Healthcare organizations identify and evaluate risks as a means to reduce injury to patients, staff members, and visitors within an organization. Traditionally risk management has focused on patient safety and the reduction of medical errors. But with the expanding role of healthcare technologies and expedited digital transformation because of the COVID-19 pandemic, healthcare risk management has become more complex over time.
In May of 2017, Moody’s Investor Services released a report highlighting the link between risk management and a hospital’s operating margins: “Maintaining high clinical quality will increasingly impact financial performance and reduce the risk of brand impairment as reimbursement moves away from a fee-for-service model and towards a greater emphasis on value and outcomes.”
For above reasons, hospitals and other healthcare systems are expanding their risk management programs from ones that are primarily reactive and promote patient safety and prevent legal exposure, to ones that are increasingly proactive.
A medium or large hospital typically has anywhere from 500 to 800 health information interfaces between health systems for registration, orders, results, charges, etc. With the expanding technologies, there are increasing number of electronic systems used in various departments and specialties. These systems are either hosted internally or increasingly hosted in the cloud.
With increasing number of systems and in turn increasing number of interfaces between systems, it is becoming a risk to rely on manual reporting of system issues in production environment. It typically anywhere from 40-60 min to identify an issue in live environments and its’ completely reliant on users finding the issue and informing help desk to begin the process of diagnosing and fixing the issue on hand. Prolonged system issues in live environment can lead to potential adverse patient outcomes because of missing critical information.
Enterprise risk management strategy of an organization are considering using proactive automated live system checks and interfaces monitoring to reduce risk associated with increasing number of electronic systems and applications in healthcare.
Learn more about Tido’s End to End Systems Monitoring to automate live systems issues detection and significantly reduce time to diagnose and resolve potential patient safety issues.
In the latest episode of This Week In Health Tech, Vik and Jimmy continue the series on Test Automation in the healthcare space, focusing on EMR and Health Systems Test Automation.
Here is what they discussed:
“What is so different about testing in EMRs as opposed to web based applications?”
Web based applications may or may not deal with patient data. However, EMRs and other hospital systems all have patient health information (PHI). Vik states that because patient data is involved, the impact of an EMR error or hospital system (PACS, Ambulatory, Laboratory, etc.) error is much higher as it could lead to critical adverse effects for patients.
“How are things typically done now in regards to testing?”
Changes are continuously being made to health systems, based on feedback from clinical staff for different workflows. When these changes are implemented, testing needs to be done in order to ensure bugs have not occurred. Vik explains in details the traditional approach for testing changes in a healthcare organization, which still relies heavily on manual testing and cross-department collaboration.
“If testing is so important, why do organizations place it on the back burner?”
Jimmy asks Vik why emphasis on testing is so low. The traditional manual testing approach involves feedback from hospital staff. Vik talks on how it is not the staff’s (Doctors, Nurses, etc.) top priority to test every aspect of a system, since they are dealing with their own job deadlines. Vik details how much time is needed to manually test properly and the staggering cost involved with such a process.
“What can be done better in the industry in terms of testing?”
Vik states that an organization cannot simply rely on manual testing. Using technology to automate testing will save an organization time and costs. Initially, once an assessment is done to capture all the different workflows and downstream systems used, the team can then develops test scripts. They also use integration framework since all the information to downstream systems going through the interfaces can be used to cross check information between EMR and downstream systems.
Listen to the full episode:
Click below for more information regarding Tido’s test automation packages:
The development cycle for a product/service involves many stages. From gathering initial design requirements up to after-launch maintenance, each stage plays a crucial role in providing a reliable product. Often times however, emphasis on testing gets under emphasized, especially in the healthcare industry because that web development / testing is not and should not be the focus of healthcare IT teams. Tido Inc. believes testing to be one of the most important steps in making sure the best product is available to consumers. As stated before by Vik Patel, COO of Tido Inc., “You can never have enough testing.”. This blog focuses on how we at Tido Inc. implement Automated Web Testing for healthcare organizations.
What is Automated Website Testing and why is it important?
Web Testing needs to be done on a when a change has been made to a webpage to make sure no bugs have occurred and that site quality is top notch. Traditionally, this is done with live manual testing. However as more content and the number of web pages grow, continuously live testing can become an almost impossible task to complete, not to mention regression testing. This is where automated testing comes into play. During the process of manually live testing an organizations’ web and mobile properties, we simultaneously write our test scripts, building our test suite along the way.
