ONC Conformance Test Tools

The following tools are ASTP/ONC-approved Conformance resources to help developers implement standards to enable health information interoperability. They are organized by tool, criteria and regulatory floor standards. Please visit SITE to find links to all ASTP/ONC-approved tools and further information on tools and testing for the ONC Health IT Certification Program.

Criteria with an asterisk (*) will be included in the described test tool but are not yet available to the public. ASTP/ONC will notify users of updated availability in the near future.

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Inferno

Test ToolsUse in ONC Health IT Certification ProgramBase Standards Under Test for the ONC Health IT Certification Program
Inferno Framework§ 170.315(g)(10) Standardized API for patient and population servicesHL7® FHIR®
HL7® FHIR® US Core Implementation Guide STU3 Release 3.1.1
[Adoption of this standard expires on January 1, 2026]

HL7® FHIR® US Core Implementation Guide STU 6.1.0 – STU6
[This standard is required by December 31, 2025]

HL7® FHIR® Release 4 (v4.0.1)

HL7® FHIR® SMART Application Launch Framework Implementation Guide Release 1.0.0
[Adoption of this standard expires on January 1, 2026]

HL7® FHIR® IG: SMART Application Launch Implementation Framework v2.0.0

HL7® FHIR® Bulk Data Access (Flat FHIR®) (v1.0.1: STU 1)


Other standards
OpenID Connect Core 1.0 incorporating errata set 1

United States Core Data for Interoperability (USCDI), Version 1 (July 2020 Errata)
[Adoption of this standard expires on January 1, 2026]

United States Core Data for Interoperability (USCDI), Version 3 (October 2022 Errata)
[This standard is required by December 31, 2025]
§170.315(g)(31) Provider prior authorization API – coverage requirements discovery*
 
§170.315(j)(20) Workflow triggers for decision support interventions—clients*		HL7 FHIR® Da Vinci—Coverage Requirements Discovery (CRD) Implementation Guide, Version 2.0.1—STU 2
 
HL7® CDS Hooks Implementation Guide, Version 2.0.1—STU 2 Release 2
§170.315(g)(32) Provider prior authorization API – documentation templates and rules*HL7 FHIR® Da Vinci—Documentation Templates and Rules (DTR) Implementation Guide, Version 2.0.1—STU 2
§ 170.315(g)(33) Provider prior authorization API – prior authorization support*
 
§ 170.315(j)(21) Subscriptions—client*		HL7 FHIR® Da Vinci Prior Authorization Support (PAS) FHIR Implementation Guide, Version 2.0.1—STU 2
 
HL7 FHIR® Subscriptions R5 Backport Implementation Guide, Version 1.1.0—Standard for Trial Use

SITE / Edge Testing Tool (ETT)

Test ToolsUse in ONC Health IT Certification ProgramBase Standards Under Test for the ONC Health IT Certification Program
Direct Testing
This tool provides capabilities to validate your Direct implementation to applicable standards-specifications. It also includes XDM, XDR, Direct Message validators and HISP testing.		§ 170.315(b)(1) Transitions of CareApplicability Statement for Secure Health Transport,  Version 1.2

IHE IT Infrastructure Technical Framework Volume 2b (ITI TF- 2b)

Implementation Guide for Direct Edge Protocols, Version 1.1, June 25, 2014
§ 170.315(h)(1) Direct ProjectApplicability Statement for Secure Health Transport, Version 1.2
Implementation Guide for Delivery Notification in Direct Version 1.0
§ 170.315(h)(2) Direct Project, Edge Protocol, and XDR/XDMApplicability Statement for Secure Health Transport, Version 1.2

XDR and XDM for Direct Messaging Specification, Version 1.0

Implementation Guide for Direct Edge Protocols, Version 1.1, June 25, 2014

Implementation Guide for Delivery Notification in Direct, Version 1.0
C-CDA Testing
These tools test conformance of artifacts to industry standards and specific criteria, and include: C-CDA and USCDI validators.		§ 170.315(b)(1) Transitions of Care

