us_core_test_kit 0.1.0 → 0.2.1

checksums.yaml

@@ -1,7 +1,7 @@
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data/lib/us_core_test_kit/custom_groups/capability_statement/conformance_support_test.rb

@@ -1,6 +1,6 @@
 module USCoreTestKit
   class ConformanceSupportTest < Inferno::Test
-    id :us_core_311_conformance_support
+    id :us_core_conformance_support
     title 'FHIR Server supports the conformance interaction'
     description %(
       The conformance 'whole system' interaction provides a method to get the

data/lib/us_core_test_kit/custom_groups/capability_statement/fhir_version_test.rb

@@ -1,6 +1,6 @@
 module USCoreTestKit
   class FHIRVersionTest < Inferno::Test
-    id :us_core_311_fhir_version
+    id :us_core_fhir_version
     title 'Server is using FHIR R4'
     description %(
         This test inspects the CapabilityStatement returned by the server to

data/lib/us_core_test_kit/custom_groups/capability_statement/instantiate_test.rb

@@ -0,0 +1,19 @@
+module USCoreTestKit
+  class InstantiateTest < Inferno::Test
+    id :us_core_instantiate
+    title 'Server instantiates US Core Server'
+    description %(
+        This test inspects the CapabilityStatement returned by the server to
+        verify that the server instantiates http://hl7.org/fhir/us/core/CapabilityStatement/us-core-server
+      )
+    uses_request :capability_statement
+
+    run do
+      assert_resource_type(:capability_statement)
+      capability_statement = resource
+
+      assert capability_statement.instantiates.include?('http://hl7.org/fhir/us/core/CapabilityStatement/us-core-server'),
+        "Server CapabilityStatement.instantiates does not include 'http://hl7.org/fhir/us/core/CapabilityStatement/us-core-server'"
+    end
+  end
+end

data/lib/us_core_test_kit/custom_groups/capability_statement/json_support_test.rb

@@ -1,6 +1,6 @@
 module USCoreTestKit
   class JSONSupportTest < Inferno::Test
-    id :us_core_311_json_support
+    id :us_core_json_support
     title 'FHIR server capability states JSON support'
     description %(
       FHIR provides multiple [representation

data/lib/us_core_test_kit/custom_groups/capability_statement/profile_support_test.rb

@@ -1,6 +1,6 @@
 module USCoreTestKit
   class ProfileSupportTest < Inferno::Test
-    id :us_core_311_profile_support
+    id :us_core_profile_support
     title 'Capability Statement lists support for required US Core Profiles'
     description %(
       The US Core Implementation Guide states:
@@ -14,45 +14,6 @@ module USCoreTestKit
     )
     uses_request :capability_statement
 
-    PROFILES = {
-      'AllergyIntolerance' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance'].freeze,
-      'CarePlan' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan'].freeze,
-      'CareTeam' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam'].freeze,
-      'Condition' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition'].freeze,
-      'Device' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device'].freeze,
-      'DiagnosticReport' => [
-        'http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab',
-        'http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note'
-      ].freeze,
-      'DocumentReference' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference'].freeze,
-      'Encounter' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter'].freeze,
-      'Goal' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal'].freeze,
-      'Immunization' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization'].freeze,
-      'Location' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-location'].freeze,
-      'Medication' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication'].freeze,
-      'MedicationRequest' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest'].freeze,
-      'Observation' => [
-        'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab',
-        'http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age',
-        'http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height',
-        'http://hl7.org/fhir/us/core/StructureDefinition/us-core-pulse-oximetry',
-        'http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus',
-        'http://hl7.org/fhir/StructureDefinition/bp',
-        'http://hl7.org/fhir/StructureDefinition/bodyheight',
-        'http://hl7.org/fhir/StructureDefinition/bodyweight',
-        'http://hl7.org/fhir/StructureDefinition/heartrate',
-        'http://hl7.org/fhir/StructureDefinition/resprate',
-        'http://hl7.org/fhir/StructureDefinition/bodytemp',
-        'http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile'
-      ].freeze,
-      'Organization' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization'].freeze,
-      'Patient' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient'].freeze,
-      'Practitioner' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner'].freeze,
-      'PractitionerRole' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole'].freeze,
-      'Procedure' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure'].freeze,
-      'Provenance' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance'].freeze
-    }.freeze
-
     run do
       assert_resource_type(:capability_statement)
       capability_statement = resource
@@ -71,11 +32,13 @@ module USCoreTestKit
 
