diff --git a/healthcare/datasets/package.json b/healthcare/datasets/package.json
index 5c29cb9add..a360df018c 100644
--- a/healthcare/datasets/package.json
+++ b/healthcare/datasets/package.json
@@ -9,11 +9,11 @@
     "node": ">=6.0.0"
   },
   "scripts": {
-    "test": "ava -T 1m --verbose system-test/*.test.js"
+    "test": "mocha system-test/*.test.js --timeout=60000"
   },
   "devDependencies": {
     "@google-cloud/nodejs-repo-tools": "^3.0.0",
-    "ava": "^0.25.0"
+    "mocha": "^5.2.0"
   },
   "dependencies": {
     "googleapis": "^37.0.0",
diff --git a/healthcare/datasets/system-test/datasets.test.js b/healthcare/datasets/system-test/datasets.test.js
index c15f3d2f0f..d1f1979d9a 100644
--- a/healthcare/datasets/system-test/datasets.test.js
+++ b/healthcare/datasets/system-test/datasets.test.js
@@ -15,65 +15,66 @@
 
 'use strict';
 
-const path = require(`path`);
-const test = require(`ava`);
-const tools = require(`@google-cloud/nodejs-repo-tools`);
-const uuid = require(`uuid`);
+const path = require('path');
+const assert = require('assert');
+const tools = require('@google-cloud/nodejs-repo-tools');
+const uuid = require('uuid');
 
-const cmd = `node datasets.js`;
-const cwd = path.join(__dirname, `..`);
+const cmd = 'node datasets.js';
+const cwd = path.join(__dirname, '..');
 const datasetId = `dataset-${uuid.v4()}`.replace(/-/gi, '_');
 const destinationDatasetId = `destination-${uuid.v4()}`.replace(/-/gi, '_');
 const keeplistTags = 'PatientID';
 
-test.before(tools.checkCredentials);
-test.after.always(async () => {
+before(tools.checkCredentials);
+after(async () => {
   try {
     await tools.runAsync(`${cmd} deleteDataset ${destinationDatasetId}`, cwd);
+    // eslint-disable-next-line no-empty
   } catch (err) {} // Ignore error
 });
 
-test.serial(`should create a dataset`, async t => {
+it('should create a dataset', async () => {
   const output = await tools.runAsync(`${cmd} createDataset ${datasetId}`, cwd);
-  t.is(output, `Created dataset: ${datasetId}`);
+  assert.strictEqual(output, `Created dataset: ${datasetId}`);
 });
 
-test.serial(`should get a dataset`, async t => {
+it('should get a dataset', async () => {
   const output = await tools.runAsync(`${cmd} getDataset ${datasetId}`, cwd);
-  t.regex(output, /name/);
-  t.regex(output, /timeZone/);
+  assert.strictEqual(new RegExp(/name/).test(output), true);
+  assert.strictEqual(new RegExp(/timeZone/).test(output), true);
 });
 
-test.serial(`should patch a dataset`, async t => {
+it('should patch a dataset', async () => {
   const patchTimeZone = 'GMT';
   const output = await tools.runAsync(
     `${cmd} patchDataset ${datasetId} ${patchTimeZone}`,
     cwd
   );
-  t.is(output, `Dataset ${datasetId} patched with time zone ${patchTimeZone}`);
+  assert.strictEqual(
+    output,
+    `Dataset ${datasetId} patched with time zone ${patchTimeZone}`
+  );
 });
 
-test.serial(`should list datasets`, async t => {
+it('should list datasets', async () => {
   const output = await tools.runAsync(`${cmd} listDatasets`, cwd);
-  t.regex(output, /datasets/);
+  assert.strictEqual(new RegExp(/datasets/).test(output), true);
 });
 
-test.serial(
-  `should de-identify data in a dataset and write to a new dataset`,
-  async t => {
-    const output = await tools.runAsync(
-      `${cmd} deidentifyDataset ${datasetId} ${destinationDatasetId} ${keeplistTags}`,
-      cwd
-    );
-    t.is(
-      output,
-      `De-identified data written from dataset
+it('should de-identify data in a dataset and write to a new dataset', async () => {
+  const output = await tools.runAsync(
+    `${cmd} deidentifyDataset ${datasetId} ${destinationDatasetId} ${keeplistTags}`,
+    cwd
+  );
+  assert.strictEqual(
+    output,
+    `De-identified data written from dataset
             ${datasetId} to dataset ${destinationDatasetId}`
-    );
-  }
-);
+  );
+});
 
