From Testing to Real-World Readiness: i2X at Plugathon and Connectathon

Testing events are where polite agreement ends and reality begins. You bring your system, someone else brings theirs, and you find out whether the specification you both swore you implemented actually means the same thing in both.

i2X has been part of two major IHE Europe Connectathon weeks — Vienna and Brussels — alongside its own dedicated initiatives. Here is what we learned.

Testing is not where the work ends. It is where the work becomes visible.

What we tested

• Patient Summary exchanges against the IPS profile, in scenarios derived from real clinical workflows
• ePrescription / eDispensation flows, including edge cases around cross-border dispensation
• Laboratory results against the EU Laboratory Implementation Guide, with attention to reference ranges and reflex testing
• Vendor systems against the conformance suite under preparation for the Pisa i2Xathon

What worked, what broke

The transport layer is in a much better place than it was twelve months ago. Where things still strain is in semantics — terminology bindings, value sets, how implementers interpret optionality in the IGs. The fixes are not enormous, but they only get caught when systems actually talk to each other.

A second pattern: the systems that performed best were not the ones with the most resources. They were the ones whose teams had been in the SIGs and the Integrated Technical Team conversations for the longest. Engagement compounds.

What this means for vendors preparing for EHDS

• Get into a test environment early — the Gazelle testbed is open to vendors beyond the consortium
• Treat semantics as a first-class concern, not a follow-up sprint
• Join the Industry SIG and / or the IT2 — most of the cost of testing comes from preventable miscommunication that those rooms surface early
• Plan a presence at the next i2Xathon — Pisa, October 2026, co-located with HospitalsOnFHIR