QA Madness Blog   Prescribing Quality Assurance: Solving Key Challenges of Healthcare Software Testing

Prescribing Quality Assurance: Solving Key Challenges of Healthcare Software Testing

January 25, 2024 Reading time: 14 min

Contrary to what Occam’s Razor teaches us, not all complicated things have simple solutions. Healthcare software is among the most intricate systems there are. And to create a truly good product, you need to understand its difficulties. Not only that, you ought to know exactly how to solve them.

So, today, we dive into the challenges of healthcare software testing and ways to overcome them.

What Makes Healthcare Testing Distinct?

Let’s cut to the chase. The biggest distinction of healthcare software testing services is their complexity. From EHR (Electronic Health Records) to medical imaging software – making reliable, accurate, and user-friendly software is a task to behold.

If you’re wondering why exactly it’s difficult, here’re the three main aspects our QA engineers highlight.

The Intricacy of the Healthcare Systems

Healthcare software is incredibly convoluted. To test it properly is to know its underlying structure and specifics. The QA team needs to have ample domain expertise, understand regulations, and prioritize patients in a myriad of ways. Regarding the latter, think data safety, accessibility, stable performance, etc.

The Layered Nature of Such Software

Sometimes, one might think that healthcare apps are for doctors or patients. Maybe both. But, in reality, there are also insurance companies, governmental organizations, pharmacies, and so on. And the product needs to work for each stakeholder, as an error or a holdup on one end can be life-altering for end users.

The Need to Make Difficult Stuff Simple

Every software’s primary purpose is to make our tasks easier. So, even HMS (Hospital Management System) needs to be digestible. And turning exceptionally complicated software into a product that even a less tech-savvy consumer can use is the deal breaker. In other words, a revolutionary project that’s too hard to figure out won’t find a big audience.

In a way, to test medical software well is to detach from the traditional perception of testing. Here, it’s not “checking an app”. It’s directly impacting human lives.

Seven Key Challenges of Software Testing in Healthcare

Now, how do these three aspects impact the bigger picture? Let’s review the main seven challenges for healthcare software quality assurance. And we won’t forget about how to mitigate those hurdles either.

Multifaceted System Intricacy

The complexity of healthcare software is due to the integration of multiple components. Let’s take an EHR system, for example. Its five primary elements are:

  1. Patient management (PM) that keeps and retrieves patient data.
  2. The clinical side of PM, where medical practitioners input obtained client info, including doctor-patient interactions.
  3. Alerts and messaging that inform of errors, automatically send case updates, etc., all with high levels of security.
  4. Financial dashboards that let users generate reports, add and edit data, analyze monetary operations, and more.
  5. RCM (Revenue Cycle Management) that records the entire patient life-cycle, from registration to billing.

So, you can see that one system includes countless other modules. And it needs all of them running properly to work.

Tip #1. Good Documentation

Meticulous documentation provides a clear and detailed record of testing processes. It helps developers and QA engineers know exactly what’s going on with the product and how to make it what it should be. Accessible records also encourage better collaboration, project understanding, and improvement pathways.

Tip #2. Extensive Testing

By taking a multifaceted approach to testing, QA teams secure software that’s both valuable and pleasant. In other words, it’s never enough to focus only on smooth functioning. You should always think about how easy it is to use the software, what UX it offers, and how to make it stand out.

Tip #3. Integration Testing

In the healthcare ecosystem, different modules need to work in harmony. That means testing the operations of the core part as well as the myriad of other connected apps. If you center on the main system only, you leave it isolated. In turn, this limits your product’s potential. And QA experts know how to create truly collaborative software.

Tip #4. Negative Scenarios

Identifying how the software reacts to unusual inputs or unexpected conditions is a must. By anticipating and addressing these scenarios, QA ensures the software’s resilience even in less-than-ideal situations. For example, one accidental misclick can sabotage a patient’s data. By thinking of such situations in advance, QA secures a reliable product that understands its users’ daily struggles.

Tip #5. Compatibility Testing

Digital healthcare products should deliver a consistent and seamless UX across different platforms. By that, we mean that anyone can fully benefit from such software. Skilled QA for healthcare apps act almost like prophets. They can predict where compatibility issues are likely, how to resolve them promptly, and how to guarantee high-level usability.

Extensive & Complex Integrations

It’s typical for healthcare software to integrate with diverse third-party systems. They improve its functionality and offer a more comprehensive solution for healthcare providers. For instance, the Soleran platform’s integrations extend the main module’s capabilities in many ways:

  • Improving revenue cycle management.
  • Enhancing EHR capabilities.
  • Streamlining physician scheduling, etc.

To better understand this, think about any smartphone. You can browse the web, use social media, look up the weather, and call a cab. But to do all this, the device needs to know how to interact with other apps. On top of that, it needs to protect its owner’s data from all other channels.

So, while incredibly valuable, extensive integrations introduce potential security and compatibility issues. If not tested thoroughly, they can jeopardize the confidentiality of patient data and disrupt the flow of information.