-test.serial(`should delete a dataset`, async t => {
+it('should delete a dataset', async () => {
   const output = await tools.runAsync(`${cmd} deleteDataset ${datasetId}`, cwd);
-  t.is(output, `Deleted dataset: ${datasetId}`);
+  assert.strictEqual(output, `Deleted dataset: ${datasetId}`);
 });
diff --git a/healthcare/dicom/package.json b/healthcare/dicom/package.json
index 3d14f46954..c5d4d1d351 100644
--- a/healthcare/dicom/package.json
+++ b/healthcare/dicom/package.json
@@ -9,11 +9,11 @@
     "node": ">=6.0.0"
   },
   "scripts": {
-    "test": "ava -T 1m --verbose system-test/*.test.js"
+    "test": "mocha system-test/*.test.js --timeout=60000"
   },
   "devDependencies": {
     "@google-cloud/nodejs-repo-tools": "^3.0.0",
-    "ava": "^0.25.0"
+    "mocha": "^5.2.0"
   },
   "dependencies": {
     "googleapis": "^37.0.0",
diff --git a/healthcare/dicom/system-test/dicom_stores.test.js b/healthcare/dicom/system-test/dicom_stores.test.js
index c33f459b66..d77808d256 100644
--- a/healthcare/dicom/system-test/dicom_stores.test.js
+++ b/healthcare/dicom/system-test/dicom_stores.test.js
@@ -15,15 +15,15 @@
 
 'use strict';
 
-const path = require(`path`);
-const test = require(`ava`);
-const tools = require(`@google-cloud/nodejs-repo-tools`);
-const uuid = require(`uuid`);
+const path = require('path');
+const assert = require('assert');
+const tools = require('@google-cloud/nodejs-repo-tools');
+const uuid = require('uuid');
 
-const cmdDataset = `node datasets.js`;
-const cmd = `node dicom_stores.js`;
-const cwdDatasets = path.join(__dirname, `../../datasets`);
-const cwd = path.join(__dirname, `..`);
+const cmdDataset = 'node datasets.js';
+const cmd = 'node dicom_stores.js';
+const cwdDatasets = path.join(__dirname, '../../datasets');
+const cwd = path.join(__dirname, '..');
 const datasetId = `nodejs-docs-samples-test-${uuid.v4()}`.replace(/-/gi, '_');
 const dicomStoreId = `nodejs-docs-samples-test-dicom-store${uuid.v4()}`.replace(
   /-/gi,
@@ -35,19 +35,15 @@ const pubsubTopic = `nodejs-docs-samples-test-pubsub${uuid.v4()}`.replace(
 );
 
 const bucketName = process.env.GCLOUD_STORAGE_BUCKET;
+
 const dcmFileName = `IM-0002-0001-JPEG-BASELINE.dcm`;
 const gcsUri = bucketName + '/' + dcmFileName;
 
-test.before(tools.checkCredentials);
-test.before(async () => {
-  return tools
-    .runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets)
-    .then(results => {
-      console.log(results);
-      return results;
-    });
+before(async () => {
+  tools.checkCredentials();
+  await tools.runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets);
 });
-test.after.always(async () => {
+after(async () => {
   try {
     await tools.runAsync(
       `${cmdDataset} deleteDataset ${datasetId}`,
@@ -56,58 +52,67 @@ test.after.always(async () => {
   } catch (err) {} // Ignore error
 });
 
-test.serial(`should create a DICOM store`, async t => {
+it('should create a DICOM store', async () => {
   const output = await tools.runAsync(
     `${cmd} createDicomStore ${datasetId} ${dicomStoreId}`,
     cwd
   );
-  t.regex(output, /Created DICOM store/);
+  assert.strictEqual(new RegExp(/Created DICOM store/).test(output), true);
 });
 
-test.serial(`should get a DICOM store`, async t => {
+it('should get a DICOM store', async () => {
   const output = await tools.runAsync(
     `${cmd} getDicomStore ${datasetId} ${dicomStoreId}`,
     cwd
   );
-  t.regex(output, /Got DICOM store/);
+  assert.strictEqual(new RegExp(/Got DICOM store/).test(output), true);
 });
 
-test.serial(`should patch a DICOM store`, async t => {
+it('should patch a DICOM store', async () => {
   const output = await tools.runAsync(
     `${cmd} patchDicomStore ${datasetId} ${dicomStoreId} ${pubsubTopic}`,
     cwd
   );
-  t.regex(output, /Patched DICOM store with Cloud Pub\/Sub topic/);
+  assert.strictEqual(
+    new RegExp(/Patched DICOM store with Cloud Pub\/Sub topic/).test(output),
+    true
+  );
 });
 