       assert supported_resources.include?('Patient'), 'US Core Patient profile not supported'
 
-      other_resources = PROFILES.keys.reject { |resource_type| resource_type == 'Patient' }
+      target_profiles = config.options[:target_profiles]
+
+      other_resources = target_profiles.keys.reject { |resource_type| resource_type == 'Patient' }
       other_resources_supported = other_resources.any? { |resource| supported_resources.include? resource }
       assert other_resources_supported, 'No US Core resources other than Patient are supported'
 
-      PROFILES.each do |resource_type, profiles|
+      target_profiles.each do |resource_type, profiles|
         next unless supported_resources.include? resource_type
 
         profiles.each do |profile|

data/lib/us_core_test_kit/custom_groups/clinical_note_attachment_test.rb

@@ -0,0 +1,45 @@
+module USCoreTestKit
+  class ClinicalNoteAttachmentTest < Inferno::Test
+    id :us_core_clinical_note_attachments
+    title 'DiagnosticReport and DocumentReference reference the same attachment'
+    description %(
+      All presentedForms urls referenced in DiagnosticReports shall have
+      corresponding content attachment urls referenced in DocumentReference.
+
+      There is no single best practice for representing a scanned, or
+      narrative-only report due to the overlapping scope of the underlying
+      resources and variability in system implementation. Reports may be
+      represented by either a DocumentReference or a DiagnosticReport. To
+      require Clients query both DocumentReference and DiagnosticReport to get
+      all the information for a patient is potentially dangerous if a client
+      doesn’t understand or follow this requirement.
+
+      To simplify the requirement, US Core IG requires servers implement the
+      duplicate reference to allow a client to find a Pathology report, or
+      other Diagnostic Reports, in either Resource.
+    )
+
+    run do
+      skip_if scratch[:document_reference_attachments].blank?,
+              "No DocumentReference attachments found"
+      skip_if scratch[:diagnostic_report_attachments].blank?,
+              "No DiagnosticReport attachments found"
+
+      unmatched_attachment_messages =
+        scratch[:diagnostic_report_attachments].flat_map do |patient_id, report_attachments|
+          unmatched_urls = report_attachments.keys
+
+          if scratch[:document_reference_attachments].key? patient_id
+            unmatched_urls -= scratch[:document_reference_attachments][patient_id].keys
+          end
+
+          unmatched_urls.map do |url|
+            "#{url} in DiagnosticReport/#{report_attachments[patient_id][url]} for Patient #{patient_id}"
+          end
+        end
+
+      assert unmatched_attachment_messages.empty?,
+            "Attachments #{unmatched_attachment_messages.join(', ')} are not referenced in any DocumentReference"
+    end
+  end
+end

