Continuous Testing for Healthcare: A Roadmap to Test Automation Success

The growth of digital health technologies, which is providing helpful solutions to address the ongoing issues and raising healthcare to new global heights, is drawing greater attention to healthcare IT.

Here are some IT systems that have had a significant impact on HealthCare:

  • Electronic Medical Record (EMR): EMRs and EHRs are collections of patient records stored in a digital format. It contains a patient’s demographics, medical history, and radiology images.
  • Health Information Security (HIS): With the digitalization of patient data, the need for robust information security measures has become most important.
  • Artificial Intelligence in Health Care: It has the ability to analyse large amounts of medical documentation quickly, and it assists in diagnosing diseases faster, suggesting more treatment options, and providing personalised treatments. It also improves medical practises
  • Health Care Administration and Medical Billing: This system has streamlined administrative tasks such as patient billing, scheduling appointments, and insurance claims.

Digital Assurance in HealthCare Applications:

The majority of healthcare applications process sensitive patient data that can be shared throughout different information systems. It includes information on the demographics, billing, and health of the patient. Digital assurance is essential in the healthcare sector because to the very sensitive data in the applications.

Digital assurance in healthcare is crucial for managing risks and ensuring patient safety. The actions and a set of steps that are planned to guarantee ongoing development in the standard of medical care are surrounded by digital assurance in healthcare. Some healthcare apps need to be examined in order to produce high-quality medical products.

The following list includes the key categories of healthcare software testing:

  • Security & Compliance Testing: To ensure the protection of sensitive patient data and compliance with industry regulations like HIPAA and GDPR.
  • Performance Testing: To check the stability of HealthCare applications under normal load and stress conditions.
  • Functional Testing: To ensure the functionality of the HealthCare feature works as per the requirements planned.
  • Compatibility Testing: To ensure the HealthCare applications are able to run on different devices and that the feature is fully compatible with the required range of Browsers and operating systems.
  • Integration Testing: To check whether the Healthcare applications work together smoothly if any of the healthcare software modules are combined. (e.g., EMR, Laboratory Information System, Medical Devices, etc.)
  • Interoperability Testing: To check if a healthcare solution can exchange medical data accurately with major data transfer standards such as HL7, NCDPD, IHTSDO, CDISC, DICOM, and more.

Continuous Testing in Healthcare:

Continuous testing is a development process in which Healthcare applications are tested continuously throughout the entire software development life cycle (SDLC). The aim of Continuous testing is to determine whether the software quality across the SDLC will meet the quality standards, ensuring the applications are free from defects and enabling higher-quality and faster deliveries.

Here are some key points regarding continuous testing in healthcare:

  • Automation: Continuous testing relies heavily on test automation. Automated test scripts are designed to validate various phases of healthcare applications, such as UI, data integration, interoperability, security, standards, and compliance.
  • Test Coverage: Continuous testing aims to provide complete test coverage across different modules of healthcare systems, including electronic medical records (EMRs), laboratory decision support systems, online medicine platforms, and mobile health applications. It helps to identify issues early on, reducing the risk of patient safety concerns.
  • Speed and Efficiency: Continuous testing enables rapid feedback on the quality of healthcare software. By automating tests and integrating them into the development pipeline, healthcare organisations can find and resolve issues promptly, accelerating the delivery of high-quality software.
  • Regression Testing: Continuous testing includes regression testing, which ensures that new changes or updates to the software do not affect the unchanged areas or break existing functionality. This is crucial in healthcare, where software changes can have significant implications for patient care.
  • Security and Compliance: Continuous testing incorporates security and compliance testing to identify vulnerabilities and ensure adherence to industry regulations and standards such as HIPAA (Health Insurance Portability and Accountability Act) in the United States. This helps protect patient data and maintain the privacy and confidentiality of health information.
  • Integration and Interoperability: Healthcare systems often involve multiple interconnected healthcare modules and interfaces. Continuous testing verifies the smooth integration and interoperability of these systems, ensuring consistent data exchange and communication between different healthcare applications.