-test.serial(`should list DICOM stores`, async t => {
+it('should list DICOM stores', async () => {
   const output = await tools.runAsync(
     `${cmd} listDicomStores ${datasetId}`,
     cwd
   );
-  t.regex(output, /DICOM stores/);
+  assert.strictEqual(new RegExp(/DICOM stores/).test(output), true);
 });
 
-test.serial(`should export a DICOM instance`, async t => {
+it('should export a DICOM instance', async () => {
   const output = await tools.runAsync(
     `${cmd} exportDicomInstanceGcs ${datasetId} ${dicomStoreId} ${bucketName}`,
     cwd
   );
-  t.regex(output, /Exported DICOM instances to bucket/);
+  assert.strictEqual(
+    new RegExp(/Exported DICOM instances to bucket/).test(output),
+    true
+  );
 });
 
-test.serial(`should import a DICOM object from GCS`, async t => {
+it('should import a DICOM object from GCS', async () => {
   const output = await tools.runAsync(
     `${cmd} importDicomObject ${datasetId} ${dicomStoreId} ${gcsUri}`,
     cwd
   );
-  t.regex(output, /Imported DICOM objects from bucket/);
+  assert.strictEqual(
+    new RegExp(/Imported DICOM objects from bucket/).test(output),
+    true
+  );
 });
 
-test(`should delete a DICOM store`, async t => {
+it('should delete a DICOM store', async () => {
   const output = await tools.runAsync(
     `${cmd} deleteDicomStore ${datasetId} ${dicomStoreId}`,
     cwd
   );
-  t.regex(output, /Deleted DICOM store/);
+  assert.strictEqual(new RegExp(/Deleted DICOM store/).test(output), true);
 });
diff --git a/healthcare/dicom/system-test/dicomweb.test.js b/healthcare/dicom/system-test/dicomweb.test.js
index a12e2528f0..de76a5ebf9 100644
--- a/healthcare/dicom/system-test/dicomweb.test.js
+++ b/healthcare/dicom/system-test/dicomweb.test.js
@@ -15,38 +15,33 @@
 
 'use strict';
 
-const path = require(`path`);
-const test = require(`ava`);
-const tools = require(`@google-cloud/nodejs-repo-tools`);
-const uuid = require(`uuid`);
+const path = require('path');
+const assert = require('assert');
+const tools = require('@google-cloud/nodejs-repo-tools');
+const uuid = require('uuid');
 
-const cmdDataset = `node datasets.js`;
-const cmdDicomStore = `node dicom_stores.js`;
-const cmd = `node dicomweb.js`;
-const cwdDatasets = path.join(__dirname, `../../datasets`);
-const cwd = path.join(__dirname, `..`);
+const cmdDataset = 'node datasets.js';
+const cmdDicomStore = 'node dicom_stores.js';
+const cmd = 'node dicomweb.js';
+const cwdDatasets = path.join(__dirname, '../../datasets');
+const cwd = path.join(__dirname, '..');
 const datasetId = `nodejs-docs-samples-test-${uuid.v4()}`.replace(/-/gi, '_');
 const dicomStoreId = `nodejs-docs-samples-test-dicom-store${uuid.v4()}`.replace(
   /-/gi,
   '_'
 );
 
-const dcmFile = `resources/IM-0002-0001-JPEG-BASELINE-edited.dcm`;
-const boundary = `DICOMwebBoundary`;
+const dcmFile = 'resources/IM-0002-0001-JPEG-BASELINE-edited.dcm';
+const boundary = 'DICOMwebBoundary';
 // The studyUid is not assigned by the server and is part of the metadata
 // of dcmFile.
-const studyUid = `1.2.840.113619.2.176.3596.3364818.7819.1259708454.105`;
+const studyUid = '1.2.840.113619.2.176.3596.3364818.7819.1259708454.105';
 
-test.before(tools.checkCredentials);
-test.before(async () => {
-  return tools
-    .runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets)
-    .then(results => {
-      console.log(results);
-      return results;
-    });
+before(async () => {
+  tools.checkCredentials();
+  await tools.runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets);
 });
-test.after.always(async () => {
+after(async () => {
   try {
     await tools.runAsync(
       `${cmdDataset} deleteDataset ${datasetId}`,
@@ -55,7 +50,7 @@ test.after.always(async () => {
   } catch (err) {} // Ignore error
 });
 