data/lib/us_core_test_kit/custom_groups/clinical_note_type_test.rb

@@ -0,0 +1,109 @@
+require_relative '../search_test'
+
+module USCoreTestKit
+  class ClinicalNoteTypeTest < Inferno::Test
+    include SearchTest
+
+    id :us_core_clinical_note_types
+    title 'Server demonstrates support for the required DocumentReference types and DiagnosticReport categories.'
+
+    input :patient_ids,
+          title: 'Patient IDs',
+          description: 'Comma separated list of patient IDs that in sum contain all MUST SUPPORT elements'
+
+    REQUIRED_CATEGORIES = ['LP29708-2', 'LP7839-6', 'LP29684-5'].freeze
+
+    def document_reference_types_found(patient_id)
+      search_params = { patient: patient_id }
+      status_values = ['current,superseded,entered-in-error']
+
+      search_and_check_response(search_params, 'DocumentReference')
+
+      if response[:status] == 400
+        perform_search_with_status(
+          params,
+          patient_id,
+          status_search_values: status_values,
+          resource_type: 'DocumentReference'
+        )
+      end
+
+      resources = fetch_all_bundled_resources(resource_type: 'DocumentReference')
+                    .select { |resource| resource.resourceType == 'DocumentReference' }
+
+      scratch[:document_reference_attachments] ||= {}
+      scratch[:document_reference_attachments][patient_id] ||= {}
+      attachments = scratch[:document_reference_attachments][patient_id]
+
+      codes_found =
+        resources.flat_map do |resource|
+          resource.content
+            &.select { |content| !attachments.key? content.attachment&.url}
+            &.each { |content| attachments[content.attachment.url] = resource.id }
+
+          resource.type&.coding&.map { |coding| coding.code }
+        end
+
+      codes_found.compact.uniq
+    end
+
+    def diagnostic_report_categories_found(patient_id)
+      search_params = { patient: patient_id }
+      status_values = ['registered,partial,preliminary,final,amended,corrected,appended,cancelled,entered-in-error,unknown']
+
+      search_and_check_response(search_params, 'DiagnosticReport')
+
+      if response[:status] == 400
+        perform_search_with_status(
+          params,
+          patient_id,
+          status_search_values: status_values,
+          resource_type: 'DiagnosticReport'
+        )
+      end
+
+      resources = fetch_all_bundled_resources(resource_type: 'DiagnosticReport')
+                    .select { |resource| resource.resourceType == 'DiagnosticReport' }
+
+      scratch[:diagnostic_report_attachments] ||= {}
+      scratch[:diagnostic_report_attachments][patient_id] ||= {}
+      attachments = scratch[:diagnostic_report_attachments][patient_id]
+
+      codes_found =
+        resources.flat_map do |resource|
+          resource.presentedForm
+            &.select { |attachment| !attachments.key? attachment&.url}
+            &.each { |attachment| attachments[attachment.url] = resource.id }
+
+          resource.category&.flat_map { |category| category.coding&.map { |coding| coding.code } }
+        end
+
+      codes_found.compact.uniq
+    end
+
+    run do
+      missing_types = config.options[:required_types].dup
+      missing_categories = REQUIRED_CATEGORIES.dup
+
+      patient_id_list.each do |patient_id|
+        missing_types -= document_reference_types_found(patient_id)
+        missing_categories -= diagnostic_report_categories_found(patient_id)
+      end
+
+      pass if missing_types.empty? && missing_categories.empty?
+
+      message = 'Could not find these '
+
+      if missing_types.present?
+        message += "DocumentReference types: #{missing_types.join(', ')}"
+        message += ' and ' if missing_categories.present?
+      end
+
+      if missing_categories.present?
+        message += "DiagnosticReport categories #{missing_categories.join(', ')}."
+      end
+
+      skip message
+    end
+  end
+end

