Current Connectathons

  Links to information about upcoming Connectathons world-wide:


NA Connectathon 2020 Resources

IHE USA welcomes your participation in the IHE North American Connectathon, Jan 21-24, 2020 in Cleveland.  

This page points you to the resources you need to prepare and succeed!  Registration is open in Gazelle Test Management from Sep 12 - Oct 25, 2019.  Infomation for some items below will be added as we get closer to January.

If you have questions, please contact the IHE NA Connectathon sponsors:


For Participants

Schedule and Logistics

Connectathon System Registration

-- Pre-Registration Advice
-- How to Register in Gazelle and Generate a Contract
-- Thorough vs Supportive Testing Explained

Specifications to be tested

Technical resources for all

Technical resources for targeted profiles

Training Material / Webex Presentations


Contact us!




For Monitors:

  • Connectathon Monitor Resources Page

IHE Europe 2019 Connectathon in Rennes (France)

Official information (about Hotel, Transportation, Location) from IHE Europe available at the following URL:

This page points you to the resources you need to prepare and succeed!  Registration will open in gazelle on Nov 30th 2018 to January, 26th 2019.

Some years ago, Dave Franken shared good tips with us about how to prepare to be successful in Luxembourg, read him here.


 Technical Resources

Registration, tools, network, digital certs, all stuff technical...

 Schedule and Logistics

Schedule, fees, payment, badges, hotel, shipping info...

 Weekly reminders

What should I be working on this week? Stay on-track with your preparation!

 Monitor Resources

Logistics, training, and resources for our wonderful volunteers!

 Training Resources

Tutorials, webinars, and how-to documentation.

 Contact Us!

Get help when you need it.


EU Connectathon 2019 Technical Resources

Getting ready for participation in the April Connectathon involves more than buying a plane ticket to The Netherlands. From January until April, participants complete a set of required pre-connectathon tests. March through mid-April participants share configuration information with test partners, perform internet testing for some profiles, pre-load test data, finish some last-minute pre-connectathon tests, and familiarize themselves with the tests they will be required to run at the connnectathon. The links below contain details for your Connectathon preparation activities.

Email list for Connectathon announcements 
All participants in the EU Connectathon must join this group. It is used for technical and logistical announcements from the EU Connectathon sponsors and technical managers. To subscribe, send an email to EU_connectathon+subscribe@googlegroups.comPlease note that you need to sign in to a Google account (or create one) in order to join this group. Please provide your company name when subscribing, your request might not be accepted otherwise.
Gazelle Gazelle is IHE's online tool for managing registration, pre-Connectathon & Connectathon testing.
Profiles to be tested

Review the list of profiles to be tested. Please note those that are 'dropped' or which have low registration.

Access the list

IHE Technical Frameworks

Ensure that you are working off the latest documentation (not an out-of-date version on your hard drive). Final Text Technical Frameworks & Trial Implementation Supplements are published on

Some are interested in knowing the specifics of the updates since last year.  Each domain's Technical Committee processes Change Proposals that are then incorporated into Technical Frameworks annually.   

Tool resources Find an index to IHE test tools, a mapping of tools to profiles, tool documentation, test cases, and tool training material.
ATNA testing & digital certificates Pre-connectathon & connectathon testing requirements for the ATNA profile.  How to get your digital certificate.
Training resources Pointers to training & documentation about tools, gazelle & connectathon processes
Profile-specific preparation In order to make you more efficient at the Connectathon, for some profiles we encourage you to do this preparation in advance.
Network & configuration details  Configurations for your test systems, OID assignments, IP addresses, Connectathon network description
XDS/XDS-I ATNA Tues-Wed partner assignments On Tues & Wed of Connectathon week, we assign some test partners for infrastructure actors in XDS, XDS-I and ATNA (Audit Record Repositories and Doc Registries & Repositories)
Cross-Community testing 

Explanation of multiple affinity domain Connectathon tests for participants testing XDS.b, XDS-I.b, PDQ/PDQv3, PIX/PIXv3, and cross-community profiles XC* (eg XCA, XCPD, etc)

Thorough/Supportive testing explained This page describes the difference between Thorough and Supportive connectathon testing 
Connectathon test review Your connectathon preparation should include reviewing tests you will have to run during Connectathon week.  Here's how.
10 Connectathon tips from the pros This page shares tips from vendors that have participated in the Connectathon for many years.
Connectathon logistics (TBC) IHE Europe staff manages contracts, fees, badges, hotel & shipping, and provides help for all non-technical details regarding the connectathon.
Connectathon FAQ Answers to questions many first-time participants ask.