-test.serial(`should store a DICOM instance`, async t => {
+it('should store a DICOM instance', async () => {
   await tools.runAsync(
     `${cmdDicomStore} createDicomStore ${datasetId} ${dicomStoreId}`,
     cwd
@@ -64,31 +59,31 @@ test.serial(`should store a DICOM instance`, async t => {
     `${cmd} dicomWebStoreInstance ${datasetId} ${dicomStoreId} ${dcmFile} ${boundary}`,
     cwd
   );
-  t.regex(output, /Stored instance/);
+  assert.strictEqual(new RegExp(/Stored instance/).test(output), true);
 });
 
-test.serial(`should search DICOM instances`, async t => {
+it('should search DICOM instances', async () => {
   const output = await tools.runAsync(
     `${cmd} dicomWebSearchInstances ${datasetId} ${dicomStoreId}`,
     cwd
   );
-  t.regex(output, /Instances/);
+  assert.strictEqual(new RegExp(/Instances/).test(output), true);
 });
 
-test.serial(`should retrieve a DICOM study`, async t => {
+it('should retrieve a DICOM study', async () => {
   const output = await tools.runAsync(
     `${cmd} dicomWebRetrieveStudy ${datasetId} ${dicomStoreId} ${studyUid}`,
     cwd
   );
-  t.regex(output, /Retrieved study/);
+  assert.strictEqual(new RegExp(/Retrieved study/).test(output), true);
 });
 
-test.serial(`should delete a DICOM study`, async t => {
+it('should delete a DICOM study', async () => {
   const output = await tools.runAsync(
     `${cmd} dicomWebDeleteStudy ${datasetId} ${dicomStoreId} ${studyUid}`,
     cwd
   );
-  t.regex(output, /Deleted study/);
+  assert.strictEqual(new RegExp(/Deleted study/).test(output), true);
 
   // Clean up
   await tools.runAsync(
diff --git a/healthcare/fhir/package.json b/healthcare/fhir/package.json
index 3d14f46954..c5d4d1d351 100644
--- a/healthcare/fhir/package.json
+++ b/healthcare/fhir/package.json
@@ -9,11 +9,11 @@
     "node": ">=6.0.0"
   },
   "scripts": {
-    "test": "ava -T 1m --verbose system-test/*.test.js"
+    "test": "mocha system-test/*.test.js --timeout=60000"
   },
   "devDependencies": {
     "@google-cloud/nodejs-repo-tools": "^3.0.0",
-    "ava": "^0.25.0"
+    "mocha": "^5.2.0"
   },
   "dependencies": {
     "googleapis": "^37.0.0",
diff --git a/healthcare/fhir/system-test/fhir_resources.test.js b/healthcare/fhir/system-test/fhir_resources.test.js
index 216ed48699..5808fb6a25 100644
--- a/healthcare/fhir/system-test/fhir_resources.test.js
+++ b/healthcare/fhir/system-test/fhir_resources.test.js
@@ -15,16 +15,16 @@
 
 'use strict';
 
-const path = require(`path`);
-const test = require(`ava`);
-const tools = require(`@google-cloud/nodejs-repo-tools`);
-const uuid = require(`uuid`);
+const path = require('path');
+const assert = require('assert');
+const tools = require('@google-cloud/nodejs-repo-tools');
+const uuid = require('uuid');
 
-const cmdDataset = `node datasets.js`;
-const cmdFhirStores = `node fhir_stores.js`;
+const cmdDataset = 'node datasets.js';
+const cmdFhirStores = 'node fhir_stores.js';
 const cmd = 'node fhir_resources.js';
 const cwd = path.join(__dirname, '..');
-const cwdDatasets = path.join(__dirname, `../../datasets`);
+const cwdDatasets = path.join(__dirname, '../../datasets');
 const datasetId = `nodejs-docs-samples-test-${uuid.v4()}`.replace(/-/gi, '_');
 const fhirStoreId = `nodejs-docs-samples-test-fhir-store${uuid.v4()}`.replace(
   /-/gi,
@@ -33,16 +33,11 @@ const fhirStoreId = `nodejs-docs-samples-test-fhir-store${uuid.v4()}`.replace(
 const resourceType = 'Patient';
 let resourceId;
 
-test.before(tools.checkCredentials);
-test.before(async () => {
-  return tools
-    .runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets)
-    .then(results => {
-      console.log(results);
-      return results;
-    });
+before(async () => {
+  tools.checkCredentials();
+  await tools.runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets);
 });
-test.after.always(async () => {
+after(async () => {
   try {
     await tools.runAsync(
       `${cmdDataset} deleteDataset ${datasetId}`,
@@ -51,7 +46,7 @@ test.after.always(async () => {
   } catch (err) {} // Ignore error
 });
 
