QA for a Fortune 1000 Health Information Exchange
A Fortune 1000 provider of health information exchange software needed fewer defects reaching UAT while satisfying regulatory audits. Appsierra ran a gap analysis of the existing test framework, then built a methodology aligned to the V model, translating requirements into over 7,000 checklists with functional, integration, regression and smoke testing plus HL7 validation.
About Client
The client builds health information exchange (HIE) software for caregivers (hospitals, pharmacies, assisted living and home care systems) and for patients worldwide, and it serves Fortune 1000 enterprises.
The Challenges
The Customer was building a web app and a mobile app for health information exchange. The platform coordinates care between hospitals, pharmacies, assisted living facilities, home care systems and patients around the world. Caregivers use it to see patients' medical information, message patients and providers, and work with other care providers.
Both apps were being built in Scrum, so testing had to run in the same sprints as development rather than trail behind it. The Customer also wanted proof that both apps moved data between users quickly and reliably.
The endeavor presented several key challenges:
- Fewer defects reaching User Acceptance Testing (UAT), while staying compliant with regulatory requirements and audits.
- A testing methodology built for this project rather than borrowed from another one.
- Testing costs that kept rising, and defects that were only being found late in testing.
- Too little thorough quality testing in the final implementation phase.
The Solution
Appsierra started with a gap analysis of the existing testing frameworks, based on interviews and a close read of the testing artifacts. We mapped out how hard the transition would be and studied the release plan in detail. To give the test service a single operating model, we adapted a high-level ERP program testing methodology to fit the V model and the ASAP methodology. In this model, development work is validated and verified before the project moves to the next stage.
At the start of each iteration we went through the requirements for the new features line by line and turned them into checklists, more than 7000 of them in total. Once new functionality reached the test environment, our test engineers ran a set of tests to confirm that each user flow worked as intended.
We logged every defect in Jira, and the Customer decided the order of fixes. Lower-priority issues went to the backlog. Integration testing checked how data moved between the components of the web and mobile apps and inside the application database. For this we used Postman, alongside a custom tool for validating HL7 interfaces. The team generated Continuity of Care Documents (CCD) and Admission, Discharge, Transfer (ADT) messages, then checked that each one reached the shared application database and displayed correctly in the web and mobile app interfaces.
Once the defects from functional and integration testing were fixed, our test engineers ran regression tests on the updated web and mobile builds. When regression passed, the features going to production were listed in the release scope on Confluence. We then gave the Customer a final test report listing the defects found and the defects resolved.
After each release, our test engineers ran smoke tests in production to confirm the deployed build was stable.
Solution Overview
We covered the product from every side: functional, UI, cross-platform and cross-device testing. Automation was part of the QA process from the start, which kept the testing workload manageable.
Business Benefits
Working with Appsierra, the Customer released its new application builds successfully. After these rollouts, month after month, no critical defects surfaced in production.
That came from structured requirements analysis, with every requirement traced to its test cases. Our use of RBT (Requirements-Based Testing) also cut post-production defects. Automation mattered a great deal here: regression test cycles became much shorter and simpler to run.
We also helped the client set up proper metrics collection and reporting. With that visibility, the rest of the business began to see IT and its testing services in a better light.
Key benefits stemming from this collaboration include:
- A flexible commercial model that kept the program within budget.
- A team structure that could scale, with clear governance around it.
- A 20% reduction in cycle time.
- Risk-based testing, which cut overall test effort by 21%.
- Faster time-to-market for the client, thanks to the shorter cycle time.
- With less test effort needed, the team moved to a shift-left testing approach, and defect counts fell.
Conclusion
With a QA and testing strategy that combined manual and automated work, the health information exchange provider shipped a better product, spent less effort on testing and got a more reliable release process. Healthcare domain knowledge, automation and testing built around regulation gave it a testing setup that is dependable and compliant, which supports its goal of connecting caregivers and coordinating patient care securely.
Key Result
500% increase in script creation
QA team no longer an obstacle to growth
~100% application coverage
Case study FAQs
Who was the pharma and healthcare client?
The client was a provider of health information exchange (HIE) solutions serving caregivers worldwide, including hospitals, pharmacies, assisted living, and home care systems, as well as patients. A Fortune 1000 enterprise, it was developing web and mobile applications to coordinate care services and enable caregivers to access medical information and communicate securely.
What testing challenges did the healthcare project present?
Key challenges included minimizing defects reaching User Acceptance Testing while ensuring compliance with regulatory requirements and audits, establishing a testing methodology tailored to the project, addressing escalating testing costs and late-stage defect detection, and overcoming a deficiency of comprehensive quality testing in the final implementation phase for the health information exchange platform.
How did Appsierra approach testing for the healthcare client?
Appsierra began with a comprehensive gap analysis of existing testing frameworks through interviews and artifact analysis, then tailored an ERP program testing methodology aligned with the V model and ASAP methodology. Requirements were translated into over 7000 checklists, with functional, integration, regression, and smoke testing using Jira, Postman, a custom HL7 validation tool, and Confluence.
What business benefits did the healthcare client achieve?
The client saw the absence of critical defects in production on a monthly basis, achieved through structured requirements analysis, traceability to test cases, and Requirements-Based Testing. Benefits included a 20% reduction in cycle time, a 21% reduction in overall test effort via risk-based testing, faster time-to-market, and a shift-left approach that decreased defects.
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