   Contact Us! Get help when you need it.

   Go Back! to the EU Connectathon 2015 main page

ATNA Testing for Connectathons & digital certificates

ATNA is a widely tested profile.  This page contains guidelines that address frequently asked questions about testing expectations.

THIS PAGE APPLIED TO IHE CONNECTATHONS IN 2019. The 2020 page is under construction.

Important updates to ATNA in the ITI Technical Framework

The ITI Technical Committee worked on updates to add 3 new options to the ATNA Secure Node & Secure Application actors.  The options affect the [ITI-19] Authenticate Node transaction.  As of September 2018, these options are now approved and testable at 2019 Connectathons:

  • 'FQDN Validation of Server Certificate' option
  • 'BCP195 TLS Secure Connection - All TLS Versions' option
  • 'BCP195 TLS Secure Connection - TLS 1.2 Floor' option

Please read:  CP-ITI-1145 - "Three new options related to [ITI-19] Authenticate Node".

==> Why add enhanced cybersecurity to your product?

IHE is strongly encouraging all vendors to implement and test these new options at 2019 Connectathons.  Click here to learn more!   

Security (TLS) Policy for 2019 IHE NA and EU Connectathons

These new options introduce variability in the Connectathon testing environment that did not exist in previous Connectathons.  Depending on whether or not a Connectathon test system supports these options, it may be able to support TLS 1.0, TLS 1.1, and/or TLS 1.2, and one or more of several ciphers.  On the Connectathon test floor, different systems with a mix of TLS versions and ciphers would be a barrier to connectivity. 

So, in order to ensure interoperability between systems testing over TLS, the Connectathon technical managers have selected a TLS version and cipher to use for peer-to-peer tests over TLS.  (This is analagous to a hospital mandating similar requirements at a given deployment.)

*** For 2019 IHE NA and EU Connectathons, peer-to-peer testing over TLS (without the new ATNA options) shall be done using:

  • TLS 1.2
  • cipher TLS_RSA_WITH_AES_128_CBC_SHA
    • (Note that we intentionally chose a 'less secure' cipher for 2019 and anticipate choosing one of the recommended ciphers from BCP195 for future IHE Connectathons.)
  • A digital certificate, issued by the Gazelle Security Suite (GSS) tool.  New certs are needed for 2019 Connectathons.  See the next section.
  • Note that this policy is compatible with the baseline ATNA requirements in [ITI-19] Authenticate Node, in particular referenced standard RFC 7525.

*** For the 2019 IHE NA and EU Connectathons, we will use the Gazelle Security Suite tool to test the new ATNA options:

  • client behavior for a Secure Node/Application supporting the 'FQDN Validation of Server Certificate' option
  • the ability of a Secure Node/Application to negotiate down from TLS 1.2 to 1.1 to 1.0 as required by the 'BCP195 TLS Secure Connection -- All TLS Versions' option
  • the ability of a Secure Node/Application to require that transactions occur with TLS 1.2 and one of the required ciphers in the 'BCP195 TLS Secure Connection -- TLS 1.2 Floor' option

(i.e. testing of the options will not be peer-to-peer)

Gazelle Security Suite (GSS) Tool for ATNA testing:

Tool-based testing of TLS (node authentication) and of the format and transport of your audit messages is consolidated in one tool - the Gazelle Security Suite (GSS)

  • Link to the tool:  
  • Instructions for use of the tool are contained in ATNA test descriptions - here.
  • Recorded training on the Gazelle Security Suite - here

==> GSS: Digital Certificates for IHE Connectathons

The Gazelle Security Suite (GSS) tool is the SINGLE PROVIDER OF DIGITIAL CERTIFICATES for both NA and EU Connectathons.   As of November 27, 2018, the GSS tool is updated to provide digital certificates for 2019 IHE Connectathons.

To obtain a digital certificate from the GSS tool for pre-Connectathon & Connectathon testing, follow the instructions in pre-Connectathon test 11100.