-test.serial(`should create a FHIR resource`, async t => {
+it('should create a FHIR resource', async () => {
   await tools.runAsync(
     `${cmdFhirStores} createFhirStore ${datasetId} ${fhirStoreId}`,
     cwd
@@ -63,40 +58,43 @@ test.serial(`should create a FHIR resource`, async t => {
   const createdMessage = new RegExp(
     `Created resource ${resourceType} with ID (.*).`
   );
-  t.regex(output, createdMessage);
+  assert.strictEqual(createdMessage.test(output), true);
   resourceId = createdMessage.exec(output)[1];
 });
 
-test.serial(`should get a FHIR resource`, async t => {
+it('should get a FHIR resource', async () => {
   const output = await tools.runAsync(
     `${cmd} getResource ${datasetId} ${fhirStoreId} ${resourceType} ${resourceId}`,
     cwd
   );
-  t.regex(output, new RegExp(`Got ${resourceType} resource`));
+  assert.strictEqual(
+    new RegExp(`Got ${resourceType} resource`).test(output),
+    true
+  );
 });
 
-test.serial(`should update a FHIR resource`, async t => {
+it('should update a FHIR resource', async () => {
   const output = await tools.runAsync(
     `${cmd} updateResource ${datasetId} ${fhirStoreId} ${resourceType} ${resourceId}`,
     cwd
   );
-  t.is(output, `Updated ${resourceType} with ID ${resourceId}`);
+  assert.strictEqual(output, `Updated ${resourceType} with ID ${resourceId}`);
 });
 
-test.serial(`should patch a FHIR resource`, async t => {
+it('should patch a FHIR resource', async () => {
   const output = await tools.runAsync(
     `${cmd} patchResource ${datasetId} ${fhirStoreId} ${resourceType} ${resourceId}`,
     cwd
   );
-  t.is(output, `Patched ${resourceType} with ID ${resourceId}`);
+  assert.strictEqual(output, `Patched ${resourceType} with ID ${resourceId}`);
 });
 
-test.serial(`should delete a FHIR resource`, async t => {
+it('should delete a FHIR resource', async () => {
   const output = await tools.runAsync(
     `${cmd} deleteResource ${datasetId} ${fhirStoreId} ${resourceType} ${resourceId}`,
     cwd
   );
-  t.is(output, `Deleted ${resourceType} with ID ${resourceId}.`);
+  assert.strictEqual(output, `Deleted ${resourceType} with ID ${resourceId}.`);
 
   // Clean up
   await tools.runAsync(
diff --git a/healthcare/fhir/system-test/fhir_stores.test.js b/healthcare/fhir/system-test/fhir_stores.test.js
index 54f00b0cc6..dc63ce3aca 100644
--- a/healthcare/fhir/system-test/fhir_stores.test.js
+++ b/healthcare/fhir/system-test/fhir_stores.test.js
@@ -15,15 +15,15 @@
 
 'use strict';
 
-const path = require(`path`);
-const test = require(`ava`);
-const tools = require(`@google-cloud/nodejs-repo-tools`);
-const uuid = require(`uuid`);
+const path = require('path');
+const assert = require('assert');
+const tools = require('@google-cloud/nodejs-repo-tools');
+const uuid = require('uuid');
 
-const cmdDataset = `node datasets.js`;
-const cmd = `node fhir_stores.js`;
-const cwdDatasets = path.join(__dirname, `../../datasets`);
-const cwd = path.join(__dirname, `..`);
+const cmdDataset = 'node datasets.js';
+const cmd = 'node fhir_stores.js';
+const cwdDatasets = path.join(__dirname, '../../datasets');
+const cwd = path.join(__dirname, '..');
 const datasetId = `nodejs-docs-samples-test-${uuid.v4()}`.replace(/-/gi, '_');
 const fhirStoreId = `nodejs-docs-samples-test-fhir-store${uuid.v4()}`.replace(
   /-/gi,
@@ -34,16 +34,11 @@ const pubsubTopic = `nodejs-docs-samples-test-pubsub${uuid.v4()}`.replace(
   '_'
 );
 
