In healthcare, the seamless integration of new technologies and workflows into existing processes isn’t just a technical requirement — it’s a matter of patient safety and organizational survival.
Disruptions caused by poor integration can lead to compromised care, costly billing errors, and significant operational inefficiencies. Despite this, a February 2023 HIMSS report sponsored by KeySight found that only 6% of U.S. healthcare providers are confident in their software testing processes. This alarming statistic underscores the significant operational risks many healthcare organizations face.
The Challenge is Clear
Developing and maintaining integration test scripts is a complex task. If not handled properly, it can lead to inefficiencies, system failures, patient safety risks, and increased operational costs. However, by following a few strategic steps and using the right tools, your organization can create and manage integration test scripts that not only ensure system integrity but also enhance overall operational efficiency.
What is Integration Testing and Why is it Important?
Integration testing is the process of executing pre-determined scenarios to confirm user workflows, software applications, and devices work together seamlessly. Unlike unit testing, which focuses on individual components, integration testing ensures combined systems and processes work together cohesively. By crossing roles, departments, applications, technologies, and systems to validate end-to-end process workflows you ensure there are no adverse effects from the changes and avoid disruptions.
This testing is crucial because even minor updates can have ripple effects across departments, roles, applications, and technologies. For instance, altering clinical documentation might impact charge capture and patient billing, leading to costly errors if these integrated workflows aren’t thoroughly tested together. This is especially critical in healthcare, where dynamic workflows and frequent changes due to software updates, regulatory shifts, and advancements in science and technology are common (Healthcare Application Testing – Its Condition is Critical).
As discussed in “Protect your Organization with the 4 Pillars of Quality Testing”, properly created and maintained integration test scripts are invaluable corporate assets. Without proper maintenance, however, these scripts become outdated project artifacts, leading to inefficiencies and errors when they are eventually needed.
6 Steps to Creating Great Integration Test Scripts
To help your organization develop integration test scripts that stand the test of time, follow these six essential steps:
1. Determine Which Scenarios to Incorporate
Start by identifying the most critical scenarios to include in your integration testing. For patient care systems, focus on the highest volume discharge diagnoses and the highest revenue-generating procedures. By combining these two groups, you know that the most important workflows are covered while maximizing value and minimizing work effort with the fewest test scripts.
When dealing with workflows not directly related to patient care, focus on identifying areas with the highest volume or user impact to determine scenarios for integration testing.
2. Script the Story of Each Scenario
Once you’ve identified which scenarios to test, clarify the key workflows and functions for each one. Engage subject matter experts (SMEs) from relevant departments, along with informaticists, business analysts, and application analysts to gather the necessary details to script the story.
Your scripts should include the demographics, roles involved, entry points, hand-offs, actions taken, and expected outcomes. To make this process easier, consider using a tool like MAKE’s TransIT to organize the information systematically.
3. Ensure All Major Workflows are Incorporated
Do you have a list of all major workflows for each department in your organization? If not, now is the time to create one. This list should include major workflows and key application functions and technologies from all clinical and business departments, as well as patient and consumer points of entry and engagement.
Once the scenarios are scripted, cross-reference them with your list. Document which scenario scripts cover each workflow and application function. This tracking ensures comprehensive coverage and allows for easy verification all workflows are covered. MAKE’s TransIT Plans and TransIT Testing features can help maintain an up-to-date checklist of all your major workflows and functions.
If there are items on the list that are not included determine if you can easily incorporate them into one of the existing scenario scripts. If not, you may need to create an additional script. However, avoid making scripts overly complex; sometimes, creating a separate scenario is more efficient than complicating existing ones.
4. Add the Details
With your scenarios and workflows in place, it’s time to fill in the details. For test scripts to be a valuable corporate asset they must include step-by-step action documentation and the expected outcomes. Without these details, it’s impossible to guarantee consistent execution or desired outcomes each time the scripts are run.
Detailed scripts also allow individuals unfamiliar with the workflows and little to no training of the technology to execute the scripts, increasing end-user participation and establishing user acceptance before training and go-live. Additionally, these details facilitate the creation of better end-user training materials.
5. Conduct a "Dry Run"
Before full-scale testing, conduct a “dry run” with your integration test scripts. These scripts will contain hundreds, if not thousands, of steps, so it’s crucial to minimize errors beforehand. Have the informaticists, business analysts and application analysts who configured the technologies run through the integration test scripts prior to the first round of integration testing with end users.
This process helps identify and correct mistakes early, ensuring smoother testing and greater confidence in the process.
6. Maintain the Integration Test Scripts
Each time test scripts are run, a mechanism should be in place for testers to report script errors and needed changes, just like they do when they encounter workflow or technical issues. Correcting these mistakes before the next use of the script will save time and maintain confidence in the testing process. Repeated script errors can erode trust and extend testing timelines. MAKE’s TransIT Testing allows you to easily report requested script changes and efficiently update the test scripts.
Ensure Your Scripts Remain a Corporate Asset
Too often, healthcare organizations view testing only as a project implementation activity. Once the project is complete, the integration test scripts are shelved until the next major upgrade or project, leading to a scramble to update the scripts, delaying the project timeline.
Instead, organizations should treat testing and test script maintenance as an ongoing operational process. Use the test scripts consistently as workflows change to keep them current and ensure all changes are validated. MAKE’s TransIT case study on Nicklaus Children’s Health System demonstrates the benefits of this by establishing mechanisms that help call out when there are any changes to current state workflows, as well as when new systems, devices, or software upgrades occur.
Maintaining updated test scripts is not just about avoiding costly delays and managing resource demands – it’s also about ensuring patient safety, maintaining compliance with regulations, and protecting your organization from disruptions and failures. Well-maintained integration test scripts that reflect real-world workflows lead to smoother go-lives, greater adoption of changes, and a more resilient organization (“The Importance of End-User Involvement in Workflow Testing” and “Avoiding a Global Outage Through Workflow Testing: The TransIT Advantage”).
How MAKE Solutions can help
MAKE’s TransIT tool and Testing as a Service (TaaS) are designed to support the unique challenges of complex end user workflow and technology integration testing.
With TransIT you can automate and streamline test script development, maintenance, and execution.
Features like auto-generation of scripts from workflow diagrams, planning and resource scheduling, automated notifications, and integrated issue management and reporting, TransIT will save you time, lower testing costs, and provide significant labor savings.
TransIT is your comprehensive solution for quality healthcare workflow and application testing. Visit MAKE Solutions and explore the Testing ROI Calculator to see the substantial savings your organization can quickly achieve.
For further operational excellence insights, review our other articles under Assets-Insights on our website and access our Resource Center for organizational discovery and assessment tools.
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