Some facts about the new digital certificates:

  1. If you have a digital certificate from a Connectathon in 2018 or earlier, it will not work for 2019 Connectathons.
  2. If you generated your digital certificate in GSS before Nov 27, 2018, you must generate a new one.
  3. Your new digital certificate:
    1. is from a new Certificate Authority (CA) with a stronger key - 2048 length (before Nov 2018, the CA created certificates with 1024 key length).  You must add the certificate for the new CA in your trust store.
    2. will contain the fully-qualified domain name (FQDN) of your test system.   When you use GSS to request the certificate, the tool will prompt you for this value.  The FQDN value(s) will be in the subjectAltName entry of your digital certificate.  (You may need to provide more than one FQDN when you generate your certificate, eg if you will use your system to test TLS connections outside of the Connectathon network, such as with the NIST XDS Tools in your local test lab.)
  4. Pre-Connectathon test 11100 contains detailed instructions for generating your certificate, including how to get the fully-qualified domain for your test system on the Connectathon network.
  5. Item (3.b.) means that each system testing TLS transactions during Connectathon week will have a digital certificate that is compatible with the new FQDN validation option in ATNA.  Thus, TLS connections with test partners will work whether the client is performing FQDN validation, or not.  This is intentional.

Note that the certificates are only for testing purposes and cannot be used outside of the IHE Connectathon context.

==> GSS: ATNA Questionnaire

Systems testing ATNA are required to complete the ATNA Questionnaire in the GSS tool, ideally during pre-Connectathon testing.  Embedded in the questionnaire are Audit Record tests and TLS tests customized for the profiles & actors you will test at Connectathon.

  • Follow instructions in pre-Connectathon test 11106.
  • Note: You must use TLS 1.2 and the new digital certificates when performing TLS tests in the questionnaire.

==> GSS: ATNA Logging Tests

Read the Technical Framework; you are responsible for all requirements in Record Audit Event [ITI-20] transaction. We will not repeat the requirements here.


WHICH SCHEMA???:  The ITI Technical Framework defines the Record Audit Event [ITI-20] transaction, and specifies use of the DICOM schema for audit messages.  

We expect implementations to be compliant, and we have tested audit messages using the DICOM schema at IHE Connectathons since 2016.

  • The GSS tool will only provide validation against the DICOM schema. If you fail that test, it is our signal to you that your audit messages are not compliant with the latest DICOM schema.  See pre-Connectathon test 11116.
  • We expect peer-to-peer testing at the Connectathon to occur using messages compliant with the DICOM schema.
  • Some might be interested in this email exchange on the IT Tech Cmte email list.

SENDING AUDIT MESSAGES:   You can send your audit records to the GSS tool simulating an Audit Record Repository  See pre-connectathon test 11117.

Questions about ATNA Testing?

Contact Lynn Felhofer, Technical Project Manager for the IT Infrastructure domain.

PDF icon IHE_and_Cybersecurity.pdf158.21 KB
PDF icon CP-ITI-1145-01-ballot49.pdf183.71 KB

EU Connectathon 2019 Schedule & Logistics

  IHE Europe manages the schedule and logistics for the event.  Pointers to details are gathered here. If you have questions or need help, please contact the IHE Europe staff at 

Connectathon location & dates

Rennes, FR (See this link for further details)
April 8-12, 2019

Opening hours: 

  • Monday 8:00am - 5:30pm
  • Tuesday - Thursday: 8:30am - 5:30pm
  • Friday : 8:30am - noon

Testing hours

  • Monday - Thursday: 9:00am - 5:30pm
  • Friday : 9:00am - noon


All participants are required to attend until noon on Friday ! Even though you are fine with your tests, some partners may still need your assistance to finish up their tests.

Email list for Connectathon announcements All participants in the EU Connectathon must join this group. It is used for technical and logistical announcements from the NA Connectathon sponsors and technical managers. To subscribe, send an email to EU_connectathon+subscribe@googlegroups.comPlease note that you need to sign in to a Google account (or create one) in order to join this group.
Connectathon Technical Resources Find details about technical preparation for connectathon:  tools, network, training, and much more.
Policies & Guidelines IHE Europe publishes these policies for contracting, payment, and participation in the IHE European Connectathon 2019.
Connecthon FAQ Answers to questions many first-time participants ask.