-test.before(tools.checkCredentials);
-test.before(async () => {
-  return tools
-    .runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets)
-    .then(results => {
-      console.log(results);
-      return results;
-    });
+before(async () => {
+  tools.checkCredentials();
+  await tools.runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets);
 });
-test.after.always(async () => {
+after(async () => {
   try {
     await tools.runAsync(
       `${cmdDataset} deleteDataset ${datasetId}`,
@@ -52,50 +47,53 @@ test.after.always(async () => {
   } catch (err) {} // Ignore error
 });
 
-test.serial(`should create a FHIR store`, async t => {
+it('should create a FHIR store', async () => {
   const output = await tools.runAsync(
     `${cmd} createFhirStore ${datasetId} ${fhirStoreId}`,
     cwd
   );
-  t.regex(output, /Created FHIR store/);
+  assert.strictEqual(new RegExp(/Created FHIR store/).test(output), true);
 });
 
-test.serial(`should get a FHIR store`, async t => {
+it('should get a FHIR store', async () => {
   const output = await tools.runAsync(
     `${cmd} getFhirStore ${datasetId} ${fhirStoreId}`,
     cwd
   );
-  t.regex(output, /Got FHIR store/);
+  assert.strictEqual(new RegExp(/Got FHIR store/).test(output), true);
 });
 
-test.serial(`should list FHIR stores`, async t => {
+it('should list FHIR stores', async () => {
   const output = await tools.runAsync(
     `${cmd} listFhirStores ${datasetId}`,
     cwd
   );
-  t.regex(output, /FHIR stores/);
+  assert.strictEqual(new RegExp(/FHIR stores/).test(output), true);
 });
 
-test.serial(`should patch a FHIR store`, async t => {
+it('should patch a FHIR store', async () => {
   const output = await tools.runAsync(
     `${cmd} patchFhirStore ${datasetId} ${fhirStoreId} ${pubsubTopic}`,
     cwd
   );
-  t.regex(output, /Patched FHIR store/);
+  assert.strictEqual(new RegExp(/Patched FHIR store/).test(output), true);
 });
 
-test.serial(`should get FHIR store metadata`, async t => {
+it('should get FHIR store metadata', async () => {
   const output = await tools.runAsync(
     `${cmd} getMetadata ${datasetId} ${fhirStoreId}`,
     cwd
   );
-  t.regex(output, /Capabilities statement for FHIR store/);
+  assert.strictEqual(
+    new RegExp(/Capabilities statement for FHIR store/).test(output),
+    true
+  );
 });
 
-test(`should delete a FHIR store`, async t => {
+it('should delete a FHIR store', async () => {
   const output = await tools.runAsync(
     `${cmd} deleteFhirStore ${datasetId} ${fhirStoreId}`,
     cwd
   );
-  t.regex(output, /Deleted FHIR store/);
+  assert.strictEqual(new RegExp(/Deleted FHIR store/).test(output), true);
 });
diff --git a/healthcare/hl7v2/package.json b/healthcare/hl7v2/package.json
index 5c29cb9add..a360df018c 100644
--- a/healthcare/hl7v2/package.json
+++ b/healthcare/hl7v2/package.json
@@ -9,11 +9,11 @@
     "node": ">=6.0.0"
   },
   "scripts": {
-    "test": "ava -T 1m --verbose system-test/*.test.js"
+    "test": "mocha system-test/*.test.js --timeout=60000"
   },
   "devDependencies": {
     "@google-cloud/nodejs-repo-tools": "^3.0.0",
-    "ava": "^0.25.0"
+    "mocha": "^5.2.0"
   },
   "dependencies": {
     "googleapis": "^37.0.0",
diff --git a/healthcare/hl7v2/system-test/hl7v2_messages.test.js b/healthcare/hl7v2/system-test/hl7v2_messages.test.js
index 901a87aea9..928c23f255 100644
--- a/healthcare/hl7v2/system-test/hl7v2_messages.test.js
+++ b/healthcare/hl7v2/system-test/hl7v2_messages.test.js
@@ -15,37 +15,32 @@
 
 'use strict';
 
-const path = require(`path`);
-const test = require(`ava`);
-const tools = require(`@google-cloud/nodejs-repo-tools`);
-const uuid = require(`uuid`);
+const path = require('path');
+const assert = require('assert');
+const tools = require('@google-cloud/nodejs-repo-tools');
+const uuid = require('uuid');
 
