February 21, 2024

Healthcare Application Testing – Its Condition is Critical

by Tamara Pomerantz

The challenges faced by health systems and providers are more pronounced than ever.

New technologies, operational hurdles, burnout concerns, and other complexities are driving a significant increase in IT spending.  

According to a September 2023 KLAS Research study, 80% of healthcare providers moderately to significantly increased their IT spending over the past year and will continue to do so.

A survey published in 2024 by Sage Growth Partners showed only 17% of healthcare executives strongly believe their existing EHR will meet future needs; and over 60% identified EHR optimization as the top technology initiative for the year. 

A “foundational back-to-basics” focus is a common optimization approach for “future proofing” with organization’s listing the following strategies:

  • Utilizing knowledge analyzers and increasing data analytics to drive better clinical decision-making.
  • Reviewing workflows to improve patient throughput and increasing interoperability with seamless applications (multiple systems and devices fluently working together) for better care coordination.
  • Investing in infrastructure to ensure fast, reliable, and secure system performance.

However, a foundational back-to-basics and interoperable strategy that can be attained and sustained must include rigorous application and workflow testing processes.

The effectiveness of technology investments hinges upon the organization’s testing practices.  Failure to adequately test user workflow processes and integration leads to undesired outcomes and undermines realization of intended benefits.  

Without a robust testing framework, the full potential of these investments may remain unrealized, posing challenges to overall system performance and the achievement of operational and technical optimization.

Organizations must emphasize testing processes to ensure their investments deliver high-quality, efficient, and streamlined healthcare workflows that add tangible value.

Can you rely on your application testing?

Despite the critical role healthcare software plays in ensuring quality of care, reducing burnout, and maximizing financial returns, health system testing practices are often lax, inconsistent, and inadequately documented. 

A February 2023 HIMSS report revealed only 6% of US healthcare providers believe their organization’s healthcare software testing is sufficient.

Every clinical and business workflow necessitates thorough testing, especially when undergoing changes or adjustments.  Testing needs to ensure the new change works as intended without causing harm to other functions, systems, or workflow processes.  

Vendors often do not evaluate technical functionality based on a healthcare organization’s unique workflows and processes that require many role, system, and department handoffs.  Health systems must do this on their own or face patient safety risks, operational disruption, regulatory non-compliance, or financial repercussions due to software design and build issues. 

Even when the software functions as intended by vendors, a poorly localized design disconnected from the end user workflow can create significant problems and make the software unusable. 

As providers lean more and more on technology for care interventions and alerts, the demand for integrated and interoperable digital systems grows, and resource scarcity increases, the requirements for efficient but simple application testing also increases.  

The reliance on disparate tools and spreadsheets for testing, though common, is inefficient and lacks the scalability required to keep pace with the evolving landscape of healthcare  technology and user workflows to ensure proper testing is completed.

Why is it so hard?

Several challenges contribute to the inadequacy of current testing practices.

  • High Maintenance Effort:  Inefficient tools lead to a substantial maintenance effort to keep test scripts accurate and up to date.
  • Evolving Requirements:  Frequent changes in functionality, interoperability demands, useability requirements, and regulatory compliance create a strain on resources.
  • Resource Turn-over:  Staff turnover and knowledge loss make it difficult to comprehend and document the intricacies of multi-system functionality, interoperability, compliance requirements, necessary for effective role and workflow-based test script development and testing.
  • Fast-Paced Technological Growth:  The rapid pace of technology growth and complexity reduces the time available and impacts the ability to prioritize effective testing amidst code releases, upgrades, daily support, and project implementation efforts.
  • Unplanned Demand for Limited Resources:  Unanticipated or properly planned demands for limited resources (time, money, and people) necessitates cutting corners, reducing testing time, and compromising thoroughness.
  • Lack of Tools:  Inadequate testing tools hinder the efficient documentation and analysis of test round information necessary to enhance future testing scripts and processes.
  • Selecting the Right Tools: The complexity of healthcare scenarios, interoperable systems and devices, multiple user handoffs with parallel processes limits the effective utilization of auto-validation software.  A trap many fall into when evaluating ways to improve their testing process.

What you can do

Counter these challenges with a tool that automates your testing processes. Features should support the organizations ease and ability to:

  • Document a testing strategy outlining testing expectations for any project or change.  The enterprise strategy should include defined testing types and criteria for when they should be applied, role and responsibilities, and documentation requirements. 
  • Provide cross-platform, vendor agnostic testing that enables testing coordination across the organization’s portfolio of projects as well as supports system interoperability - providing consistency and reliability in process and quality regardless of which vendors, applications, devices and workflows are involved.
  • Ensure scalability so testing practices are easily applied to small and large changes.
  • Develop a comprehensive test script library that can be easily re-used, maintained, and quickly tailored for specific workflows and scenarios.
  • Generate detailed workflow-based test scripts from process maps and diagrams supporting the proactive identification of workflow and handoff issues as well as facilitate development of training materials.
  • Establish testing management for planning and organizing test rounds, including resource identification and scheduling.  Avoid testing delays due to insufficient resource coverage for test script development and test execution.
  • Automate notifications to testers, issue owners, and anyone assigned a task ensuring real time awareness and updates.
  • Ensure universal real-time tracking of testing progress, status, and issues; alerting coordinators and testers of how much time they have before they are up, when things are falling behind, and when they are done for the day. 
  • Integrate issue logging within test scripts so testers do not need to leave the test script to document issues, and important information regarding where, when, and how the issue occurred is automatically captured directly from testing details.
  • Apply real-time analytics to manage test rounds, with immediate feedback to maintain timelines and inform testing plans and strategy.