Why it’s important:
Time management greatly improved. Teams do not need to spend as much time live testing
Cost savings and significant ROI as fewer resources needed for testing web and mobile properties. On average it would take about 25,000 hours for manual testing of all web and mobile properties, change testing, and regression testing. This would amount to at-least $1.25 million dollars per year for cost of QA resources.
Once test suit has been built, its very easy to reuse suite for other projects
Feedback from running tests/regressions much quicker
In-depth test analytics and live monitoring of web and mobile properties
Higher test coverage
Different Types of Testing
Functionality Testing: testing all forms, web apps, and other functional features of a webpage
Compatibility Testing: testing to ensure webpage displays correctly across multitude of different devices
Performance Testing: testing to make sure webpages work under heavy loads. Gathering and testing data such as load time.
Cross-Browser Testing: testing to ensure webpage displays correctly across combination of different browsers.
Accessibility Testing: testing to ensure that the webpage is usable by people with disabilities
Usability Testing: testing all menus, buttons, and navigational links
Our Strategy
Understanding your clients needs and digging into their web analytics is the first step in figuring out what the priorities are. Along with understanding which sites are visited the most, web analytics provide crucial data such as which browser, device, platform, etc., are used the most. Once we establish our goals and priorities, we can begin the process of testing.
For our test suites, here are some of the tools and frameworks to assist us in the automation process:
Real devices cloud – Sauce Labs: this cloud-based continuous platform enables us to run our automated test suite across desktops, emulators, simulators and real devices. Along with Cross-Browser and Compatibility testing, Sauce Labs provides performance reports and real-time feedback of tests in progress.
Selenium and Appium: We incorporate both of these test automation frameworks in conjunction with Java using Eclipse IDE. Selenium is an open-source test automation tool used for desktop testing. The Selenium WebDriver allows for easy Cross-Browser/Platform testing. Appium is an open-source test automation tool suite used for mobile app testing. The Appium framework allows us to test an organizations website using a combination of different of mobile platforms and devices.
TestNG: An open-source automation testing framework for writing unit tests and generating test results. TestNG allows the execution of multiple tests in parallel.
Deque AXE: library to run web accessibility tests in Java projects with the Selenium automation tool.
What makes working with Sauce Labs great is they also provide a Live testing suite to handle Cross-browser, Mobile real, or Mobile virtual tests:
Using the Live Testing suite also provides a recorded video of your live testing session:
When it is time to automate our tests, we can always look back at our previously recorded live tests and base our scripts from there. For developing the automated test suite, we used the Page Object Model. Page Object Model is an object design pattern in Selenium that creates an Object Repository for web UI elements. Under this model, each webpage will have a corresponding Page Class. From these Page Classes, we can write and call our test methods.
Page Object Model
File Organization
Collecting and analyzing test results is done using Sauce Labs Insights:
Click here for more information about Tido’s test automation packages.
In this episode of This Week Health Tech, Vik and Jimmy talk on website test automation strategies for healthcare. This is the first part in a month long series focusing on Healthcare Web, Mobile, EHR Testing and Test Automation.
Here is what they discussed:
“What is test automation?”
Vik begins this episode by defining testing and the importance of test automation. Testing within the healthcare space is underrated, mainly because of low QA resources. Vik explains why test automation should become a top priority for healthcare providers.
“Who is in charge of managing the website, testing, etc.?”
Website management is a collaboration between departments, including IT and Marketing. Vik elaborates on how different departments have specific roles in terms of maintenance, updating, testing, etc.
“Let’s divide testing into 3 categories: Continuous, Automated, and Live”
Along all stages of development, continuous testing needs to be performed. When the test script development is finished, then those scripts can be used to automate testing against a combination of browsers/OS. Live testing must be done as well, to ensure a correctly working user experience.
“Once you have the Selenium automated test scripts written, you can fire them off anytime.”
Vik describes the process of using a testing framework, such as Selenium, to perform automated tests. Test scripts can be written in a multitude of languages (Java, Python, C#, etc.). By using a real cloud device, the automated scripts can be ran against hundreds of browser/device/OS combinations.
“Lets talk about testing techniques.”
