Test patient records generated by Cypress randomly select codes from a value set. Some of these codes are obsolete or not used in the U.S. An example of streptokinase is attached. During testing, EHRs that maintain only relevant values would be prevented from entering these data.

Potential solutions include selecting another value from the same value set, or requiring that EHRs include all values, obsolete or otherwise, in their systems.

The issue extends further to certification testing in that some EHRs may only contain values that are relevant to their customer base. By randomly selecting any value from a value set for testing purposes, the possibility of selecting a value that does not relate to the EHR customer base exists. There is no current requirement that an EHR contain all values for all value sets, so possibility exists that the test patients would contain elements not relevant to that EHR's target customer demographic.