  Contact Us! Get help when you need it.

Connectathon 2019 Monitor Resources

Welcome! We gather resources here for our wonderful volunteer monitors.

  1. Monitor recruitment
  2. Monitor Email list
  3. Logistics: Travel, Expenses, Non-Disclosure & Confict of Interest forms 
  4. WHERE & WHEN? Schedule, Gazelle, Table Assignments
  5. WHO & WHAT? Monitors' Profile Assignments
  6. HOW? Training Material
  7. IHE Technical Framework Documentation
  8. Our FAQ for vendor participants
  9. Nice video on the benefits of being a monitor
  10. Contact us

Monitor recruitment

The recruitment period for the 2019 connectathon in Rennes is now open. Submit your application through the form available at You are required to be logged in to access this page; if you do not have an account on Gazelle website (different than the one for Gazelle applications), please email to Hilary Ramanantsalama and Anne-Gaëlle Bergé to get an access. 

Monitor Email list

When the recruitment period is over and the manage team has selected the monitors, all monitors will be invited to join the Google group dedicated to monitors. No personal email will be sent.


Please carefully review the following material:

If you have questions about travel or other logistics, Hilary Ramanantsalama and Anne-Gaëlle Bergé are happy to help.

WHEN & WHERE? Schedule, Gazelle & Table Assignments

The 2019 European Connectathon, IHE's week-long interoperability testing event, is held in Rennes.

Table Assignments

show where monitors & tests systems will be located in April.

  • Spreadsheet with table assignments: To be published
  • PDF of table layout at the Connectathon: To be published

HOW? Training Material

We expect additional profile- and tool-specific training to be available here.

Date-Time / Duration
Req'd for new monitors

Returing monitors are welcome

Connectathon monitor - process overview
- Monitor responsibilities
- Connectathon process for monitors
- Q&A





Req'd for new monitors

Returing monitors are welcome

Gazelle walk-through
We have two resources for you.

- Webex training on how monitors use gazelle & the proxy during connectathon week to work with participants and verify tests. 
New monitors

Interpreting the IHE Technical Framework

This covers terminology used in IHE Technical Frameworks explains the structure of IHE documentation, and describes IHE's publication cycle. If you've never read IHE documentation before, you will find this background information helpful.

(Streaming link) (.mp4)

New monitors Connectathon Terminology:
Definitions needed to understand using Gazelle during a connectathon (known to most returning participants; highly recommended for new participants & monitors)


**optional** educational material for monitors

IHE 2017 Educational Webinar Series
IHE sponsored its annual educational webinar series during summer and fall. You will find overview presentations for each IHE domain as well as 'speciality' presentations on topics like security, cross-community sharing of healthcare information, etc. These presentations *are not* connectathon-specific.

IT Infrastructure domain training material
These presentations *are not* connectathon-specific. They are geared to an audience which is familiar with healthcare interoperability problems in general but is not familiar with the way IHE addresses problems or the specific profiles provided by ITI. You may find topics of interest to you in your "day job".

multiple presentations available; duration varies
  Some of you may be interested in the training material we compile for vendor participants, but monitors do not need to review it. We collect participants' material on our Training Page.  


IHE Technical Framework Documentation

To prepare for the connectathon, we recommend you read the chapter in "Volume 1" for the profiles you are assigned to evaluate. Each IHE domain's Technical Framework is segmented into multiple volumes; Volume 1 contains the use cases the profile addresses, the process flow and a diagram of the actors & transactions in the profiles. The technical details of the transactions are not in Vol 1, and as a monitor, you do not need to be an expert at that level. If you are reading a Trial Implementation Supplement, you will see that the contents are separated into Volume 1 and Volume 2 within the supplement.

If you are not familiar with IHE documentation, we recommend you view the "Interpreting the IHE Technical Framework" video in the training section above before you read the documentation.

IHE publishes its documents, organized by domain, on the Technical Framework page of

Our FAQ for vendor participants

We have put together this FAQ with answers to questions we frequently receive from our vendor participants. You may find it informative.