A Success Story 

Nicklaus Children’s Health System faced a common issue: while they acknowledged the importance of application testing, they were encountering several challenges:

  • Inaccuracies and inefficiencies were being seen because test scripts were not in a standard format and located in a centralized place.
  • Management and tracking of testing events and activities were inconsistent and uncoordinated, increasing costs and time.
  • Resources were overwhelmed with project tasks and other responsibilities with no time to write and maintain test scripts - scripts were often not ready or correct, leading to project delays.
  • Remotely run testing was difficult to manage; status tracking and testing handoffs were hard to coordinate for timely completion of test scripts.

They needed a tool that could facilitate remote testing and improve their ability to develop and maintain complex integration testing scripts.  It also needed to be something their analysts and testers could easily learn and use to save time and increase efficiency.

The organization chose to implement MAKE Solutions’ TransIT tool to address their testing needs and goals. They complemented this with MAKE’s Testing as a Service (TaaS) to further alleviate the resource burden and enhance the quality of their testing process.

Their approach involved three key steps:

  1. Adopting TransIT to better manage testing rounds, integrate issue logging, and improve real-time status tracking.
  2. Leveraging TransIT’s modular and AI capabilities to develop and refine functional and integration test scripts, creating a centralized library of high-quality scripts adaptable to technological and workflow changes.
  3. Engaging MAKE’s Testing as a Service (TaaS) team to expand improvement and creation of test scripts across all system applications as part of the continuous operational lifecycle.

The results were immediate.  The organization saw increased Accuracy and Tracking and  decreased Time and Effort.  The testing process became more Accessible, Organized, and Faster.

TransIT’s step-by-step test scripts highlighted missed handoffs and processes.  This early identification as part of a project’s test script development process improved the design prior to go-live, avoiding costly delays and creating a better end user experience.

Increased Accuracy and Tracking

  • Improved universal library of standard test scripts
  • Advanced project task tracking – from planning to workflow development, script preparation, resource allocation, and backloading and cutover processes
  • Dedicated Testing Coordination

Decreased Time and Effort

  • Virtual elimination of time spent writing and correcting test scripts
  • Reduced time spent logging and tracking testing issues
  • Decreased project delays from testing activities
  • Elimination of unproductive time spent by testing resources waiting around

Accessible and Organized

  • A centralized, accessible cloud-based location for all testing related materials, activities, and compliance
  • Improved daily Testing start and completion times
  • Integrated notes capture for easy script adjustments
  • Adoption of consistent processes and practices

Prior to TransIT we would spend 2 to 3 weeks, upwards of 800 hours across multiple resources, reviewing and updating test scripts as part of a major upgrade or implementation project.

Now that we have TransIT, testing and maintenance practices are part of our continuous operational lifecycle, virtually eliminating this intensive time demand on our resources.

TransIT makes it easy to stay current, include new functionality, implement repeatable plans and practices, and communicate.

- David Miller, Nicklaus Children's Health System

Faster Testing

  • Enhanced scheduling and alerting through auto-notifications
  • Reduced time spent identifying and communicating where and how issues occurred with integrated issue logging and tracking
  • Improved accuracy with real time status reporting

Discover more success stories and case studies from organizations just like yours on our website.

It’s time to upgrade your testing strategy

MAKE’s TransIT tool automates and streamlines test script development, maintenance, and execution.  With features supporting auto-generation of scripts from workflow diagrams, planning and documentation, resource scheduling, automated notifications, reporting, and integrated issue management and reporting, TransIT will lower your testing costs and provide significant labor savings. 

Visit MAKE Solutions today to proactively identify and resolve gaps in provider workflows and  further your application testing, efficiency, and consistency.  Discover more about TransIT and explore the Testing ROI Calculator to evaluate your current costs and see the substantial savings your organization can quickly achieve.

For further operational excellence insights, review our other articles on our website under Assets-Insights and access our Resource Center for organizational discovery and assessment tools.

Contact Tamara Pomerantz, VP Client Operations at Tamara.Pomerantz@makesolutionsinc.com for more information.

References

Hammond, R and Bullough, R. 2023 Healthcare Provider IT Report: Doubling Down on Innovation.  KLAS Research.      15 September 2023.

HIMSS Report. Vital Signs Key Trends and Projections for Software Testing in Healthcare.  Keysight.  3123-1379.EN. 2 June 2023.

D’Orazio, D, Kovalick, S, and Hatter, K. The New Healthcare C-Suite Agenda.  Sage Growth Partners.  17 January 2024.

Dyrda, L. Health system CEOs' Tech Wishlist. Becker’s Health.  19 December 2023.

Diaz, N. How CIOs are 'future proofing' their EHRs.  Becker’s Health.  25 January 2024.

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Tamara Pomerantz

About the author

Tamara Pomerantz has spent her career as a trusted advisor to healthcare organizations across the country. Over her 25 years in the industry, Tamara has proven herself to be an experienced leader, mixing innovative solutions with industry best-practices to create change and deliver results. She specializes in Operational Excellence to develop strategic and operational goals, installing process and data-driven performance metrics, motivating operational change, and providing consulting services.

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