Brief about the Client and their Product

The client is a healthcare solution provider in the USA. 

Their product aims at solving the below-mentioned challenges:

In 2004, the US govt took initiatives to address concerns related to maintenance of medical health records, considering aspects like cost and accuracy.  

Many tests were repeated by the patients which incurred additional costs to them as well as to the insurance companies, and manual entries of these records led to human errors. 

–  It was concluded that introducing completely electronic healthcare systems connected across the nations could address these concerns. 

In 2004, the US government formed The Office of the National Coordinator for Health Information Technology (ONC). ONC came up with an initiative of National Health Information Network (NHIN). NHIN was formed through the collaboration of Regional Health Information Organizations (RHIO). 

RHIO worked by implementing Health Information Exchanges (HIEs). HIEs were IT-based systems which collaborated information across different EHR entities such as OPDs, Rehabilitation Systems, Clinical Laboratories and Public Health Records etc. 

For exchanging messages, Health Level 7 (HL7) format was created; these systems also incorporated standards from HIPAA as well as IHE profiles.

Brief about the Kind of Engagement

AFour worked with this customer for 3+ years. 

At the inception of the project, the challenges the customer was facing were: 

The product was in the alpha stage of release; initial pilots were going on where they were trying to implement the HIE. 

Challenges faced were: Low testing coverage and anomalies in the nature of Ad hoc testing which were arising with defects in the later stage,         hence delaying the release. 

Other problems were API layer not being tested well, hence it was required to change at the end which was causing defects and delay in the overall release. 

This project was bagged due to our vast Microsoft Technology experience. 

The project started with automating one of their compatibility tests w.r.t the different versions of the HL7 standard. 

Initially, the focus was to implement test automation on some of their test cases. 

Automation of HL7 related test cases were done in the system, followed by functional testing, test cycle management and performance, security, reliability and scalability (PSRS) testing of the product.      

Key highlights/achievements (technical/non-technical)

Added qualitative as well as quantitative value to this project. 

Successfully converted 10000+ test cases into 3000 efficient test cases, and reduced production defects with better test coverage. 

Established rich demo environments which used rich HL7 data.

Developed a build acceptance and QA release criteria which helped in organizing build release process. 

Quantitatively automated 100 per cent of their Microsoft HL7 compatibility test cases. 

Performed PRS testing with a test automation data of 1million patient demographic records and 30million clinical data records. 

Automated IHE compliance test cases 

Team composition

Functional testing team which comprised of 5 members. 

Performance, Reliability, Security and Scalability testing team consisted of 2 members.

Test automation team had 2 members. 

A test architect headed all these teams. The test architect was balancing his time on technical and monitoring aspects equally.