Why do you test? When do you test? How deep do you test? Do you test? These are common questions of an organization implementing an Electronic Health Record (EHR), but building and implementing an organizational testing program is much more pervasive for the organization. EHR Testing doesn’t begin or end with the implementation. Rather it’s a critical element of running an ongoing Information Technology function. The same principles should apply to your organizational testing program.
Testing should be a consistent program within the organization and should be applied, in relevant forms, to any ongoing change. This includes implementing new technology, upgrades, ongoing maintenance, building new system-driven workflows, even regular data uploads that come from your third party vendors (e.g., RelayHealth, 3M).
Given the recent onslaught of EHR implementation vendor solutions, there are many horror stories of what can happen if appropriate, consistent and comprehensive testing is not completed. However, there are equally as many anecdotes focused on the prevention of major issues through testing.
COMMON PAIN POINTS AND OUTCOMES OF INSUFFICIENT TESTING
- Core functions of the system do not work or do not work as designed
- Users are dissatisfied and in severe cases, are not able to complete their daily activities
- The patient flow is disrupted and in some cases, patient safety is threatened
- Resources are redirected from organizational priorities to research and fix issues that could have been identified during a testing exercise
- Financial metrics are impacted including the most substantive drivers of performance including cash and revenue capture
CREATING AND MAINTAINING A SUCCESSFUL TESTING PROGRAM
The first rule of a successful organizational testing program is to build it and keep it. Healthcare organizations today are moving at a record pace to build market share, care for their patients, recruit the best medical personnel – all while trying to sustain a margin to continue growth and operational performance. To do this requires technology – and not just static, best of breed technology solutions that last 20 years. Today’s market with its demand to share information, care for the wealth of a patient not just single transactions, integrate across multi-functional care delivery sites and provide safe and innovate health solutions, requires not just an EHR, but a strategic inventory of solutions that are always advancing and changing.
Testing is not just a sporadic activity to implement a significant change. Organizational Testing should be considered a strategic program ready to support the organization’s ongoing needs for innovation and change.
CRITICAL SUCCESS FACTORS FOR AN ORGANIZATIONAL TESTING PROGRAM
Establish an Organizational Testing Program, Guiding Principles and Team: Organizational Testing programs should not only have relevant team assignments, but should also have policies and processes for when to test, who complete the testing, how tests are conducted, how testing outcomes are documented and addressed, and most importantly, who should be involved in building the testing plans and scope.
Build an Organizational Testing Program Scope and Policies for Application: There are many categories of testing that address single, unit-based testing all the way to integrated workflow testing that follows functionality through an entire workflow and includes interfaces, role-based hand-offs and in some cases, multiple vendor solutions. A testing program should define all the categories of testing available and have guiding principles that determine which categories are applied based on the scope of the change. Common categories of testing include (but are not limited to) the following:
Consider the Following Tactical Elements of Executing a Testing Exercise
- Allow adequate time and testing cycles to support an accurate result
- Get the end-users, as well as business, operational, clinical and technical SMEs involved in the process
- Ensure you have leadership and stakeholder sign off on testing scope, outcomes, and completion
- Make sure appropriate testing policies are applied, for every testing program. Examples may include documentation standards, turnaround times for resolution and retesting, thresholds for testing and retesting, etc.
- Build testing activities scripts to address technical functionality, but to also reflect the business of your organization. Testing activities should consider end to end patient workflows that represent the business, the organization, the clinical complexity, the service lines and the patient mix
- Build testing activities to address all the key clinical and financial patient flow scenarios, including key integration points with devices, hardware, other systems, interfaces, etc.
- Establish a program to track and document testing activities that include the testing process, but also outcomes, issues, and resolution
- Monitor and possibly augment aggressive testing for areas that are typically vendor-led (e.g., scalability, performance, downtime)
Optimum Healthcare IT has supported over 100 clients in the last five years to successfully implement new vendor technologies and solutions. We offer end-to-end advisory and consulting services for planning, implementation and post go-live optimization, including building and executing a comprehensive testing program.
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