"div": "<div xmlns="http://www.w3.org/1999/xhtml">
Patient
Name: KRAUS, DAVID
Status: Active
DOB: Jan 2, 1970
Birth Sex: Male
Administrative Gender: Male
Marital Status: Single
"Include:
Expected behavior
I would expect a failure when the same contact appears numerous times with different relationships
Actual behavior
Failures on numerous tests
Inferno Standalone Patient App, MedicationRequest Tests, USCMR-10 test failed with the error message :MedicationRequest.medication.ofType(Reference): Unable to find matching profile.
The MedicationRequest resource includes a contained Medication Resource (see the output below).
Your environment
Steps to reproduce
Tell us how to reproduce this issue.
Use a test patient with medications and run Single Patient API MedicationRequest tests. Medicaction should be a contained resource within the MedicationRequest resource. According to HL7 FHIR® US Core Implementation Guide STU3 Release 3.1.1 guide, https://www.hl7.org/fhir/us/core/MedicationRequest-uscore-mo2.html MedicationRequest can include a reference to a contained Medication resource.
Include:
Actual behavior
Tell us what happens instead. Include screenshots if possible.
{
"resourceType": "MedicationRequest",
"id": "4B01EB2C42D349209991AB814DC0DB5F.10001",
"meta": {
"lastUpdated": "2020-11-16T18:22:35-05:00"
},
"medicationReference": {
"reference": "#10001"
},
"contained": [
{
"resourceType": "Medication",
"id": "10001",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "208416",
"display": "Sulfamethoxazole 400 MG / Trimethoprim 80 MG Oral Tablet [Bactrim]"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "198334",
"display": "Sulfamethoxazole 400 MG / Trimethoprim 80 MG Oral Tablet"
}
],
"text": "sulfamethoxazole-trimethoprim"
}
}
],
"status": "active",
"intent": "order",
"reportedBoolean": false,
"subject": {
"reference": "Patient/4B01EB2C42D349209991AB814DC0DB5F",
"display": "Matchett,Greta-baby Blake"
},
"encounter": {
"reference": "Encounter/4B01EB2C42D349209991AB814DC0DB5F.108260",
"display": "Inferno,Initial"
},
"authoredOn": "2020-11-16T18:22:33-05:00",
"requester": {
"reference": "Practitioner/40134EF110CA4C07988F544E90057844",
"display": "Admin,Admin"
},
"dosageInstruction": [
{
"text": "sulfamethoxazole-trimethoprim (Bactrim) 400 mg-80 mg Tablet Directions: 1 tablet oral daily Continued By: Admin Admin "
}
],
"text": {
"status": "generated",
"div": "<div xmlns="http://www.w3.org/1999/xhtml\">MedicationRequest
Patient:Matchett,Greta-baby Blake;
Encounter:Inferno,Initial;
Status:active;
Intent:order;
Medication:
System:http://www.nlm.nih.gov/research/umls/rxnorm Code:208416 Display:Sulfamethoxazole 400 MG / Trimethoprim 80 MG Oral Tablet [Bactrim] Text:sulfamethoxazole-trimethoprim;
System:http://www.nlm.nih.gov/research/umls/rxnorm Code:198334 Display:Sulfamethoxazole 400 MG / Trimethoprim 80 MG Oral Tablet Text:sulfamethoxazole-trimethoprim;
Authored On:2020-11-16T18:22:33-05:00;
Dosage Instructions:sulfamethoxazole-trimethoprim (Bactrim) 400 mg-80 mg Tablet Directions: 1 tablet oral daily Continued By: Admin Admin ;
"
}
}
When running the Single Patient API tests, the tests for Observations fail when I have one with the effectivePeriod field. This is the error message:
Invalid Observation: Observation.effective.ofType(Period): vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day [($this as dateTime).toString().length() >= 8]
Imho, this error is incorrect, since the vs-1 constraint should only fire when the field is of type dateTime.
If I do not supply an Observation with an effectivePeriod, I cannot get all the tests to pass either, since it is one of the mustSupport elements.
Steps to reproduce
Add an Observation with an effectivePeriod field to your server and run the Single Patient API tests on that server.
See some of the Observation tests fail with the error listed above.
Expected behavior
The Observation with effectivePeriod should pass validation of the constraint without any problem.
Hi,
when the application is looking for only three resources i.e, Patient, Condition, Observation then what is purpose of passing other scopes which are automatically populated in the box.
however, the application is verifying the other resources that are not requested at the time of authorisation.
Suppose if user has given access to client only three resources i.e, Patient, Condition, Observation in that case if client request for other scope then it would be rejected.
Thanks,
Tarun
The (g)(10) program certification tests are designed so that implementers can use different FHIR & authorization endpoints for the standalone-patient and ehr-clinician launches. If an implementer chooses to do this, then the there shouldn't be an expectation for the two separate well-known endpoints to both advertise all capabilities. The well-known endpoint only needs to advertise capabilities appropriate for that endpoint, and therefore that use case.
This applies to the *-OSD-06 set of tests.
This may require slight rewording of this step in the ONC test procedure:
[Both] The health IT developer demonstrates the ability of the “.well-known/smart-configuration.json” path to support at least the following as detailed in the implementation specification adopted in § 170.215(a)(3):
“authorization_endpoint”;
“token_endpoint”; and
“capabilities” (including support for all the “SMART on FHIR Core Capabilities”).
Unknown proprietary codes and systems are issuing a warning. We recommend changing this to an "informational" message.
ONC certification criteria states that all USCDI v1 needs to be supported, including the following:
However, US Core v3.1 does not currently tag relevant elements as 'MUST SUPPORT':
Since they are not marked as MUST SUPPORT, Inferno does not require them to be present before passing the tests. US Core is planning an errata release that will address this issue, but in the meantime Inferno should communicate the fact that these also need to be represented in order to meet the requirements of USCDI.
After completing the tests of "Single Patient Api", Inferno is giving "504 Gateway Time-out" error instead of results. Please help me with this.
Is your feature request related to a problem? Please describe it.
I am running inferno v2.9.0 locally and trying to validate against a locally run fhir server.
Describe the solution you'd like to see implemented
In our solution, we support 2 dates for CarePlan resource.
Eg: http://localhost/r4/2c4XXX-XXX-XXX-XXX5fde9f/CarePlan?patient=9898989&date=ge2020-01-08T15:40:00.000Z&date=le2020-01-08T15:40:36.000Z.
However I do not see how to extend USCore310CareplanSequence to add such a scenario. If i supply 2 dates, it overwrites and takes the latest variable
Describe alternatives you've considered
Looking for suggestions.
Also would like to see if I run locally and try to validate my locally run FHIR server, does inferno reads my capability statement and adjust the tests to be run accordingly? Did not see get any clarity from the documentation
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