Network Testing
Health Gorilla connects to multiple national exchange networks in production, including Carequality, CommonWell, eHealth Exchange, and QHINs under the TEFCA framework. Each network has different policies, routing logic, and patient matching behavior. When building and testing your integration, it is important to understand how these differences affect query results, especially when moving from sandbox to production.
Know the Network Models
Each network operates differently, and those differences impact how patient records are discovered and returned.
| Network | Behavior Summary |
|---|---|
| Carequality | Queries are routed based on directory publishing. Requires endpoint registration and trust via SAML assertions. |
| CommonWell | Uses identity linking. Queries only return documents for patients who have been pre-linked. |
| eHealth Exchange | Uses IHE XCA/XDS protocols. Routing and availability depend on static endpoint configuration. |
| QHIN (TEFCA) | Queries use the Record Locator Service (RLS) and QHIN-to-QHIN routing. Requires matching and authorization under TEFCA policies. |
Understand the Sandbox Environment
The sandbox environment does not simulate the full routing logic, directory resolution, patient matching, or document availability found in production—especially across networks like Carequality, CommonWell, eHealth Exchange (eHEX), and QHINs under TEFCA. Use it for functional testing and initial development.
In the Sandbox Environment:
- Patient matching and identity resolution are simplified or bypassed
- Network features such as directory publishing, SAML assertions, or RLS visibility are not enforced
- Network simulation returns randomized, synthetic results for any patient you query
Plan for Production Differences
In production, network participation impacts record retrieval. Success may depend on:
- Completing Exhibit 1 forms and directory publishing (Carequality)
- Establishing patient identity links (CommonWell)
- Routing queries to known endpoints (eHealth Exchange)
- Resolving patients through the RLS and receiving approval from the responding QHIN (TEFCA)
Work with Health Gorilla Support to validate your configuration before go-live.