MII Testdata Contribution

Guide for contributing FHIR test data to the centralized MII testdata repository.

Repository Overview

Repository: https://github.com/medizininformatik-initiative/mii-testdata Structure: kds-testdata/input/fsh/

Directory Structure

kds-testdata/input/fsh/
├── Bundle.fsh                    # Master bundle definitions + AddBundleEntry RuleSet
├── aliases.fsh                   # Shared aliases
├── test-data-label.fsh           # TestDataLabel RuleSet
├── modul-{module-name}/          # Module-specific test data
│   ├── {Module}Aliases.fsh       # Module-specific aliases
│   └── {ResourceType}.fsh        # Instance definitions

Naming Convention

mii-exa-test-data-{module}-{resource-type}-{number}[-variant]

Examples:

• mii-exa-test-data-patient-1
• mii-exa-test-data-onko-diagnose-1
• mii-exa-test-data-molgen-variante-1

Required RuleSets

TestDataLabel

All instances must include the HTEST security label:

* insert TestDataLabel

AddBundleEntry

For adding resources to transaction bundles:

* insert AddBundleEntry(mii-exa-test-data-{resource}-1, {ResourceType})

Transaction Bundle Pattern

Instance: mii-exa-test-data-bundle-{module}-{number}
InstanceOf: Bundle
Usage: #example
Description: "Bundle: {description}"
* insert TestDataLabel
* type = #transaction
* timestamp = "2025-01-03T10:00:00+01:00"

// Infrastructure resources first
* insert AddBundleEntry(mii-exa-test-data-patient-1, Patient)
* insert AddBundleEntry(mii-exa-test-data-organization-1, Organization)

// Then domain-specific resources
* insert AddBundleEntry(mii-exa-test-data-{module}-{resource}-1, {ResourceType})

Workflow: Adding Module Test Data

Phase 1: Build Coverage Index

Before creating test data, build an index of what needs coverage.

1.1 Extract MS Elements from Profiles

For each profile in the source module, extract Must-Support elements from the differential:

# From StructureDefinition JSON (after sushi build in source module)
for sd in fsh-generated/resources/StructureDefinition-mii-pr-*.json; do
  echo "=== $(basename $sd .json) ==="
  jq -r '.differential.element[] | select(.mustSupport == true) | .path' "$sd"
done

Note: The differential only shows MS elements defined in this profile. Parent profiles (MII KDS base, German base profiles, FHIR core) may have additional MS elements, bindings, and cardinality constraints. These inherited constraints will surface when running SUSHI and the validator.

1.2 Map SearchParameters for MS Elements

Every Must-Support element must be searchable via a SearchParameter. Resolve SPs using this 4-level hierarchy (check in order, use the first match):

Level	Source	Example
1. FHIR R4 Base	Standard SPs defined in the FHIR spec	Patient.name, Condition.code
2. MII Meta	Cross-module SPs from kerndatensatz-meta	Shared SPs across KDS modules
3. Dependencies	SPs from referenced modules/packages	SPs from parent or related modules
4. Module itself	Module-specific SPs for own elements	Custom SPs defined in the module

If no SP exists at any level for an MS element, a new SP must be defined in the module itself.

Automated Analysis

Run the SP coverage analysis script to automatically resolve the full 4-level hierarchy:

# After sushi build in the module directory
scripts/analyze-sp-coverage.sh /path/to/module

# JSON output for programmatic use
OUTPUT_FORMAT=json scripts/analyze-sp-coverage.sh /path/to/module

# Verbose (shows SP counts per level)
VERBOSE=1 scripts/analyze-sp-coverage.sh /path/to/module

The script is located at mii-kerndatensatz-dev/scripts/analyze-sp-coverage.sh and produces:

• Coverage summary (total MS elements, covered, uncovered, %)
• Per-element SP mapping with source level
• Slice discriminator analysis
• Profile identification check

