Testing, Testing and More Testing

An electronic health record is a very complicated beast.  Not only complicated in it’s own right, but doubly complicated due to interfaces with many other products.  Installation of new software involves multiple rounds of testing to make sure the software will function as desired. In the early phases, the testing is only as robust as the technicians and analysts doing the testing.  With experience, repetitive testing can follow a standard script.

Once the software is installed, testing must occur every time there is a change in software settings or an upgrade to the software program. Though vendors perform a series of tests prior to a release, there is never software without bugs.  The vendor can not test how you have deployed their product. Your testing needs to find where the product is no longer functioning as it did previously.  You have a certain element of control over the timing of testing when vendors send you new releases to install on your servers. You have no control over timing if your software is hosted by the vendor and updated on their schedule not yours.

Today’s electronic health record is typically a summation of data gathered through multiple interfaces to products provided by a multitude of vendors.  Whenever any of the associated programs is updated, additional testing is necessary to ensure the integrity of the entire system.

Testing requirements quickly mount since the complexity of the system increase by the square of the number of elements involved. For example, if the number of connections doubles, the complexity of the system increases by a factor of four. Complexity increases the chance a small change in how a program operates, will have significant downstream effects.

As your  EHR  becomes more complex, you reach a point where automated testing scripts makes sense.

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3 Responses to “Testing, Testing and More Testing”

  1. Billy Says:

    Testing becomes even more intense when you have multiple interfaces to different systems. I.e. lab, pharmacy, etc… Even if your EHR vendor supports modules to all of these it’s often the case that you need to interface with business partners or semi-affiliated practices. All of this makes testing much much more complex.

    Where have you found benefit with automated testing scripts and what tools seem to work well for healthcare workflow? We formed a QA team a year ago, dedicated rather than virtual, for this very reason and we’re always curious to hear best practices from other organizations.

  2. David Robbins Says:

    I enjoyed your post.

    Have you considered virtualizing your environment in a test segment of your network? This allows you to pull data from production into an isolated segment and you then can expose the new software modules to actual data. Naturally this is dependent on the size of the network, database servers, etc. However, VMWare ESX is now priced at a level where it is a worthwhile investment. A one time cost of $50,000 is better invested in a testing environment that can be re-used as opposed to the 50,000 X ??? to investigate an error in production.

  3. Scott Knutson Says:

    Great postings, great photography.

    Wholehearted agreement on the complexities of EHR upgrading. I appreciate your comments.

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