Tip #6. API Testing

QA professionals test APIs by simulating diverse scenarios of data transfer. For instance, they can check how EMR software handles third-party applications by sending distinct patient profiles and medical records to the system. This helps define how it processes information, identify bottlenecks, data format discrepancies, or communication issues.

Tip #7. Security Testing

To protect software against vulnerabilities, QA teams use advanced security testing. They scrutinize third-party integrations for loopholes, run penetration tests to locate threats, and more. But to protect a system, “poking around it” isn’t ideal. It’s better to know what to look for and how to best find it. That’s another reason why QA skills matter.

Hardware Testing for Elaborate Devices

We also can’t forget that healthcare software isn’t “mainstream” in one specific way. It often works with complex medical hardware, such as insulin pumps, lab devices, and others. And you can’t exactly compare your typical laptop with, say, an MRI machine.

Just last year, Becton Dickinson, a medical tech company, recalled Alaris infusion pumps that caused 13 patient injuries. The devices couldn’t function properly with a different type of syringe and would “either refuse to operate or incorrectly estimate the volume of liquid in the syringe”.

As you can see, interoperability is on a whole new level for such products. Sure, we always say that testing doesn’t guarantee 100% bug-free software. But for healthcare, this is one of the biggest QA challenges, as it must be as close to perfection as possible.

Tip #8. API and Data Sharing Protocols

Here, the main goal is to make sure that software communication works correctly. Also, APIs should receive increased attention, as those like FHIR (Fast Healthcare Interoperability Resources) serve as standards for info exchange. So, QA experts combine their tech mastery and compliance expertise to secure a proper balance between functionality and regulations.

Tip #9. Domain Knowledge

Sector expertise has one huge benefit – it lets you test better and faster. Our QA professionals often cite the importance of actually understanding healthcare products’ functionalities and compliance rules. Niche expertise allows QA to focus on known problematic areas, realize what to pay attention to, and when the software can be considered truly high-quality.

Tip #10. Extensive Documentation (Yes, Again)

Comprehensive records help keep software consistent across varied hardware configurations. By documenting testing processes, outcomes, and insights, QA teams establish better project understanding. And other stakeholders can use this data to improve the product, ease future testing, and uphold the same quality standards. Plus, documentation is a true asset for troubleshooting, compliance validation, and continuous improvement.

Compliance Regulations (A Lot of Them)

Law and software testing services often go hand in hand. And for healthcare, non-compliance can lead to legal repercussions, reputation damage, and, most importantly, compromised patient care. For instance, in 2019, the University of Rochester Medical Center (URMC) violated HIPAA’s Privacy and Security Rules. The result? A $3 million fine and a whole lot of questions for URMC’s status.

Many HIPAA rules, like Security and Privacy, are about data safety. But they don’t end on digital protection. They also govern backup creation, automated alerts in cases of improper data disclosure, and others.

What’s more, each country can have its own set of standards, security protocols, and data protection requirements. Even healthcare facilities within the same region may have specific rules tailored to their operational nuances.

Tip #11. Compliance Testing

QA teams evaluate a system’s adherence to relevant regulations. This involves comparing how a product is with how it should be. And, frankly, compliance testing may involve a lot of back and forth to secure optimal results. Yet, specialists with domain knowledge already know what to do and can halve the average time these tests usually take (around three months).

Tip #12. Internal Standardization

To put it briefly, as QA experts work on your project, they make a roadmap of how to best perform a certain task. Internal standardization encompasses practices such as:

  • Documentation protocols.
  • Coding standards.
  • Testing methodologies, etc.

With such a strict (in a good sense) framework, you can create a pipeline that facilitates ongoing compliance while streamlining development and testing processes.

Highly Diverse User Audience

Ideally, healthcare software should be for everyone. In other words, the product should accommodate users that:

  • Don’t understand tech very well.
  • May not update their OS or have devices with lower processing capabilities.
  • Use assistive technologies or special device configurations.
  • Have unreliable connectivity and others.

All these are united by one aspect without which even the best software wouldn’t survive – user-friendliness. In fact, consumer-centricity is among the top healthcare IT challenges. When a user can’t figure out your software, it can lead to frustration, degraded ROI, and even errors that could cost a life.

And, let’s be honest, healthcare software is infamous for its cluttered interfaces, shallow learning curves, and suffocating structures. Why is that? Well, there’s a couple of reasons:

  • Abundant features to cover medical staff’s needs.
  • A colossal number of integrations.
  • Difficulty in creating a universally intuitive UI.
  • Patient data regulations can lead to cautious design choices.
  • And the reliance on legacy systems (for around 40% of healthcare leaders).

So, a very important task for you is achieving a balanced functional UI testing for healthcare apps. The emphasis on users contributes not only to the accessibility of the software but also to its overall reliability and performance.

Tip #13. Cross-Browser and Cross-Device Testing

QA verifies that the software maintains its user-friendly design and functionality across diverse environments. This ensures that all users, regardless of the technology they prefer, can seamlessly interact with the software, promoting consistent UX.