§ 170.315(b)(2) Clinical informationreconciliation and incorporation

§ 170.315(b)(7) Security tags—summary of care—send

§ 170.315(b)(8) Security tags—summary of care—receive

§ 170.315(b)(9) Care plan

§ 170.315(e)(1) View, download, and transmit to 3rd party

§ 170.315(g)(6) Consolidated CDA creation performance

§ 170.315(g)(9) Application access—all data request		HL7® CDA®
HL7® Implementation Guide for CDA® Release 2: IHE Health Story Consolidation, DSTU Release 1.1 (US Realm) Draft Standard for Trial Use July 2012

HL7 CDA® R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes, Release 2.1

HL7 CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 2 [Adoption of this standard expires January 1, 2026]

HL7 CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 4.1  [This standard is required by December 31, 2025]

HL7® Implementation Guide: Data Segmentation for Privacy (DS4P), Release 1

USCDI
United States Core Data for Interoperability (USCDI), Version 1 (July 2020 Errata)  [Adoption of this standard expires January 1, 2026]

United States Core Data for Interoperability (USCDI), Version 3 (October 2022 Errata) [This standard is required by December 31, 2025]

Clinical Quality Measures (CQMs) Testing

Test ToolsUse in ONC Health IT Certification ProgramBase Standards Under Test for the ONC Health IT Certification Program
Cypress§ 170.315(c)(1) Clinical quality measures (CQMs)—record and exportHL7® CDA®
HL7® CDA® R2 Implementation Guide: Quality Reporting Document Architecture – Category I (QRDA I); Release 1, DSTU Release 3 (US Realm)
§ 170.315(c)(2) Clinical quality measures (CQMs)—import and calculateHL7® CDA®
HL7® CDA® R2 Implementation Guide: Quality Reporting Document Architecture – Category I (QRDA I); Release 1, DSTU Release 3 (US Realm)

HL7® CDA® R2 Implementation Guide:  Quality Reporting Document Architecture Category III (QRDA III), DSTU Release 1 – US Realm

Errata to the HL7® Implementation Guide for CDA® Release 2: Quality Reporting Document Architecture—Category III, DSTU Release 1 (US Realm)
§ 170.315(c)(3) Clinical quality measures (CQMs)—reportOther Standards
CMS Implementation Guide for Quality Reporting Document Architecture: Category I; Hospital Quality Reporting; Implementation Guide for 2020, Version 1.1

CMS Implementation Guide for Quality Reporting Document Architecture: Category III; Eligible Clinicians and Eligible Professionals Programs; Implementation Guide for 2020, Version 1.2
§ 170.315(c)(4) Clinical quality measures (CQMs)—filterHL7® CDA®
HL7® CDA® R2 Implementation Guide: Quality Reporting Document Architecture – Category I (QRDA I); Release 1, DSTU Release 3 (US Realm)

HL7® CDA® R2 Implementation Guide: Quality Reporting Document Architecture Category III (QRDA III), DSTU Release 1 – US Realm, Implementation Guide for CDA Release 2

Errata to the HL7® Implementation Guide for CDA® Release 2: Quality Reporting Document Architecture—Category III, DSTU Release 1 (US Realm)


Other Standards
Medicare Provider and Supplier Taxonomy Crosswalk, April 2015 [Adoption of this standard expires on January 1, 2026]

Medicare Provider and Supplier Taxonomy Crosswalk, October 2021 [This standard is required by December 31, 2025]

Public Health Data Standards Consortium Source of Payment Typology Code Set Version 5.0 (October 2011) [Adoption of this standard expires on January 1, 2026]

Public Health Data Standards Consortium Source of Payment Typology Code Set, Version 9.2 (December 2020) [This standard is required by December 31, 2025]

CDC Race and Ethnicity Code Set – Version 1.0 [Adoption of this standard expires on January 1, 2026]

CDC Race and Ethnicity Code Set – Version 1.2 [This standard is required by December 31, 2025]

SNOMED CT®, US Edition, September 2015 Release [Adoption of this standard expires on January 1, 2026]

SNOMED CT®, US Edition, March 2022 Release [This standard is required by December 31, 2025]

HL7® Version 3 Standard (HL7® v3), Value Sets for AdministrativeGender and NullFlavor [Adoption of this standard expires January 1, 2026]

Sex must be coded in accordance with, at a minimum, the version of SNOMED CT® U.S. Edition codes specified in SNOMED CT®, US Edition, March 2022 Release