data/lib/us_core_test_kit/custom_groups/v3.1.1/capability_statement_group.rb

@@ -0,0 +1,110 @@
+require 'tls_test_kit'
+require_relative '../capability_statement/conformance_support_test'
+require_relative '../capability_statement/fhir_version_test'
+require_relative '../capability_statement/json_support_test'
+require_relative '../capability_statement/profile_support_test'
+
+module USCoreTestKit
+  module USCoreV311
+    class CapabilityStatementGroup < Inferno::TestGroup
+      id :us_core_v311_capability_statement
+      title 'Capability Statement'
+      short_description 'Retrieve information about supported server functionality using the FHIR capabilties interaction.'
+      description %(
+        # Background
+        The #{title} Sequence tests a FHIR server's ability to formally describe
+        features supported by the API by using the [Capability
+        Statement](https://www.hl7.org/fhir/capabilitystatement.html) resource.
+        The features described in the Capability Statement must be consistent with
+        the required capabilities of a US Core server. The Capability Statement
+        must also advertise the location of the required SMART on FHIR endpoints
+        that enable authenticated access to the FHIR server resources.
+
+        The Capability Statement resource allows clients to determine which
+        resources are supported by a FHIR Server. Not all servers are expected to
+        implement all possible queries and data elements described in the US Core
+        API. For example, the US Core Implementation Guide requires that the
+        Patient resource and only one additional resource profile from the US Core
+        Profiles.
+
+        # Test Methodology
+
+        This test sequence accesses the server endpoint at `/metadata` using a
+        `GET` request. It parses the Capability Statement and verifies that:
+
+        * The endpoint is secured by an appropriate cryptographic protocol
+        * The resource matches the expected FHIR version defined by the tests
+        * The resource is a valid FHIR resource
+        * The server claims support for JSON encoding of resources
+        * The server claims support for the Patient resource and one other
+          resource
+
+        It collects the following information that is saved in the testing session
+        for use by later tests:
+
+        * List of resources supported
+        * List of queries parameters supported
+      )
+      run_as_group
+
+      PROFILES = {
+        'AllergyIntolerance' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance'].freeze,
+        'CarePlan' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan'].freeze,
+        'CareTeam' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam'].freeze,
+        'Condition' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition'].freeze,
+        'Device' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device'].freeze,
+        'DiagnosticReport' => [
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note'
+        ].freeze,
+        'DocumentReference' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference'].freeze,
+        'Encounter' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter'].freeze,
+        'Goal' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal'].freeze,
+        'Immunization' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization'].freeze,
+        'Location' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-location'].freeze,
+        'Medication' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication'].freeze,
+        'MedicationRequest' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest'].freeze,
+        'Observation' => [
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab',
+          'http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age',
+          'http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-pulse-oximetry',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus',
+          'http://hl7.org/fhir/StructureDefinition/bp',
+          'http://hl7.org/fhir/StructureDefinition/bodyheight',
+          'http://hl7.org/fhir/StructureDefinition/bodyweight',
+          'http://hl7.org/fhir/StructureDefinition/heartrate',
+          'http://hl7.org/fhir/StructureDefinition/resprate',
+          'http://hl7.org/fhir/StructureDefinition/bodytemp',
+          'http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile'
+        ].freeze,
+        'Organization' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization'].freeze,
+        'Patient' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient'].freeze,
+        'Practitioner' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner'].freeze,
+        'PractitionerRole' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole'].freeze,
+        'Procedure' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure'].freeze,
+        'Provenance' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance'].freeze
+      }.freeze
+
+      test from: :tls_version_test,
+          id: :standalone_auth_tls,
+          title: 'FHIR server secured by transport layer security',
+          description: %(
+            Systems **SHALL** use TLS version 1.2 or higher for all transmissions
+            not taking place over a secure network connection.
+          ),
+          config: {
+            options: {  minimum_allowed_version: OpenSSL::SSL::TLS1_2_VERSION }
+          }
+      test from: :us_core_conformance_support
+      test from: :us_core_fhir_version
+      test from: :us_core_json_support
+
+      test from: :us_core_profile_support do
+        config(
+          options: { target_profiles: PROFILES }
+        )
+      end
+    end
+  end
+end

