The development of healthcare systems is a complex task involving multiple layers of technology and a variety of end users. They are critical and complex systems, as they handle sensitive information and have a direct impact on people's health and well-being.
Testing of healthcare systems is essential to ensure their reliability, safety and effectiveness. The testing process presents numerous challenges that must be carefully addressed, as testing has particularities that make it different from other systems, such as e-commerce.
Whether you are an experienced tester or just entering the world of health systems testing, this blog will provide you with valuable information and practical tips to help you overcome challenges and improve your skills in this specialized field.
Here are some of the main challenges of health systems testing:
Challenge #1: Data confidentiality.
Nowadays, data privacy in healthcare services is of utmost importance. These data are highly sensitive and personal, and unauthorized disclosure can have serious consequences. Therefore, healthcare organizations that handle this information must ensure that it is adequately protected.
One recommended approach to address this challenge is to perform specialized security testing. Security testing includes, for example, testing the system’s resistance to unauthorized access attempts, performing role-based access controls and user authentication to protect information, taking into account who can access the data and under what circumstances. And, in turn, verify whether it is possible to circumvent these controls to access sensitive data.
Challenge # 2: Data Reliability
Another important aspect of data is data reliability. Data associated with a specific patient must be correctly linked and related to each other and, in turn, must be correctly updated and consistently reflected throughout the system.
Functional testing is a key ally in verifying data fidelity. It is essential to ensure that each entry is stored exactly as the user entered it and in the field that refers to that attribute.
With the same criteria, tests are also run to ensure that there is no duplicate data in the system, to look for redundant records or data that may cause confusion or lead to errors in the treatment of the patient.
It is also necessary to consider consistency in data formats, ensuring that data is displayed consistently in terms of format and presentation. This includes verifying that names, dates, units of measure and other details are represented consistently in the health system. Inconsistency in formats can make it difficult to interpret and understand the data.
Challenge #3: Interoperability
Interoperability of healthcare systems is critical to enable the secure and efficient exchange of information between different systems and stakeholders.
Some of the areas where interoperability plays an important role are the coordination of schedules, administrative processes and patient clinical data. All of these aspects contribute to informed decision making by healthcare professionals.
Interoperability testing is essential to ensure that healthcare systems work together, focusing on ensuring that they can communicate and share data effectively.
The most widely accepted interoperability standards in the industry are HL7 v2/v3 and HL7 – FHIR, which are fundamental for communication between different healthcare systems. The tests must verify, among other things, that data exchanges are carried out correctly and that the integrity of the information is maintained at all times.
- Message format validation: it is important to perform tests to verify the format of the message being sent.
- Making sure that the correct information is sent in the correct field: we must be sure that the information we want to send is sent in the correct field, so that no erroneous data is generated.
- Required and optional fields: we have to make sure which fields are required and which are not, to verify that this condition is met.
Challenge #4: System performance
Since healthcare systems can be used by thousands of users simultaneously, it is essential to perform load and performance tests. These tests simulate peak usage scenarios to ensure that the system can handle large volumes of data without degrading performance.
There are several scenarios where it is important to perform performance testing on healthcare systems. The most common is the concurrence of many users at the same time, in order to simulate the attention at a certain time that is considered “peak”.
Another scenario to simulate is the massive sending of prescriptions and clinical documents to the different systems that receive them, since they are fundamental parts of the healthcare system ecosystem.
With this approach, valuable information is obtained in order to identify opportunities for improvement in the system and make decisions on how to solve them.
Challenge #5: Regression Testing
Healthcare systems are subject to constant changes and upgrades. Testing is essential to ensure that these updates are implemented smoothly and do not adversely affect the existing system.
Whenever an upgrade is made or new functionality is added, regression testing is necessary. When dealing with healthcare systems, this can be a challenge due to the size and complexity of the systems. Running exhaustive manual regression tests on these types of systems is unrealistic in terms of cost and time because, for example, there are a variety of different forms, whose fields are tailored depending on the medical specialty and age range of the patient.
Two possible alternatives are:
- Automate testing. In this type of system in particular, it is very useful to have a suite of automated tests of the essential flows, those that are related to the vital functionalities of the system, for example, the electronic signature of a medical consultation or the prescription of medication.
- Execute tests manually, selecting a set of test cases that are sufficiently representative of the critical functionalities of the software, ensuring that they cover the main paths and critical scenarios without including non-essential cases.
Conclusions
Testing healthcare systems is an important process that requires attention to detail and extensive knowledge of healthcare regulations, technology and clinical needs. As these health systems advance and are updated, the involvement of the testing team becomes increasingly important in this process.
Committing resources to testing health systems is essential to delivering world-class care. Ensuring data accuracy, process efficiency and patient safety helps healthcare organizations to strengthen their healthcare services.
From our experience we know that, although the challenges of testing healthcare systems are varied, it is possible to overcome them by applying the tips mentioned earlier in this blog. Our testing team is continuously updated with the latest tools and testing strategies. If you want advice on software testing for healthcare systems in any of your projects, we invite you to contact us.
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