Typical techniques include Functional, Compatibility, and Performance testing. Vik goes into detail on how each type relates to testing.
“The number of web and mobile applications will continue to grow.”
Vik makes the case again on the importance of testing for the future. The number of health apps will continue to grow, especially because of COVID. Continued testing for mobile apps is the only way to ensure that the consumer will receive a correctly working product.
Listen to the full episode:
Click below for more information regarding Tido’s test automation packages: Test Automation Packages
In the latest episode of This Week in Health Tech, Vik and Jimmy are joined by Mark Bowman, CIO of Commonwealth Healthcare Corporation.
Here is what they discussed:
“Digital change basically happened overnight..”
Mark discusses the impact COVID-19 had regarding the quick digital transformation needed. In particular, he discusses the rapid adoption of Telehealth.
“How have practitioners adjusted to Telehealth?”
Jimmy asks Mark how practitioners feel about telehealth and if they will continue with it post COVID-19.
The trio next elaborate on remote monitoring and in-hospital monitoring.
“The industry is clearly moving over to the cloud.”
The adoption of Cloud services is inevitable. Mark discusses his views on cloud adoption within the healthcare industry.
Vik indicates a hybrid approach, local + cloud, could be optimal.
“Have you noticed a work-culture change in response to virtual workspaces?”
Jimmy asks Mark how the change to virtual work has impacted the culture. Mark agrees that the culture has changed, and elaborates on the effects.
Listen to the full episode:
Click below for more information regarding Tido’s test automation packages:
In this episode of This Week in Health Tech, Vik and Jimmy discuss the basics of an API and its impact on digital transformation in health systems.
Here is what they discussed:
“What is an API?”
Vik explains to Jimmy how APIs work together with other apps. APIs act like a bridge that connect different systems and make it easy to share data.
The digital transformation happening now requires APIs to be able to connect apps such as telehealth and remote monitoring.
“With the Cures Act coming from the government, health systems have to enable data sharing..”
COVID has certainly accelerated the digital transformation shift, but the shift had already been started. Vik explains the incentives for customers, healthcare, and the government to push for more data sharing, starting ultimately with better patient care.
“From a CIO standpoint, what do I need to have to run everything efficiently?”
Vik states that its starts with having the correct strategy. This means being able to plan for the use APIs over the traditional approach for integration.
“Once you do all the hard work and have the infrastructure in place for APIs, then you can simply reuse it.”
Vik explains the pros of using APIs over traditional integration.
“What is the ROI for using APIs over the traditional approach?”
Vik explains the competitive advantage of using APIs over traditional integration, ranging from reduced work time to providing a better user experience for all parties involved.
In this episode of This Week in Health Tech, Vik and Jimmy cover the timely topic of COVID-19 vaccine scheduling/distribution.
Here is what they discussed:
“What is the protocol for getting a vaccine?”
As the vaccine continues to be administered, Jimmy asks Vik what the protocol is on who gets the vaccine first. Vik lays out the protocol, starting with essential workers and the elderly getting it first.
“Phone lines are clogged up bad, and it’s starting to affect patients.”
More and more people are calling hospitals to gain information on vaccine scheduling. This has caused the phone lines to be clogged up, which could lead to other critical issues not getting the attention they need. Vik mentions a couple solutions to the problem of phone lines, such as using a robust intranet to give information, such as an FAQ.
“What do you think are some good FAQ questions?”
Jimmy asks Vik to lay out the types of questions that would help address questions related to vaccine scheduling, such as where/when to schedule.
“Use the technology at your hands to help people.”
Vik talks how Tido Inc. has helped hospital systems deal with the logistics of vaccines and using certain tools to make sure that the 1st and 2nd dose are administered for the correct time window.
“Lets try and use technology in healthcare to help with this really complex situation.”
On top of providing good healthcare, there has been a logistical issue that technology can help deal with. Vik mentions the importance of automation in making sure that vaccines are scheduled correctly.
In this episode of This Week in Health Tech, Vik and Jimmy recap their favorite moments from 2020 and discuss the future for 2021.
Here is what they discussed:
“Let’s dive right into security and malware and viruses…”
The duo celebrate the one year anniversary of the show. They talk about how security was an important topic early on and how it will never really leave.
“It’s free on paper, but the data obtained by these apps are priceless..”
