Testing Healthcare Applications: How To Test Healthcare Software
Tags: testing, qa, softwareengineering
Published: 2023-10-04 11:39:33

Healthcare software is very popular and important because it helps both healthcare professionals and patients at the same time. Healthcare IT systems are becoming more capable and more complex by the minute, and software development in the healthcare market is already impacting healthcare quality and availability worldwide.

However, the complexity of such software systems imposes certain conditions on the development and testing software for healthcare providers. Healthcare testing is critical for pretty much every healthcare field. As a company that provides technical support to a few industry-leading healthcare software companies, we are no strangers to quality assurance practices for custom medical software specifically, so here is a quick guide on testing medical software.

#What users expect from healthcare software

Medical requirements change rapidly in order to adapt to the most recent discoveries in science, which is a good thing, of course. However, this means the more advanced healthcare becomes, the higher get users’ expectations from the software for it. In the days when everything is highly dependent on technology, medical device software development companies have no other choice but to meet the highest of a standard. This is well reflected in the custom healthcare software development: if a team wants its digital product to be useful, it has to fully correspond to the following requirements:

**Reliability**
Unreliable software that doesn’t perform as you expect it is always annoying, to say the least. But when it comes to the industry that deals with matters of life and death on a daily basis, the responsibility gets to a whole new level. Medical applications have to deliver error-free performance regardless of the workload or content-heavy databases. This can be achieved only through the quality-first approach to healthcare software testing and development.

**Compatibility**
There are three main components of any healthcare system: human factor, hardware, and software. All of these have to work in lockstep with each other in order to keep patient care effective. This explains why healthcare entities often prefer to work with a custom healthcare software development company rather than buy an off-the-shelf solution. Custom development allows practitioners to achieve a program specifically tailored to their operations instead of some average systems for average hospitals as imagined by software providers.

https://j6v5t8r7.stackpathcdn.com/wp-content/uploads/2022/06/Testing-Healthcare-Applications-Step-by-Step-2.png

**Ease of use (aka UI/UX)**
Medical software design defines how easy it will be to use the final product, and with healthcare applications high usability is crucial. This is because the target audience of such software is extremely diverse: from busy personnel working at hospitals to patients using apps to control their conditions, track medicine consumption, schedule appointments, etc. Not all of them have a high level of computer skills nor have time and/or willingness to learn how to use some sophisticated-looking programs. To avoid possible troubles, the UI/UX design of medical applications has to be clear, concise, and intuitive. 

**Privacy and security**
One of the primary aims of healthcare software systems is to collect and store patient data. Such records are considered sensitive information so no wonder people are concerned about keeping it confidential. Data storage solutions remain one of the complex components of healthcare applications. Oftentimes, developers go for data encryption technologies like Blockchain to make the information stored less prone to attacks.

**Rich integrations**
Whether we are talking about healthcare software for professional or personal use, it won’t find user appreciation without useful integrations. APIs allow developers to expand the feature set of their product without building from scratch thereby saving resources and time to market. In regards to medical software development, you can find a ton of APIs designed for patients, doctors, and even scientists who contribute to the healthcare industry through studies and researches (like GluVue by Stanford University).

**Regulatory & conformance compliance**
Healthcare services cannot be distributed without abidance by the corresponding regulatory acts and laws, like HIPAA in the United Stated or NHS White Paper in the United Kingdom. This especially applies to CRM systems for healthcare institutions and SaaS medical solutions. Also, healthcare software has to correspond to the high industry standard and provide the content that aligns with the most recent scientific discoveries and condition protocols.

“Unreliable software that doesn’t perform as expected is annoying, to say the least. But when it comes to the industry that deals with matters of life and death on a daily basis, the responsibility gets to a whole new level”.

#Common testing types in healthcare domain testing

Testing is the only way to ensure that the healthcare application works as required. Having outlined the user expectations from healthcare software development services, you can see there are a lot of aspects to check when working on such projects. That is why the quality assurance for medical software is usually a multi-level activity that tests an app from different angles. Below are the key types of software testing for healthcare applications.

**Load & smoke testing**
Load and smoke testing refer to the basic software testing techniques: put the developed component under some level of load (in the case with smoke testing ― under the minimal one) and document the results. Smoke testing is used at the earlier stages of development to check how a program reacts to low pressure. The actual load testing takes place later and uses more realistic or even overstated levels of workload on the product.

**Data security testing**
Data security testing ensures the timely discovery of weaknesses in the application’s codebase. Data security testing becomes even more crucial for healthcare solutions, which deal with sensitive healthcare information on a daily basis. If this step isn’t taken seriously, it may result in data losses, unauthorized users, hacker attacks, and other accidents that might discredit the application. Security QA is usually performed as a penetration test, a sort of staged attack on the app’s digital system. Other than checking the hack-proof quality of software, data security testing can also exploit it in many different ways to come up with scenarios that would help to repel an attack when needed.