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A Roadmap to Test Automation Success in the Healthcare Industry: 

Implementing test automation successfully in the healthcare industry needs careful planning and consideration of regulatory requirements.

Below is the roadmap to help you achieve test automation success in the healthcare industry:

fig. Roadmap to Test Automation Success

Define clear objectives: Identify the goals and objectives for test automation in the healthcare industry. Determine what can be achieved through automation, such as improved testing efficiency, increased test coverage.

Understand regulatory requirements: Understand the regulatory requirements specific to the healthcare industry, such as HIPAA (Health Insurance Portability and Accountability Act) and PSQIA (Patient Safety and Quality Improvement Act) compliance.

Conduct a thorough assessment: Perform a comprehensive assessment of testing processes, including manual testing practises, test coverage, and high-risk areas. Identify the most suitable areas for automation and prioritise based on their impact on patient safety, business processes, and return on investment.

 Choose the right test automation framework: Select a test automation framework that best suits the healthcare industry. Open-source frameworks like Selenium and BDD tools like Cucumber and JBehave are popular choices in this domain. Popular choices in this domain.

Build a robust test environment: Create a dedicated test environment that closely mimics the production environment to ensure accurate testing. Set up test data management processes that include anonymization and data protection techniques to comply with privacy regulations.

Develop a test automation strategy: Define the test automation strategy that includes the types of tests to be automated (e.g., Functional, Performance, Security, Integration), the selection of appropriate test tools, and the establishment of testing standards and guidelines. Consider utilizing behavior-driven development (BDD) or similar techniques to align the automation efforts with business requirements.

Implement test automation gradually: Begin with a pilot project or a small set of test cases to validate your automation strategy and identify any challenges or bottlenecks.

Collaborate with stakeholders: Involve key stakeholders, such as clinicians, business analysts, and regulatory compliance experts, throughout the test automation process. Get their input to ensure that the automation efforts align with their needs and address their concerns.

Establish continuous integration and delivery: Integrate test automation efforts into your development and deployment pipelines. This helps identify issues early and reduces the risk of deploying faulty software.

Monitor and maintain the test automation suite: Regularly monitor the performance and effectiveness of your test automation suite. Maintain and update your test scripts to accommodate changes in the healthcare system, software updates, and evolving regulatory requirements.

Invest in training and skill development: Provide training and support to the testing team to ensure they have the necessary skills and expertise to leverage test automation effectively.

By following this roadmap, we can increase patient safety, reduce risks, and provide enhanced software quality.

Case Study: According to the CISQ report (Consortium for IT Software Quality), software failures have affected a variety of industries, and most businesses spend more to detect and remedy flaws.

A few recent examples of how software affected brands are as follows:

• Because of an error in their accounting software, Wells Fargo Bank had to foreclose on loans for consumers.

• Application failures brought on by crew scheduling issues damage the airline industry more.

• Due to a problem with its management software, Tesla incurred significant costs, and the stock price fell by almost 3% the next day.

Numerous incidents that occurred in banks, health care facilities, and other institutions may have been discovered and fixed with the use of automation testing and continuous testing.

Embrace the future of healthcare with robust IT systems. Explore the impact of EMRs, AI, and security measures.

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Following COVID-19, the healthcare industry underwent significant change, and governmental laws and regulations were loosened. Without appropriate healthcare applications, the healthcare sector today cannot function. When processing massive amounts of data, it’s critical for those apps to be effective, secure, and compliant with all applicable standards and laws. Therefore, it is necessary for healthcare goods to undergo ongoing testing to guarantee that the software complies with all requirements, norms, and regulations. We will produce high-quality software, improve the effectiveness and efficiency of QA test efforts in the healthcare industry, and avert the inevitable errors of manual testing by adhering to the automation roadmap in healthcare.

Author: Dhakshayani Ramamoorthy
Dhakshayani is a Senior Test Lead at Indium, bringing in over 8 years of experience in the tech industry. Her journey as a QA Lead reflects her strong dedication to quality, collaboration, and continuous improvement. With her expertise in Quality Assurance (QA), Dhakshayani is committed to delivering excellence in software development. Throughout her career, she has served as a mentor and advocate for junior QA professionals.