Main validations divergent of online published tool

[jsilva-cohere]

We have been running inferno test kits on our FHIR servers, and to ensure adherence to all validations, we have cloned this repository, started it local, and fired request agains our local environment, fixed all issues pointed by inferno, and now we are ready to publish our new FHIR Server, but there is an issue.

Looks like the validations on main branch of this repository are different of the ones published on https://inferno.healthit.gov/suites/dtr_payer_server, all validations passed on local, but in the online tool we are receiving strange errors.

For instance:

• Run: https://inferno.healthit.gov/suites/dtr_payer_server/7Khj56Je7fw#1
• Item 1.3:
• Error: The System URI could not be determined for the code 'choice' in the ValueSet 'http://hl7.org/fhir/ValueSet/item-type|4.0.1'

But, if you visit the url provided by inferno (http://hl7.org/fhir/ValueSet/item-type%7C4.0.1), you can see that choice is a valid options, as follows:

Are we missing something regarding this error? The same error is happening on other validations also.

Regarding the other errors, we are ok with the missing Libraries ones since we pointed this in the issue #80 :

[karlnaden]

Something strange is going on here, but I'm not sure exactly what yet. For context, Inferno has a significant dependency on the HL7 FHIR Validator which uses the HL7 Terminology server at tx.fhir.org. These components are what are returning the error that you're observing on inferno.healthit.gov.

Unfortunately, the public HL7 service times out when trying to perform validation against the DTR profile (packages take too long to load), so I can't tell if this behavior is replicated on the validator instance that they host, but when I check questionnaire conformance on a local instance of the validator against the dtr standard questionnaire and its parent profiles, here's what I get:

• DTR Standard Questionnaire (profile specified in your verified request): error on the choice value
• SDC Base Questionnaire: no error
• [FHIR Base Questionnaire)[https://hl7.org/fhir/R4/questionnaire.html]: no error
  Interestingly, DTR does not change the definition of the type item including its value set binding. SDC only makes the item must support. I'm wondering if there is some package that DTR imports that is somehow overriding this value set definition to make it smaller. I'm not sure that's possible, but it is my only hypothesis so far. I'm going to ask in the FHIR Zulip to see if anyone there can verify whether that hypothesis is correct or suggest other possibilities. I will let you know what I hear back.

In the meantime, I think this is another error that you can ignore for now. If it is an error that we can expect to see due to issues in tooling, we will filter it out of Inferno.

In terms of why you're not seeing the issue locally when I am, I'm wondering if it is the version of inferno_core. inferno.healthit.gov is now on v 1.1.0 of inferno_core, but if you just downloaded the DTR test kit source you probably have 1.0.2. But I don't see any updates that I would expect to cause that difference. I'll double check this hypothesis later.

Thanks for reporting these issues as we do want to get these test kits reporting only true errors.

[jsilva-cohere]

Ok, thank you @karlnaden.

[karlnaden]

Here's the Zulip thread I started if you want to monitor it directly: #FHIR Validator > unexpected base FHIR value set error on DTR Questionnaire

[karlnaden]

Based on Grahame's feedback, we're working on updating our version of the validator and specifying a SNOMED version in our use of it. We're planning to push this fix out as a part of a big update to DTR and other burden reduction test kits coming by the end of June.