HAPI FHIR validation shows errors for ValueSet codes, but FHIR validation CLI says there are no ValueSet code errors

[benjamin-reddy]

Describe the bug
I am running a HAPI FHIR server that is using a custom FHIR IG package. The server is using FHIR version R4B. It is also using RemoteTerminologyServiceValidationSupport with https://tx.fhir.org/r4. When I run a validation using the HAPI FHIR server, I receive several error messages that look like the following:

<severity value="error"/>
        <code value="processing"/>
        <details>
            <coding>
                <system value="http://hl7.org/fhir/java-core-messageId"/>
                <code value="Terminology_TX_NoValid_1_CC"/>
            </coding>
        </details>
        <diagnostics value="None of the codings provided are in the value set 'SPL Document Codes' ([http://hl7.org/fhir/us/spl/ValueSet/splDocumentCodes|0.1.0](http://hl7.org/fhir/us/spl/ValueSet/splDocumentCodes%7C0.1.0)), and a coding from this value set is required) (codes = [http://loinc.org#34391-3](http://loinc.org/#34391-3))"/>
        <location value="Bundle.entry[0].resource.type"/>
        <location value="Line[33] Col[15]"/>

I posted my issue to the Fhir Server Github issue forum here:
HealthIntersections/fhirserver#235

From the conversation, I learned about the FHIR validator CLI, and used that to test my input.
https://github.com/hapifhir/org.hl7.fhir.core/releases/latest/download/validator_cli.jar

The validator gave the same ValueSet error messages I saw in my HAPIFHIR validation result. However, I found that the cause of the issue was that the input display element was incorrect. When I re-tested with the FHIR validator CLI using the correct display elements for a couple of ValueSets, there were no more error messages for those ValueSet codes. I made sure that the FHIR validation CLI was running with FHIR version R4B.

However, when I used the same input with the correct display values in the HAPI FHIR validator, I still get the same ValueSet errors for all the ValueSet codes. I am not sure if HAPI FHIR’s validation method is supposed to be different from the FHIR validator CLI, or there is a bug with the HAPIFHIR validator itself when it comes to these ValueSets.

To Reproduce
Steps to reproduce the behavior:

1. Add the following code to StarterJpaConfig:

//NEW validationSupportChain for terminology support
	@Primary
	@Bean
	public CachingValidationSupport validationSupportChain(JpaValidationSupportChain theJpaValidationSupportChain, IFhirSystemDao<?, ?> fhirSystemDao) {
		FhirContext ctx = fhirSystemDao.getContext();
	
		DefaultProfileValidationSupport defaultSupport = new DefaultProfileValidationSupport(ctx);
		theJpaValidationSupportChain.addValidationSupport(defaultSupport);
	
		System.out.println("RemoteTerminologyServiceValidationSupport BEFORE INVOKE");

		RemoteTerminologyServiceValidationSupport remoteTermSvc = new RemoteTerminologyServiceValidationSupport(ctx, "https://tx.fhir.org/r4");

		theJpaValidationSupportChain.addValidationSupport(remoteTermSvc);
	
		System.out.println("RemoteTerminologyServiceValidationSupport IS INVOKED");
		
		return ValidationSupportConfigUtil.newCachingValidationSupport(theJpaValidationSupportChain);
	}
	
	//NEW validatorModule for terminology support
	@Primary
	@Bean
	public IValidatorModule validatorModule(CachingValidationSupport validationSupport) {
		return new FhirInstanceValidator(validationSupport);
	}

2. Have the following enabled in application.yaml

hapi.fhir.enable_repository_validating_interceptor = true
hapi.fhir.tester.home.validation.requests_enabled = true
hapi.fhir.tester.home.validation.responses_enabled = true
hapi:
  fhir:
    implementationguides:
       spl_dev:
          packageUrl: classpath:Package/hl7.fhir.us.spl.tgz
          name: hl7.fhir.us.spl
          version: dev

3. Download the custom FHIR IG from here:
   https://github.com/HL7/fhir-spl/blob/main/package/hl7.fhir.us.spl.tgz

After you download, run the following commands to remove the index files to prevent issues:

tar -xvzf hl7.fhir.us.spl.tgz
rm .index.json .index.db usage.ini hl7.fhir.us.spl.tgz
tar -cvzf hl7.fhir.us.spl.tgz package

After the package is put back into tar, put the package under /src/main/resources/Package

4. Start up HAPI FHIR server

5. Create POST request using postman with the URL http://localhost:8080/fhir/Bundle/$validate. Use the following XML in the body to test:
   HapiFhir-Bundle-AllopurinolTabletLabelBundle.zip

The ValueSets I have been testing with for now are 34391-3, 34089-3, 34090-1. The correct display codes are these:

6. See the validation results

Expected behavior
The ValueSet codes with the correct description (34391-3, 34089-3, 34090-1) should not have any errors in the validation result.

Environment (please complete the following information):

• HAPI FHIR Version: R4B
• OS: Windows 11
• Browser: Chrome
• Java 17

Additional context
There is one other validation issue that looks like this:

<severity value="error"/>
        <code value="processing"/>
        <details>
            <coding>
                <system value="http://hl7.org/fhir/java-core-messageId"/>
                <code value="Validation_VAL_Profile_Minimum"/>
            </coding>
        </details>
        <diagnostics value="Bundle.entry:Composition: minimum required = 1, but only found 0 (from http://hl7.org/fhir/us/spl/StructureDefinition/ProductSubmissionBundle|0.1.0)"/>
        <location value="Bundle"/>
        <location value="Line[3] Col[37]"/>

The result says there are 0 Bundle Entries, even though there is one. This may be related to the validation issue above. For now, I'm trying to figure out the ValueSet issue first.