-const cmdDataset = `node datasets.js`;
-const cmd = `node hl7v2_messages.js`;
-const cmdHl7v2Store = `node hl7v2_stores.js`;
-const cwdDatasets = path.join(__dirname, `../../datasets`);
-const cwd = path.join(__dirname, `..`);
+const cmdDataset = 'node datasets.js';
+const cmd = 'node hl7v2_messages.js';
+const cmdHl7v2Store = 'node hl7v2_stores.js';
+const cwdDatasets = path.join(__dirname, '../../datasets');
+const cwd = path.join(__dirname, '..');
 const datasetId = `nodejs-docs-samples-test-${uuid.v4()}`.replace(/-/gi, '_');
 const hl7v2StoreId = `nodejs-docs-samples-test-hl7v2-store${uuid.v4()}`.replace(
   /-/gi,
   '_'
 );
 
-const messageFile = `resources/hl7v2-sample-ingest.json`;
-const messageId = `2yqbdhYHlk_ucSmWkcKOVm_N0p0OpBXgIlVG18rB-cw=`;
-const labelKey = `my-key`;
-const labelValue = `my-value`;
+const messageFile = 'resources/hl7v2-sample-ingest.json';
+const messageId = '2yqbdhYHlk_ucSmWkcKOVm_N0p0OpBXgIlVG18rB-cw=';
+const labelKey = 'my-key';
+const labelValue = 'my-value';
 
-test.before(tools.checkCredentials);
-test.before(async () => {
-  return tools
-    .runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets)
-    .then(results => {
-      console.log(results);
-      return results;
-    });
+before(async () => {
+  tools.checkCredentials();
+  await tools.runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets);
 });
-test.after.always(async () => {
+after(async () => {
   try {
     await tools.runAsync(
       `${cmdDataset} deleteDataset ${datasetId}`,
@@ -54,7 +49,7 @@ test.after.always(async () => {
   } catch (err) {} // Ignore error
 });
 
-test.serial(`should create an HL7v2 message`, async t => {
+it('should create an HL7v2 message', async () => {
   await tools.runAsync(
     `${cmdHl7v2Store} createHl7v2Store ${datasetId} ${hl7v2StoreId}`,
     cwd
@@ -63,47 +58,47 @@ test.serial(`should create an HL7v2 message`, async t => {
     `${cmd} createHl7v2Message ${datasetId} ${hl7v2StoreId} ${messageFile}`,
     cwd
   );
-  t.regex(output, /Created HL7v2 message/);
+  assert.strictEqual(new RegExp(/Created HL7v2 message/).test(output), true);
 });
 
-test.serial(`should ingest an HL7v2 message`, async t => {
+it('should ingest an HL7v2 message', async () => {
   const output = await tools.runAsync(
     `${cmd} ingestHl7v2Message ${datasetId} ${hl7v2StoreId} ${messageFile}`,
     cwd
   );
-  t.regex(output, /Ingested HL7v2 message/);
+  assert.strictEqual(new RegExp(/Ingested HL7v2 message/).test(output), true);
 });
 
-test.serial(`should get an HL7v2 message`, async t => {
+it('should get an HL7v2 message', async () => {
   const output = await tools.runAsync(
     `${cmd} getHl7v2Message ${datasetId} ${hl7v2StoreId} ${messageId}`,
     cwd
   );
-  t.regex(output, /Got HL7v2 message/);
+  assert.strictEqual(new RegExp(/Got HL7v2 message/).test(output), true);
 });
 
-test.serial(`should list HL7v2 messages`, async t => {
+it('should list HL7v2 messages', async () => {
   const output = await tools.runAsync(
     `${cmd} listHl7v2Messages ${datasetId} ${hl7v2StoreId}`,
     cwd
   );
-  t.regex(output, /HL7v2 messages/);
+  assert.strictEqual(new RegExp(/HL7v2 messages/).test(output), true);
 });
 
-test.serial(`should patch an HL7v2 message`, async t => {
+it('should patch an HL7v2 message', async () => {
   const output = await tools.runAsync(
     `${cmd} patchHl7v2Message ${datasetId} ${hl7v2StoreId} ${messageId} ${labelKey} ${labelValue}`,
     cwd
   );
-  t.regex(output, /Patched HL7v2 message/);
+  assert.strictEqual(new RegExp(/Patched HL7v2 message/).test(output), true);
 });
 
-test(`should delete an HL7v2 message`, async t => {
+it('should delete an HL7v2 message', async () => {
   const output = await tools.runAsync(
     `${cmd} deleteHl7v2Message ${datasetId} ${hl7v2StoreId} ${messageId}`,
     cwd
   );
-  t.regex(output, /Deleted HL7v2 message/);
+  assert.strictEqual(new RegExp(/Deleted HL7v2 message/).test(output), true);
 