data/lib/us_core_test_kit/custom_groups/v3.1.1/clinical_notes_guidance_group.rb

@@ -0,0 +1,51 @@
+# coding: utf-8
+require_relative '../clinical_note_attachment_test'
+require_relative '../clinical_note_type_test'
+
+module USCoreTestKit
+  module USCoreV311
+    class ClinicalNotesGuidanceGroup < Inferno::TestGroup
+      id :us_core_v311_clinical_notes_guidance
+      title 'Clinical Notes Guidance'
+      short_description 'Verify DiagnosticReport and DocumentReference resources support the US Core Clinical Notes Guidance.'
+      description %(
+        The #{title} Sequence tests DiagnosticReport and DocumentReference
+        resources associated with the provided patient. The resources returned
+        will be checked for consistency against the [US Core Clinical Notes
+        Guidance](https://hl7.org/fhir/us/core/STU3.1.1/clinical-notes-guidance.html)
+
+        In this set of tests, Inferno serves as a FHIR client that attempts to
+        access the different types of Clinical Notes specified in the guidance.
+        The provided patient needs to have the following five common clinical
+        notes as DocumentReference resources:
+
+        * Consultation Note (11488-4)
+        * Discharge Summary (18842-5)
+        * History & Physical Note (34117-2)
+        * Procedures Note (28570-0)
+        * Progress Note (11506-3)
+
+        The provided patient also needs to have the following three common
+        diagnostic reports as DiagnosticReport resources:
+
+        * Cardiology (LP29708-2)
+        * Pathology (LP7839-6)
+        * Radiology (LP29684-5)
+
+        In order to enable consistent access to scanned narrative-only clinical
+        reports, the US Core server shall expose these reports through both
+        DiagnosticReport and DocumentReference by representing the same attachment
+        url.
+      )
+      run_as_group
+
+      test from: :us_core_clinical_note_types do
+       config(
+        options: { required_types: ['11488-4', '18842-5', '34117-2', '28570-0', '11506-3'].freeze }
+       )
+      end
+
+      test from: :us_core_clinical_note_attachments
+    end
+  end
+end

data/lib/us_core_test_kit/custom_groups/v4.0.0/capability_statement_group.rb

@@ -0,0 +1,116 @@
+require 'tls_test_kit'
+require_relative '../capability_statement/conformance_support_test'
+require_relative '../capability_statement/fhir_version_test'
+require_relative '../capability_statement/json_support_test'
+require_relative '../capability_statement/profile_support_test'
+require_relative '../capability_statement/instantiate_test'
+
+module USCoreTestKit
+  module USCoreV400
+    class CapabilityStatementGroup < Inferno::TestGroup
+      id :us_core_v400_capability_statement
+      title 'Capability Statement'
+      short_description 'Retrieve information about supported server functionality using the FHIR capabilties interaction.'
+      description %(
+        # Background
+        The #{title} Sequence tests a FHIR server's ability to formally describe
+        features supported by the API by using the [Capability
+        Statement](https://www.hl7.org/fhir/capabilitystatement.html) resource.
+        The features described in the Capability Statement must be consistent with
+        the required capabilities of a US Core server. The Capability Statement
+        must also advertise the location of the required SMART on FHIR endpoints
+        that enable authenticated access to the FHIR server resources.
+
+        The Capability Statement resource allows clients to determine which
+        resources are supported by a FHIR Server. Not all servers are expected to
+        implement all possible queries and data elements described in the US Core
+        API. For example, the US Core Implementation Guide requires that the
+        Patient resource and only one additional resource profile from the US Core
+        Profiles.
+
+        # Test Methodology
+
+        This test sequence accesses the server endpoint at `/metadata` using a
+        `GET` request. It parses the Capability Statement and verifies that:
+
+        * The endpoint is secured by an appropriate cryptographic protocol
+        * The resource matches the expected FHIR version defined by the tests
+        * The resource is a valid FHIR resource
+        * The server claims support for JSON encoding of resources
+        * The server claims support for the Patient resource and one other
+          resource
+
+        It collects the following information that is saved in the testing session
+        for use by later tests:
+
+        * List of resources supported
+        * List of queries parameters supported
+      )
+      run_as_group
+
+      PROFILES = {
+        'AllergyIntolerance' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance'].freeze,
+        'CarePlan' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan'].freeze,
+        'CareTeam' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam'].freeze,
+        'Condition' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition'].freeze,
+        'Device' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device'].freeze,
+        'DiagnosticReport' => [
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note'
+        ].freeze,
+        'DocumentReference' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference'].freeze,
+        'Encounter' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter'].freeze,
+        'Goal' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal'].freeze,
+        'Immunization' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization'].freeze,
+        'Location' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-location'].freeze,
+        'Medication' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication'].freeze,
+        'MedicationRequest' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest'].freeze,
+        'Observation' => [
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-temperature',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate',
+          'http://hl7.org/fhir/us/core/StructureDefinition/pediatric-bmi-for-age',
+          'http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile',
+          'http://hl7.org/fhir/us/core/StructureDefinition/pediatric-weight-for-height',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-pulse-oximetry',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate',
+          'http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus'
+        ].freeze,
+        'Organization' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization'].freeze,
+        'Patient' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient'].freeze,
+        'Practitioner' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner'].freeze,
+        'PractitionerRole' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole'].freeze,
+        'Procedure' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure'].freeze,
+        'Provenance' => ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance'].freeze
+      }.freeze
+
+      test from: :tls_version_test,
+          id: :standalone_auth_tls,
+          title: 'FHIR server secured by transport layer security',
+          description: %(
+            Systems **SHALL** use TLS version 1.2 or higher for all transmissions
+            not taking place over a secure network connection.
+          ),
+          config: {
+            options: {  minimum_allowed_version: OpenSSL::SSL::TLS1_2_VERSION }
+          }
+      test from: :us_core_conformance_support
+      test from: :us_core_fhir_version
+      test from: :us_core_json_support
+
+      test from: :us_core_profile_support do
+        config(
+          options: { target_profiles: PROFILES }
+        )
+      end
+
+      test from: :us_core_instantiate
+    end
+  end
+end