Tip #14. UI/UX Testing

QA teams identify and rectify potential usability challenges, contributing to an intuitive and accessible interface. And the better UX your product offers, the bigger the chances that more people will use it and continue doing so.

Tip #15. Accessibility Testing

This involves assessing the software’s compatibility with assistive technologies and special features that a person might use. Proficient QA experts are well-versed in accessibility standards as well. So, when they join your project, they can quickly pinpoint problematic areas and define what and how should be improved.

Tip #16. Network Connectivity Testing

This ensures the software remains responsive and functional under all network conditions. By addressing potential issues here, QA teams contribute to the software’s reliability, providing seamless access to critical healthcare information even in times of crisis.

Colossal Amounts of Private Data

By 2025, the global annual generation of healthcare-related data will reach over 2.5 exabytes. That’s 2.5 with 18 zeros after them.

Yet, creating a system that gracefully handles copious amounts of information isn’t the biggest challenge. For healthcare software, the ultimate task is securing extra requirements that come with extensive sensitive information:

  • Cybersecurity.
  • Protected integrations.
  • Compliance.
  • And making all data operations accessible and simple.

With all these hurdles piling up, you might think that doing all this is impossible. But it’s all much easier with good QA.

Tip #17. Functional Testing for Report Generation

This ensures that software accurately generates medical reports so it’s trustworthy and readily available for those who need it. QA specialists validate the correctness of data, formatting, and the inclusion of necessary information. By thoroughly testing report generation functionalities, QA teams also advance a project’s usability and, hence, its adoption.

Tip #18. Emphasis on User Access Levels

Doing so guarantees not only compliance but user confidence, too. By simulating different user roles and scenarios, QA verifies that the software enforces strict access permissions. In turn, this minimizes the risk of data breaches, ensures adherence to privacy regulations, and fosters client trust.

Tip #19. More Security Testing

QA teams perform various security assessments, including penetration testing and code reviews, to detect weaknesses that could be exploited. By addressing potential security risks, QA engineers fortify the software against unauthorized access, malicious attacks, and other security threats.

Legacy Systems & Continuous Updates

Integrating healthcare software with legacy systems is normal. But it’s also incredibly difficult. Consider the inherent complexities of outdated technologies and lack of compatibility. Just these two make testing teams navigate obsolete architectures and understand poorly documented functionalities.

Plus, since the future of healthcare software is clearly digital, it needs to be continuously updated. Maybe not so much to introduce something new, but to polish what’s already present. And that’s another piece of the puzzle – bettering your product without compromising what it has now. As continuous updates may:

  • Introduce changes that affect compliance.
  • Disrupt existing integrations.
  • Result in downtime, etc.

Tip #20. Strategies for Updates and Patches

This involves comprehensive validating protocols that secure easy update introduction without compromising the integrity of the healthcare system. A huge help in these scenarios is automation testing services. But it also needs to be done smartly and carefully (!). And understanding when and how to automate a process is something only true QA pros can do.

Tip #21. Continuous Compliance

Given the dynamic nature of healthcare regulations, a proactive approach to continuous compliance is crucial. QA experts know how to work with regulatory experts to stay abreast of any statutory changes. This ensures that the software remains compliant with evolving healthcare standards, preventing regulatory issues and legal repercussions.

Tip #22. Feature Planning with Scalability in Mind

QA specialists thoroughly assess how new features interact with existing components, ensuring a smooth integration process. They know that scalability considerations should anticipate future growth in users and data. So, they can prevent performance bottlenecks and system failures by continuously monitoring and working the system.

Why Should a Professional QA Team Handle These Challenges?

High-quality healthcare software demands an equally high-quality QA team. After all, when you, for instance, feel sick – you go to a good medical professional. You could turn to a med student or a psychologist. But they wouldn’t yield the same results.

That’s why it’s not the best idea to delegate testing to, say, developers or less skilled QA engineers.

The advantages of engaging dedicated QA experts are very straightforward:

  • QA professionals familiar with the intricacies of healthcare systems are better equipped to identify pitfalls and devise targeted testing strategies.
  • Their domain expertise allows for a nuanced understanding of the sector’s unique challenges and regulatory requirements.
  • Outsourcing testing to a QA company facilitates a rapid infusion of domain expertise into the project, accelerating the identification and resolution of issues.
  • An external QA team brings a fresh perspective, offering unbiased evaluations that are crucial for uncovering hidden flaws or oversights.
  • Also, QA outsourcing often leads to significant long-term savings by mitigating the risks of post-deployment problems and ensuring error-free UX.

All in all, it’s very simple. Good QA = good software. That’s just how it works 🙂

To Sum Up

In a way, healthcare software is almost inspiring. Despite the myriad of challenges, from system complexity to regulatory compliance and diverse user audiences, it saves millions of lives daily. But this miracle is only possible through hard work and dedication.

And in a world full of innovation and desire to improve, quality software needs good expertise, better collaboration, and a bit of passion. That – we can help with.

Ready to discuss testing for your healthcare software?

Contact Us

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