   // Clean up
   tools.runAsync(
diff --git a/healthcare/hl7v2/system-test/hl7v2_stores.test.js b/healthcare/hl7v2/system-test/hl7v2_stores.test.js
index 9aef63ca27..bacfc0fe5a 100644
--- a/healthcare/hl7v2/system-test/hl7v2_stores.test.js
+++ b/healthcare/hl7v2/system-test/hl7v2_stores.test.js
@@ -15,15 +15,15 @@
 
 'use strict';
 
-const path = require(`path`);
-const test = require(`ava`);
-const tools = require(`@google-cloud/nodejs-repo-tools`);
-const uuid = require(`uuid`);
+const path = require('path');
+const assert = require('assert');
+const tools = require('@google-cloud/nodejs-repo-tools');
+const uuid = require('uuid');
 
-const cmdDataset = `node datasets.js`;
-const cmd = `node hl7v2_stores.js`;
-const cwdDatasets = path.join(__dirname, `../../datasets`);
-const cwd = path.join(__dirname, `..`);
+const cmdDataset = 'node datasets.js';
+const cmd = 'node hl7v2_stores.js';
+const cwdDatasets = path.join(__dirname, '../../datasets');
+const cwd = path.join(__dirname, '..');
 const datasetId = `nodejs-docs-samples-test-${uuid.v4()}`.replace(/-/gi, '_');
 const hl7v2StoreId = `nodejs-docs-samples-test-hl7v2-store${uuid.v4()}`.replace(
   /-/gi,
@@ -34,16 +34,11 @@ const pubsubTopic = `nodejs-docs-samples-test-pubsub${uuid.v4()}`.replace(
   '_'
 );
 
-test.before(tools.checkCredentials);
-test.before(async () => {
-  return tools
-    .runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets)
-    .then(results => {
-      console.log(results);
-      return results;
-    });
+before(async () => {
+  tools.checkCredentials();
+  await tools.runAsync(`${cmdDataset} createDataset ${datasetId}`, cwdDatasets);
 });
-test.after.always(async () => {
+after(async () => {
   try {
     await tools.runAsync(
       `${cmdDataset} deleteDataset ${datasetId}`,
@@ -52,42 +47,45 @@ test.after.always(async () => {
   } catch (err) {} // Ignore error
 });
 
-test.serial(`should create an HL7v2 store`, async t => {
+it('should create an HL7v2 store', async () => {
   const output = await tools.runAsync(
     `${cmd} createHl7v2Store ${datasetId} ${hl7v2StoreId}`,
     cwd
   );
-  t.regex(output, /Created HL7v2 store/);
+  assert.strictEqual(new RegExp(/Created HL7v2 store/).test(output), true);
 });
 
-test.serial(`should get an HL7v2 store`, async t => {
+it('should get an HL7v2 store', async () => {
   const output = await tools.runAsync(
     `${cmd} getHl7v2Store ${datasetId} ${hl7v2StoreId}`,
     cwd
   );
-  t.regex(output, /Got HL7v2 store/);
+  assert.strictEqual(new RegExp(/Got HL7v2 store/).test(output), true);
 });
 
-test.serial(`should patch an HL7v2 store`, async t => {
+it('should patch an HL7v2 store', async () => {
   const output = await tools.runAsync(
     `${cmd} patchHl7v2Store ${datasetId} ${hl7v2StoreId} ${pubsubTopic}`,
     cwd
   );
-  t.regex(output, /Patched HL7v2 store with Cloud Pub\/Sub topic/);
+  assert.strictEqual(
+    new RegExp(/Patched HL7v2 store with Cloud Pub\/Sub topic/).test(output),
+    true
+  );
 });
 
-test.serial(`should list HL7v2 stores`, async t => {
+it('should list HL7v2 stores', async () => {
   const output = await tools.runAsync(
     `${cmd} listHl7v2Stores ${datasetId}`,
     cwd
   );
-  t.regex(output, /HL7v2 stores/);
+  assert.strictEqual(new RegExp(/HL7v2 stores/).test(output), true);
 });
 
-test(`should delete an HL7v2 Store`, async t => {
+it('should delete an HL7v2 Store', async () => {
   const output = await tools.runAsync(
     `${cmd} deleteHl7v2Store ${datasetId} ${hl7v2StoreId}`,
     cwd
   );
-  t.regex(output, /Deleted HL7v2 store/);
+  assert.strictEqual(new RegExp(/Deleted HL7v2 store/).test(output), true);
 });