Electronic Prescribing (eRx)

Test ToolsUse in ONC Health IT Certification ProgramBase Standards Under Test for the ONC Health IT Certification Program
eRX Testing Suite§ 170.315(b)(3) Electronic prescribingNCPDP SCRIPT Standard, Implementation Guide, Version 2017071 [Adoption of this standard expires on January 1, 2028]

NCPDP SCRIPT Standard, Implementation Guide, Version 2023011

RxNorm, September 8, 2015 Full Release Update

RxNorm, July 5, 2022 Full Monthly Release 

RxNorm, December 4, 2023 Full Monthly Release

National Drug Codes (NDC)
§ 170.315(b)(4) Real-time prescription benefit*NCPDP Real-Time Prescription Benefit Standard Implementation Guide v13

RxNorm, September 8, 2015 Full Release Update

RxNorm, July 5, 2022 Full Monthly Release 

RxNorm, December 4, 2023 Full Monthly Release

National Drug Codes (NDC)

Public Health Testing Suites

Test ToolsUse in ONC Health IT Certification ProgramBase Standards Under Test for the ONC Health IT Certification Program
NIST HL7® v2 Immunization Test Suite§ 170.315(f)(1) Transmission to immunization registriesHL7® v2
HL7® Version  2.5.1 Implementation Guide for Immunization Messaging, Release 1.5

HL7® Version 2.5.1 Implementation Guide for Immunization Messaging (Release 1.5)—Addendum
NIST HL7® v2 Syndromic Surveillance Test Suite§ 170.315(f)(2) Transmission to public health agencies—syndromic surveillanceHL7® v2
PHIN Messaging Guide for Syndromic Surveillance: Emergency Department, Urgent, Care, Inpatient and Ambulatory Care, and Inpatient Settings, Release 2.0, April 21, 2015

Erratum to the CDC PHIN 2.0 Implementation Guide, August 2015
NIST Electronic Laboratory Reporting (ELR) Validation Suite§ 170.315(f)(3) Transmission to public health agencies—reportable laboratory tests and value/resultsHL7® v2
HL7® Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 1 (US Realm) with Errata and Clarifications

ELR 2.5.1 Clarification Document for EHR Technology Certification, V1.1
Antimicrobial use and resistance HL7® CDA® validator§ 170.315(f)(6) Transmission to public health agencies — antimicrobial use and resistance reportingHL7® CDA®
HL7® Implementation Guide for CDA® Release 2: Healthcare Associated Infection (HAI) Reports, Release 1
HL7® CDA® National Health Care Surveys Validator§ 170.315(f)(7) Transmission to public health agencies—health care surveysHL7® CDA®
HL7® Implementation Guide for CDA© Release 2: National Health Care Surveys (NHCS), Release 1 – US Realm

Alternative Test Methods

Test ToolsUse in ONC Health IT Certification ProgramBase Standards Under Test
for the ONC Health IT Certification Program
HIMSS Immunization Integration Test Suite§ 170.315(f)(1) Transmission to immunization registriesHL7® v2
HL7® 2.5.1 Implementation Specifications. HL7® 2.5.1 Implementation Guide for Immunization Messaging, Release 1.5

HL7® Version 2.5.1 Implementation Guide for Immunization Messaging (Release 1.5)

Other Testing Tools

Test Tools
CPOE Evaluation Tool—Please note that links on this page to any non-federal sites do not constitute an endorsement by HHS or any of its employees of the information and products presented. Source code for ASTP/ONC projects, tools and utilities can be found at: https://github.com/siteadmin. New testing tools can be added to this list by emailing: SITTeam@hhs.gov.
IHE Testing Tools—IHE has developed a growing body of software tools to facilitate testing and implementation of IHE Integration Profiles in healthcare information technology systems. These tools are available for download and licensed by their developers for free use.

Note: The above resources provide the base standards adopted in regulation for the ONC Health IT Certification Program (Certification Program). Through the Standards Version Advancement Process (SVAP), health IT developers may voluntarily update health IT products certified under the Certification Program to newer versions of adopted standards as part of the Real World Testing Condition and Maintenance of Certification requirement.  For the full list of base and SVAP approved standards, please refer to the Standards Version Advancement Process (SVAP) | HealthIT.gov.