**Compatibility testing**
A healthcare application is expected to work smoothly on every platform and with various types of software. And it’s worth noting that the number of possible hardware and software combinations can be staggering. This is why healthcare testing helps ensure that the software is equipped to work equally well on every platform, and that’s what device testing is all about. Compatibility testing checks how a program interacts with the ecosystem it is supposed to run on, including hardware, network, operating systems, and browsers. To check an application for compatibility, QA engineers try it on all devices, with all versions of operating systems, and in all browsers that were initially picked during the project planning stage.

**Integration testing**
Integration testing studies how different modules of a software system integrate with each other. Depending on the technique QA engineers choose to run integration tests ― top-down, bottom-up, functional incremental testing, sandwich testing, or big-bang one ― it can be done at different stages of development. Also, during this step, all the software modules are tested both independently and as a whole. Integration testing helps ensure that a healthcare application displays steady performance even with new units being added to the original structure.

Usability testing
This type of testing reveals how usable and ergonomic the medical software design of a particular application is. In order to make it more effective, QA teams might run UX/UI testing twice. First time, during the design phase, to reveal the unclear steps in the interface prototype, and the second time after the product’s beta version is developed. With the finalized product version, testers usually work with a focus group to get real-life feedback. 

**Regression testing**
Continuous testing of healthcare applications must also check whether the latest testing efforts did not negatively affect the solution. Regression testing helps achieve clarity and confidence in the testing process. This type of testing is responsible for verifying the correct operation of the solution after a recent update, which happens regularly at any healthcare organization. There are plenty of testing tools to help with regression testing, and it’s one of the types of QA that do well with manual testing but can truly benefit from testing automation.

**Localization testing**
Localization testing is essential for solutions aiming for international reach and applies to products that are aimed to be used in different regions. Since healthcare regulations can vary greatly from country (state, province, etc.) to country, this should be reflected in the application’s local version as well. This includes such aspects of the application language, integrations widely used in the region, and even marketing strategy.

**Compliance testing**
Compliance testing is something that should always be included in the test plan for testing healthcare applications. This type of testing aims at making sure that the application complies with the local government regulations, which can differ greatly from region to region. If you intend to build healthcare software to be used globally, use compliance testing to ensure that you are not breaking any local laws simply due to not knowing them. For example, in the US, all healthcare applications need to be HIPAA-compliant, which means that in the US, healthcare testing requires HIPAA to be taken into account, among other things.

#Key challenges in healthcare app testing
The latest healthcare developments make it clear that the healthcare industry is growing at a brisk rate. Timely and all-encompassing healthcare software testing helps make sure that you, as a product owner, don’t stay behind the rapidly developing industry. And part of that is being fully awards of the healthcare software testing process, including its challenges and limitations. Here are the issues you can face when healthcare testing is conducted.

**User-friendliness**
One of the specific challenges of healthcare domain testing includes the fact that healthcare applications are designed for a wide category of users, including patients of older age who may not necessarily be tech-savvy. This means that the team responsible for healthcare IT testing must test the product from different perspectives, meaning even the most improbable test case may turn out to be essential for the success of the whole operation.

**Interoperability**
In healthcare software and medical device software testing, there were times when interoperability was merely a best practice, not a requirement. During these times, desktop application testing was the main QA activity in healthcare. Then teams gradually started doing healthcare mobile app testing along with desktop testing. However, things changed the most when medical applications became available on a wider range of platforms. These days, interoperability is essential for QA testing in healthcare. What makes the interoperability aspect particularly challenging is that the range of devices in healthcare testing isn’t just limited to desktop computers and mobile devices, as both hospitals and patients use a myriad of heavy equipment, sensors, wearables, and other electronics for data transfer, which means that the test cases for healthcare application testing must account for all potential combinations.

**Security**
Patients use medical applications to communicate with their healthcare providers about the most sensitive subjects, so there is no room for error when it comes to the security of the solution. For the testing team, it means not only evaluating every aspect of the solution to ensure its absolute security, but also keeping sensitive information safe in the process. Many QA teams and companies now use non-invasive testing techniques, which involve testing without gaining access to private information within the application or sensitive parts of the code base.

**Summing up**
Medical software testing might seem overly complex, but the complexity of the healthcare domain testing comes from the fact that the healthcare software testing team has more responsibility behind this process is even higher compared to other projects. The described above steps and techniques aimed at polishing a medical application to the point the release of it would be valuable for the industry, useful for clinicians, and relieving for patients. Our background with medical and healthcare applications taught us to never settle for less than an A to Z tested application before the release, as well as ongoing improvement and post-launch support, so you can safely entrust us with your healthcare software testing project and expect a stellar result.