Slice-Discriminator Requirements

Sliced MS elements (e.g., code.coding:icd10-gm) require a discriminator-aware SearchParameter — a generic SP on the parent path (e.g., code) is not sufficient. The SP expression must contain the discriminator value:

# Generic SP (NOT sufficient for slices):
Condition.code

# Discriminator-aware SP (required for slices):
Condition.code.coding.where(system='http://fhir.de/CodeSystem/bfarm/icd-10-gm')

Profile Identification Requirement

Each profile must have at least one SearchParameter that uniquely identifies resources of this profile type. Candidates are elements with:

• fixedValue or patternValue with min >= 1
• Required ValueSet binding with min >= 1

meta.profile alone is not sufficient — it is not reliably populated in all systems.

1.3 Create Coverage Tracking Table

Run the automated analysis or create a tracking table manually:

| Profile | MS Element | SearchParam | SP Source | Instance | Status |
|---------|------------|-------------|-----------|----------|--------|
| MII_PR_Onko_Diagnose | code.coding:icd10-gm | condition-code-icd10gm | Dep: Diagnose | -1 | pending |
| MII_PR_Onko_Diagnose | subject | patient | FHIR R4 | -1 | pending |
| MII_PR_Onko_TNM_Klassifikation | component:TNM-T | tnm-t | Module | -1 | pending |

Important: Every MS element row must have a SearchParam and SP Source filled in. If a cell is empty, resolve the SP or create a new one before proceeding.

Phase 2: Create Test Data

1. Create branch: git checkout -b feature/add-{module}-testdata
2. Add dependency to sushi-config.yaml:

   dependencies:
     de.medizininformatikinitiative.kerndatensatz.{module}: {version}
   

3. Create module directory: mkdir -p kds-testdata/input/fsh/modul-{module}
4. Create aliases file with module-specific CodeSystems/ValueSets
5. Create instance files - populate MS elements, update tracking table
6. Create transaction bundle that includes all instances

Phase 3: Verify and Submit

1. Run SUSHI: cd kds-testdata && sushi .
2. Review coverage table - ensure all MS elements and SearchParams covered
3. Submit PR - CI/CD pipeline runs FHIR Validator

Adapting Existing Module Examples

When the source module already has examples (mii-exa-* instances):

1. Analyze existing examples: Check profile coverage against MS index
2. Adapt naming: mii-exa-{module}-{name} → mii-exa-test-data-{module}-{name}-1
3. Add TestDataLabel: Insert * insert TestDataLabel
4. Update references: Point to testdata instances
5. Fill gaps: Create new instances for uncovered MS elements

Coverage Requirements

Requirement	Description
Profile Coverage	At least one instance per published profile
MS Element Coverage	Every MS element populated in at least one instance
SearchParam Coverage	Every MS element must have a SearchParameter (from FHIR R4, MII Meta, Dependencies, or Module). Every SP's target path must be populated in test data.
Slice SP Coverage	Sliced MS elements require a discriminator-aware SP (with .where(system='...')) — a generic SP is not sufficient.
Profile Identification	Each profile must have at least one SP that uniquely identifies its resources (via fixed/pattern values or required bindings). meta.profile alone is not sufficient.
Reference Integrity	All references resolve within the bundle

SearchParameter Type Requirements

Type	Test Data Requirement
token	Populate code + system in coding element
reference	Include referenced resource in bundle
date	Use valid FHIR date format
string	Populate with searchable text
quantity	Include value + unit + system
composite	All component elements in same instance

Common Issues

Alias Conflicts

Check aliases.fsh before adding new aliases to avoid redefinition errors.

Reference Resolution

All referenced resources must exist in the bundle. Use consistent instance IDs.

Invariant Satisfaction

Some profiles have invariants requiring specific data patterns. Create multiple instances if needed to satisfy conflicting invariant paths.

Local Validation

Run SUSHI locally before submitting PR:

cd kds-testdata
sushi .

FHIR Validator runs automatically in CI/CD pipeline after PR submission.