Jimmy points out that even though apps such as Zoom are free, they are still collecting valuable data. Vik agrees, saying that healthcare disruption is inevitable as Big Tech enters the industry.
“COVID-19 has accelerated a lot of things in healthcare.”
The pair reflect on how the pandemic has forced us to adapt to a virtual lifestyle. Telehealth has become an important tool moving forward when it comes to digital strategy.
“Some of the most fun I’ve had on this podcast is talking with our guests.”
The guests that have appeared on this show have been absolutely great and knowledgeable. Jimmy comments on how much he has learned about healthcare from all the guests. Vik and Jimmy go over some of their favorite guest episodes.
“I feel like over the next few years, there’s going to be an exponential increase in app usage, from a patient and provider standpoint.”
The ONC’s Cures Act will give patients/providers more control over their data. Vik gives his predictions for tech trends heading into 2021, ranging from test automation to using cloud architecture.
In this episode of This Week In Health Tech, Vik and Jimmy are joined by Wayne Che, CTO of Sowingo Inc. The group jumps into what it takes to manage and develop mobile apps for health systems.
Here is what they discussed:
“If I’m a health system and people are asking for a certain app, should I Build or Buy the app?”
With the boom in the app economy because of COVID-19, Vik and Wayne talk about the best approach healthcare providers can take for mobile app development. Wayne goes over pro’s and con’s for Build vs Buy apps.
“We recently launched a new digital package to help health systems manage all the mobile apps, and it does include custom development.”
Tido Inc offers a Digital Package for the management of mobile and web apps for healthcare systems.
“A very important point is continually testing and maintaining the app.”
As we’ve mentioned before, you can never have enough testing. Being able to provide an app that works correctly on all devices is one of the first steps in providing good patient engagement. Wayne makes a point that testing on real devices is crucial so the best experience can be provided.
“From an infrastructure standpoint, do you want to host in-house or do you make use of cloud providers?”
With so many cloud-based providers available, Vik asks Wayne if storing the infrastructure in-house has any advantage over the cloud. Wayne makes several points in favor of cloud-based, such as privacy and security compliance, cost and for scaling.
“Regardless of the Cures Act, healthcare innovation is happening.”
The ONC’s Cures Final Act allows seamless and secure access, exchange, and use of electronic health information. Vik and Wayne discuss how API’s can be used for data sharing. The healthcare industry has been lagging behind other industries, and Vik comments that innovation needs to happen to provide the patient the best healthcare experience.
“One thing is clear, whether you build in-house, buy it, or take a hybrid approach, we are going to see more and more apps.”
Jimmy asks the best approach to mobile development, and Wayne gives his take on different development models. Vik mentions that the innovation is not going to stop with apps, citing examples such as wearables and remote-monitoring apps.
In this episode of This Week in Health Tech, Vik and Jimmy are joined by Jeff Fallon, CEO and Chairman of eVideon, where they discuss the digital transformation happening to the hospital inpatient experience.
Here is what they discussed:
“About 75 percent of hospital rooms have not changed much since the 1970’s…”
Jeff and Vik discuss the current state of hospital rooms and how the digital transformation can be achieved in hospital rooms.
“Why now do you see this different approach for providing inpatient healthcare?”
Jimmy asks Jeff why the digital transformation has taken so long in healthcare. Jeff answers that the pandemic has certainly accelerated the transition, and compares it to the changes happening in telehealth. Jeff also mentions value-based care being a big driver for hospitals to make the change.
“The right approach is to provide an experience where the patient doesn’t feel like a guest in someone’s hospital.”
Vik brings up the idea of smart hospital rooms, and Jeff agrees that the technology is there to provide better patient engagement.
The use of smart TVs and smart speakers can help give patients more control over their experience in the hospital.
“It looks like eVideon is making a more interactive/pleasant experience for patients..”
Jimmy asks Jeff about how eVideon is providing an overall better inpatient experience. Jeff elaborates on the importance of providing entertainment for patients and being able to give patients control over what apps they want to use.
“You better have a smart digital strategy for all types of folks.”
Vik makes a good point that everyone is not on the same level when it comes to using technology. Jeff addresses this as well and comments that a smart digital strategy is one that can benefit everyone, regardless of an individual’s comfortability with technology.