This is a great welcome to new monitors captured on video. While it is was done by a SIIM board member at the beginning of Connectathon monitor training in 2009, his points about the benefits of your volunteer service stand true today. We invite you to watch this 5 minute video:

Contact Us

For help with logistics (travel, hotel, expenses), please contact TBD
For questions about Connectathon processes & tools, or your assignment, contact Hilary Ramanantsalama and Anne-Gaëlle Bergé.

PDF icon Connectathon_Monitor_Training_2018.pdf345.86 KB

Monitor Recruitment Form Rennes, FR 2019

2019-01-30 Update: application period is closed. The team is processing the results; the list of monitors will be available soon.


Please use this form to express your interest in participating at the IHE Europe 2019 Connectathon as a Monitor. Filling this form is part of our recruitment process and does not mean that you will be able to join the team. Applications are reviewed and accepted based on the registration of systems (amount of systems, tested profiles and so on).

Monitors are members of the community who serve as independent test result evaluators during the IHE Connectathon. Monitors examine tests in real time or examine evidence after the test. Connectathon Monitors shall be recommended by their IHE National initiative, if one exists in their country of residence.  Monitors from countries without an IHE National Initiative may apply directly.

Monitors agree to perform their duties under the supervision of the Technical Project Manager and operate in a collaborative manner as part of the Testing Team

Monitors presence is expected during the entire connectathon event: April, 8th (noon) to April, 12th 2019 (noon).


The information entered in the form are only used by the Connectathon Management Team and will be kept in our records up to one year after the connectathon ends. Data will be deleted earlier upon writing request.

You need an account to fill out this form. If you do not have one yet, contact Hilary and Anne-Gaëlle; they will be happy to help.

IHE Change Proposals


IHE Change Proposals (CPs) are individual Microsoft Word documents that describe in detail the text changes required of an existing IHE document (Technical Framework, Trial Implementation Supplement) to correct an outright error, clarify an issue or perhaps add new functionality to an existing profile, actor or transaction. Each IHE domain manages the inbound proposals, completes the CP documents to include the appropriate deletions and additions to existing documents, publishes the CP documents and incorporates those changes into the existing Final Text or Trial Implementation supplements.


Final Text and Trial Implementation supplements are published annually (schedule depends on the domain), while Change Proposal documents can be published at any time during the year. For purposes of Connectathon testing, Connectathon participants are responsible for the updates documented in the Change Proposal documents when the Change Proposal documents are published. This allows participants at the Connectathon events to use the latest updates to existing IHE profiles.


One caveat to the paragraph above is that there does need to be a realistic cutoff date for the publication of Change Proposals. A Connectathon participant cannot be expected to modify a Connectathon system to meet a Change Proposal that is published by a committee one week prior to the Connectathon.


Change Proposal Cutoff Date

Participants in January Connectathons in North America will be responsible for CP documents published by committees on or before November the prior year.

Participants in the April Connectathons in Europe are responsible for CP documents published on or before January prior to the event.

See the table below for links to Change Proposal documents.


In the rare case that the Technical Project Manager for a domain determines that a specific Change Proposal is critical for successful testing of an IHE Integraton Profile or Trial Implementation Supplement, that Technical Project Manager will track that Change Proposal and communicate directly with the Connectathon participants regarding that issue. This is indeed a rare event. There are times that issues are found during the pre-Connectathon testing, and the Technical Project Manager for that domain will work with the appropriate Technical Committee to evaluate the issue and document a path to address the issue.


List of Resources

IHE is working on a unified process for managing Change Proposals, but that documentation process is still under development. The table below lists the domains that are offered for testing for NA and EU Connectathons. The second column in the table below indicates the domains that have links to their Change Proposal documents on IHE's main Technical Frameworks page:



Link on TF Page

Link to Change Proposal Summary
Anatomic Pathology    
IT Infrastructure Y

ITI CP Tracking Spreadsheet
-- The 'Approved CPs' tab lists CPs that have passed ballot and will be incorporated into the next Technical Framework publications
-- the 'Open CPs' tab contains CPs assigned for future work

Patient Care Coordination
Patient Care Devices
Pharmacy      not yet available
Quality, Research, Public Health   QRPH CP Tracking Spreadsheet 
Radiology Y

Radiology CP Tracking Spreadsheet
-- 'Final Text' CPs have been approved but not yet incorporated
-- 'Incorporated' CP are now in the RAD TF and TI supplements