“The image arrived” is a useful first observation. It is not a complete acceptance test. A clinically usable workflow often depends on identity, timing, metadata, routing, priors, exceptions, and the behavior of multiple systems after receipt.
Test the whole story
Define the starting state, operator or system action, expected observations in each participating system, and the evidence that proves success. Include common paths, edge cases, failure recovery, corrections, and the downstream consequence of each message.
Make exceptions visible
When a scenario cannot be run or produces a conditional result, record the reason, risk, owner, and disposition. The acceptance record should help a project make decisions, not merely accumulate checked boxes.