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May 31, 2016

An economy prospers and grows if its citizens are healthy. Governments across the world are implementing reforms and policy changes to improve healthcare quality and the well-being of citizens. An important aspect of these changes is the focus on increased use of technology, including the maintenance of electronic healthcare records (EHR). A few governments are offering incentives to companies that adopt meaningful EHR practices. As a result, healthcare providers are encouraged to flex their IT muscle, and demonstrate maturity in EHR processes. But for EHR to be meaningful, it should meet basic standards and criteria.

For example, the US federal government, through the Health Information Technology for Economic and Clinical Health (HITECH) act, attempted to modernize healthcare infrastructure, through a nationwide network of electronic health records. The act laid down common goals for EHR compliant healthcare providers:

Evolve data structures that efficiently capture patient clinical information and records
Enable electronic sharing of clinical data
Facilitate predictive analytics for accurate decision making

To achieve these goals, and by utilizing information technology to fully realize the potential of superior healthcare experience, EHR systems require verification and validation; efficient record maintenance processes; standardized approaches to measuring, reporting, and improving documentation quality; and practices that ensure consistent, error-free outcomes.

Enter quality assurance (QA) and testing. You can read my whitepaper to understand the role of testing in certifying EHR for Meaningful Use, and learn five testing best practices, which can assure the Meaningful Use of an EHR system.

Lets look at pointers for an assurance strategy that ensures an EHR systems capability to capture, share, and meaningfully report clinical data:

1. Early QA Involvement: When involved at the outset, QA teams can fully understand requirements, analyze gaps and finalize system outcomes – all first time right, without expensive rework
2. Comprehensive Planning: A comprehensive QA plan encompassing both in and out-of-scope services, implementation strategy, patient usage simplification mechanism, assumptions, exit criteria, and contingency measures, is essential to the success of the EHR system
3. Staffing and Collaboration: Appropriate staffing with the right mix of workflow and domain knowledge, combined with continuous collaboration and knowledge sharing, contributes greatly towards arresting defects, and tailoring the testing process to fit different types of verification. This improves the overall EHR system efficiency
4. Beta Roll-out and Training: Once the EHR system is built, beta testing via a short, small-scale release is essential to check, record, and correct defects. This not only improves quality, but also mitigates potential risks before production roll-out. A training plan for clinical staff helps shorten the learning curve and improve productivity
5. Compliance: Finally, testers must ensure regulatory compliance, certify the EHR system for correctness, and demonstrate its meaningful use. To be eligible for incentive payouts, providers must ensure continuous system evaluation and evolution, towards improving its overall utility and sustainability

When deployed, these five assurance pointers hold the potential to revolutionize healthcare, by raising the Effectiveness Quotient of EHR the global repository of widely accessible medical information. This revolution, however, can only succeed when healthcare providers and test professionals synergize and jointly strive to achieve excellence in the EHR system. Only then can EHR translate to administrative efficiencies, improved accessibility, affordable care, and overall citizen well-being.

Deepak Subramanian is a Consultant for Presales and Solutions and has been working with Tata Consultancy Services since 2011 in the Assurance Healthcare Unit, providing a number of Quality Assurance solutions for customers. He has also been instrumental in winning large deals for the Assurance Healthcare Services, winning new logos and creating domain offerings.


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