Continual testing for quality healthcare

Across the healthcare continuum, quality is sacrosanct in business systems and processes. Healthcare institutions find it increasingly challenging to deliver measurable business improvements. These include better quality, faster time-to-market, reduced cost, and an increased overall operational efficiency. In recent years, the idea of business assurance has gained awareness among healthcare institutions and emerged as the answer to driving qualitative digital experiences and strengthening customers’ trust.

Business assurance is about combining conventional assurance and risk management disciplines to boost an organization’s confidence in its business environment, thereby ensuring quality and generating business-differentiating value. It empowers healthcare organizations to ensure that their digital healthcare systems perform as expected, protect financial integrity, and deliver seamless customer experiences. This white paper explores the need for mitigating business risks rooted in software quality issues through end-to-end testing and quality assurance (QA)—two indispensable factors for reimagining healthcare workflows and processes.

Continual test automation for improved patient safety

In the healthcare industry, digital technologies are interlinked in every step across the value chain—from electronic medical records (EMR), admissions, discharges and transfers (ADT) to lab reports, pharmacy reports, billing, and the ‘connected hospital.’ Providers must incorporate quality engineering to ensure patient satisfaction through frictionless experiences and deliver the same level of excellence at every interaction—from understanding patients’ needs to providing high-quality products and services. Optimal and effective patient engagement is key to delivering patient-centric care. The lack of a frictionless experience can be illustrated by patients having to wait to settle the claims before physicians start the treatment. 

Yet another example would be patient-level pathology details and EMR records not flowing to the physician in real time while the patient is being prepared for the surgery. These situations can be distressing, as long wait times impact satisfaction scores and perception of care significantly, and worse if they concern matters of life and death. Payers, providers, and other healthcare segments are often perplexed about holding the business or IT accountable for these real-time challenges. Setting responsibility aside, organizations need to get the systems right, every time, 24X7. Hence, continual digital product testing is critical in fostering patient safety.

Maintaining the systems demand joint effort, wherein both IT and the business need to work in tandem through cross-functional collaboration. From the IT standpoint, multiple features are developed for various products in the product-centric model, using agile or waterfall methodology. The application under test for a specific release is often not given much importance owing to other priorities in the release view. Despite these challenges, organizations must devise a clear strategy to comply with federal, regulatory, and IT requirements. They need to reimagine the workflows and processes across systems to address the rising healthcare needs. This is where the end-to-end delivery of business capability comes into play.

End-to-end delivery of business capability: Key focus areas

QA and testing serve as strategic levers that businesses rely on to mitigate risks and protect their brands while achieving larger business goals. With work requests being delivered within the application development and testing model, the end-to-end traceability of data between the systems assures:

• New and existing business capabilities that are planned through complex and large programs (releases can span across multiple portfolios or applications over a period)

• Quality with comprehensive and targeted end-to-end tests for enterprise and tactical releases, resulting in much higher levels of confidence in IT and business teams

• Business continuity with robust end-to-end tests (manual and automated) for enterprise programs to capture and fix gaps or requirement misses in the business workflow 

• Improved collaboration between IT and business right from identifying impacted business capabilities to assuring them

• Shift from IT metrics to business KPIs and outcomes to measure the effectiveness of IT releases

The focus of business assurance testing

Organizations are shifting away from the traditional application testing paradigms and are fine-tuning their applications for better alignment with their business processes. To that end, business assurance testing (see Table 1) focuses on the intersecting points of the new programs and initiatives and the existing business processes. This rigorous and proactive approach puts business success first and technology second and relies on testing beyond the conventional.

Table 1: Business assurance testing is taking over the traditional QA approach

The first component of business assurance adoption involves setting up a robust and practical assurance framework that controls all the known risks. At the same time, the framework must be flexible to meet the changing demands of the project when required. The second component is a change in the mindset – from reactive to proactive. The third component is the ability to shift left and right simultaneously, with ease. Having an agile mindset will benefit payers and providers across the value chain. Shifting left gives the opportunity to collaborate better with IT functions, whereas shifting right enables better collaboration with the business and the users. The shift left approach helps reduce the cost of quality while shift right assists in enhancing user experience to the optimal level. A test strategy can be created by combining the techniques of shifting left and right, thus making the process faster, better, steadier, and more cost-effective for continual delivery. 

To conclude, priorities are shifting from testing the application to testing the actual customer experience. Test scenarios are changing from the point of functionality to the point of actual customer experience. Replicating the real-time customer experience will be critical, not restricting it to applications, devices, channels, and touchpoints. Apart from the tools, the testing team needs to consider the type of testers required for the job. Besides acting as an interface between the organization and its customers, software must also simulate real-world scenarios to drive compelling customer experiences.

Importance of assurance in the digital transformation journey

Quality assurance is essential in driving customer experience, which, in turn, forms an integral part of the digital transformation journey. The omnichannel world we reside in lacks a static benchmark for customer experience or customer satisfaction. Research suggests that improving customer experience is a priority for companies looking to achieve digital transformation success. However, 80% of enterprises find executing their customer experience initiatives challenging due to the absence of in-house quality engineering experts. 

This narrative can be changed with seamless interactions and differentiated experiences that turn users (internal or external) into vocal advocates of a brand. Organizations must harness the collective power of intelligence, agility, automation, and the cloud to deliver a superior customer experience. A quality engineering (QE) approach to testing applications and services is a proven path to designing innovative digital experiences. Hence, enterprises need QE expertise to help them accomplish their customer experience goals. Enterprises in partnership with a QE expert can eliminate the need to buy new infrastructure or tool licenses whenever they need to test compatibility with a new device. A QE partner addresses such requirements with a cloud-based automation script (speeding up compatibility tests) and several browser-OS combinations, enabling enormous savings.

QE has evolved as a part of business assurance. It now emphasizes the need to embed real-time processes and controls within decision-making and an organization’s culture. QE programs help hospitals improve clinical outcomes and reduce the claims processing time, and the failure rate. These programs also offer an effective way to gather feedback and insights from all the stakeholders for further improvement. Business assurance testing is here for the long term, and conventional testing needs to revamp itself to fulfill the constantly changing demands and expectations of customers and organizations.