data/lib/us_core_test_kit/custom_groups/v4.0.0/clinical_notes_guidance_group.rb

@@ -0,0 +1,54 @@
+# coding: utf-8
+require_relative '../clinical_note_attachment_test'
+require_relative '../clinical_note_type_test'
+
+module USCoreTestKit
+  module USCoreV400
+    class ClinicalNotesGuidanceGroup < Inferno::TestGroup
+      id :us_core_v400_clinical_notes_guidance
+      title 'Clinical Notes Guidance'
+      short_description 'Verify DiagnosticReport and DocumentReference resources support the US Core Clinical Notes Guidance.'
+      description %(
+        The #{title} Sequence tests DiagnosticReport and DocumentReference
+        resources associated with the provided patient. The resources returned
+        will be checked for consistency against the [US Core Clinical Notes
+        Guidance](https://hl7.org/fhir/us/core/STU4/clinical-notes-guidance.html)
+
+        In this set of tests, Inferno serves as a FHIR client that attempts to
+        access the different types of Clinical Notes specified in the guidance.
+        The provided patient needs to have the following five common clinical
+        notes as DocumentReference resources:
+
+        * Consultation Note (11488-4)
+        * Discharge Summary (18842-5)
+        * History & Physical Note (34117-2)
+        * Procedures Note (28570-0)
+        * Progress Note (11506-3)
+        * Imaging Narrative (18748-4)
+        * Laboratory Report Narrative (11502-2)
+        * Pathology Report Narrative (11526-1)
+
+        The provided patient also needs to have the following three common
+        diagnostic reports as DiagnosticReport resources:
+
+        * Cardiology (LP29708-2)
+        * Pathology (LP7839-6)
+        * Radiology (LP29684-5)
+
+        In order to enable consistent access to scanned narrative-only clinical
+        reports, the US Core server shall expose these reports through both
+        DiagnosticReport and DocumentReference by representing the same attachment
+        url.
+      )
+      run_as_group
+
+      test from: :us_core_clinical_note_types do
+       config(
+        options: { required_types: ['11488-4', '18842-5', '34117-2', '28570-0', '11506-3', '18748-4', '11502-2', '11526-1'].freeze }
+       )
+      end
+
+      test from: :us_core_clinical_note_attachments
+    end
+  end
+end