Vitalink, Flanders’ official online platform and health vault for the sharing of patient information between healthcare providers, will be using the Interoperability Test Bed for the new version of its conformance testing service.

Vitalink is an important initiative in Belgium to support the digital transformation of healthcare and improve the quality of care. It strives for better coordination of care, improved patient safety, and more efficient care processes by sharing crucial health information between all involved healthcare providers. The Vitalink platform enables doctors, pharmacists, home nurses, and other healthcare professionals to securely access relevant patient healthcare information. Vitalink also adds value towards the citizen; through integrations between Vitalink and patient portals such as MijnGezondheid.be, the citizen receives access to his/her shared healthcare data and can participate in his/her personal care journey.

Vitalink’s mission is to support the exchange of citizens’ healthcare data between all parties involved in providing preventive and curative care and support, including to the citizens themselves. Aligned with this mission, Vitalink ensures a secure, interoperable, and reliable environment to store healthcare data, and facilitate its exchange. It leverages the technical services of the eHealth-platform and follows the requirements that guarantee the Belgian standards for authentication and pseudonymisation services. Vitalink aims to contribute to efficient and accessible healthcare for every Flemish citizen in Belgium and Europe, to improve collaboration between care and support providers, and to give citizens control over their own healthcare data.

Vitalink is offered as a service and managed by the Flemish government’s Department of Care. It was first established more than 10 years ago, with a new platform having been developed to share structured and coded information through international information standards.

Vitalink shares patient data in electronic files that are exchanged between healthcare providers to enable care continuity and more informed decision-making. These files and their supporting information exchange processes, must be integrated into the software systems used by healthcare providers, and into portals such as MijnGezondheid.be for citizens.

Interoperability is of key importance to Vitalink to ensure that this data exchange occurs seamlessly. In fact a vendor’s qualification process is a mandatory step, and it is only after successful conformance testing that a vendor receives access to Vitalink as an integrator. This is the focus of IMEC, and in particular the IMEC.HIE team focused on healthcare interoperability, which is responsible for the design and implementation of Vitalink’s conformance testing service. IMEC’s goal is to provide such testing services in an independent and neutral manner, identifying and documenting issues, while at the same time providing solutions to improve and increase Vitalink usage.

In the scope of Vitalink conformance testing, IMEC contacted the Interoperability Test Bed team in September 2023, in view of designing the next iteration of Vitalink’s testing service. An initial implementation of this had been built using Atlassian’s JIRA for cost-saving reasons, but for the future Vitalink and IMEC wanted to shift towards an open-source solution that was well-supported, customisable and extensible. Furthermore, using the Interoperability Test Bed ensured that Vitalink uses an open and standards-based solution endorsed by the European Commission, that is already used for conformance testing of cross-border solutions in several policy domains. Focusing on dataspace interoperability as an example, the Interoperability Test Bed is the conformance testing platform used for Simpl-Open – the domain-agnostic middleware for dataspace interconnection – as well as the solutions realising the European Health Data Space (EHDS).

The first milestone in Vitalink’s conformance testing development was a proof-of-concept focused around allergy intolerance test cases, covering both client and server scenarios. The proof-of-concept was successfully completed in December 2023, confirming that the needs of the IMEC Interoperability Test Lab (IOL) for Vitalink were indeed covered.

During the proof-of-concept phase, several attention points were addressed, notably the support for automation, the possibility to carry out tests in an offline manner, and the coordination of services based on test events. Moreover, certain missing functional and testing capabilities were proposed by IMEC for inclusion in the Test Bed software that were promptly delivered by the Test Bed team. Besides addressing all core testing needs, a highlight noted by the IMEC team was the Test Bed’s support for containerisation that enables the management of multiple instances, each dedicated for example to different testing events or vendors, allowing simpler customisation to facilitate testing as early as possible.

The result of the proof-of-concept includes the first iteration of all developed test cases, custom extensions and configuration. To further facilitate development it was also packaged as a Test Bed sandbox instance, allowing a pre-configured and self-contained instance to be initialised by starting the defined Dockerised service. From this initial starting point the next steps involve moving to extended real-world scenarios, connection to existing eHealth services, and transitioning to an operational state.

Besides the work realised in the context of Flanders and the Vitalink platform, the resulting proof-of-concept is also of interest at a broader international level. The FHIR® standard, a family of specifications for health care data exchange published by HL7®, is the cornerstone over which Vitalink data exchange processes are built, as well as the test cases of the developed proof-of-concept. In fact the proof-of-concept wraps a FHIR® validator instance, making it possible to carry out complex validations for customisable test cases. The proof-of-concept has been presented to the FHIR® community with very positive feedback, and is currently being used as part of a testing harness implementation for FHIR® and the SMART guidelines to present to the World Health Organisation.

The work on Vitalink and FHIR® represents an interesting Test Bed use case and an important step towards eHealth interoperability in Belgium and in the broader international community. Further information on Vitalink can be found through the Vitalink portal itself, whereas an overview of the FHIR® specifications is available in HL7's online documentation. Regarding the Test Bed itself, general details on its services and other use cases can be found in its Joinup space, with its value proposition being a good starting point for newcomers. To receive updates on Test Bed news and releases remember to subscribe to the Test Bed on Joinup, and to follow Interoperable Europe’s updates on X and LinkedIn.

The Interoperability Test Bed is a service provided by the European Commission’s DIGIT, offering conformance testing and validation solutions in support of IT systems’ cross-border interoperability.