We are keen to hear the experiences and views of testing professionals in the field of testing and software quality. For our blog series Let's talk about testing, we spoke to Stevin Zand Scholten, Release and Change Coordinator at Radboudumc.
The shortcuts that users know about but we don't are now coming to light much more often.
Who is Stevin?
A positive 46-year-old man, who will turn 47 this month. I live in Deventer and am the father of a beautiful 13-year-old daughter.
In Deventer, I studied business informatics at IJsselland University of Applied Sciences (now Saxion University of Applied Sciences). I have now spent my entire working life in IT within the healthcare sector. I started out in consultancy roles at PinkRoccade and Siemens, and have now been working at Radboudumc for 10 years.
Becoming a release, change, and test manager wasn't on your wish list back then, was it?
No, definitely not. I wanted to be a fighter pilot, and I still do. But I don't think that's going to happen because I can't handle spinning movements. And age is also a factor, haha... Being a professional soccer player for Go Ahead Eagles was also one of my dreams, but unfortunately...
How did you get involved in testing?
I have always been involved in testing. It started when I was a consultant at PinkRoccade and Siemens. Especially when you are on the developer side, as I was at the time. You want everything to work properly before it reaches the customer.
At Radboudumc, I am responsible for the EPIC electronic patient record system, Radboudumc's largest IT system. Because I have a clear vision of how EPIC should be managed, I initially opposed the work of test manager Peter Smit. That was his reason for assigning me to take charge of the EPIC testing process. When Peter passed away (unfortunately too soon), I took over the entire testing process.
"These end users are the hallmark of the system's quality."
How has the testing process at Radboudumc evolved since you took over?
Testing has been taken to a higher level within information management. More testing is being done, and it is being done more carefully. And we are continuing to spread this oil slick. We now have EPIC tested by no fewer than 150 to 200 end users. These end users are the quality stamp on the system. Previously, it was application specialists who did the FAT. However, application specialists do not know all the shortcuts (processes) that a user knows in the application.
The organization now understands better than ever that testing is an important part of every IT project. New projects are now kicked off with a thorough test plan; this also applies to non-EPIC-related projects. The norm now is that the owners of a new project must first come to me.
What are the benefits of testing by so many users for Radboudumc?
Above all, a high-quality, well-functioning system. As a result, we receive almost no production reports after the EPD goes live. We still receive some technical reports, but we are going to address that as well. We do this with technical tests.
By testing so extensively with users, our on-call service is hardly ever called for production issues anymore. That's what you want! When I started at Radboudumc, I used to get called 12 times in a weekend during on-call shifts. Now, it's rare!
Users also enjoy testing. It makes them feel like they are being listened to. Good cooperation is half the battle. They have a say in IT and the applications they work with, which is seen as a positive thing.
The help desk now knows that things will remain quiet.
And what does this approach offer in terms of information management?
The shortcuts that users know about and we don't are now coming to light much more often. As IT professionals, we test from A to B, from B to C, and so on. In practice, you see that users in production go from A to E and from D to C in an application. That's how they test too. This provides insight into errors that we were less likely to see before.
An application has a certain logic. We try to eliminate errors that arise from shortcuts. This ensures that the logic in the application is followed again. This helps users to work more efficiently in production, which reduces the pressure on the helpdesk. The help desk now knows that things will remain calm. We have gone from 20 people on site to 5 for a live launch. The person responsible is now migrating his/her build from home.
Are functional and application administrators still involved in testing?
Yes, we test connections and large adjacent systems in integrated tests. This way, we know that connections will continue to work after an update. They also conduct their own tests for this.
Which major adjacent systems are you referring to?
Large systems such as Lab (GLIMS) and Imaging (X-ray and radiology). If these systems go down, patient safety is at risk and costs skyrocket. So you can understand why testing is important. A day without an operating room costs a lot of money, so a good testing process with a good test management tool quickly pays for itself.
The strange thing is that testing isn't very difficult if you set it up properly and carry it out using a good test management tool. You can finish testing in five minutes, so to speak, saving yourself a lot of hassle and money. Why this effort and investment is sometimes the first thing to be cut back on remains a mystery.
Will any more adjacent systems be tested in the future?
My first step must be to ensure that we, as information management, conduct comprehensive testing ourselves wherever management and development take place. We must set an example when we ask the organization to participate in testing. This process is already underway and must now continue. I am fully committed to this endeavor.
"...management will see that testing is important."
What milestone have you achieved at Radboudumc?
That users participated in testing and that this resulted in a reduction in production reports after going live.
Another growing milestone is that management is starting to see the importance of testing. People without IT training or background are coming to work in information management. They are good people to have around. They are very good at the processes and are extremely valuable, but they don't know anything about testing. It's nice to have such a mix, and it makes you strong.
What role does Testersuite play Testersuite Radboudumc's testing process?
Testersuite facilitating testing easy. It is simple, professional, and anyone can quickly learn how to use it. In addition, Testersuite works and has a "no more, no less" feature. Tools like this should provide you with good support, and that is exactly what it does.
In addition, the short lines of communication with Testersuite are Testersuite . You respond very quickly, are easy to approach, and are pleasant people.
Are you also looking into automated testing?
Automated testing is not yet an option for us. First, we need to establish a solid foundation before developing this further. Perhaps in the future we will do something with test automation for Microsoft products, but it is not a priority.
I see test automation primarily as an additional check on your normal testing, and it is too expensive for that purpose.
In the finance world, for example, you have less to do with people and there will be fewer changes, so you can automate that. Our processes are extensive and complex. There is a significant human factor involved, and there are so many different disciplines and turns in processes. That is difficult to capture with test automation. You never know which turn a patient will take in the process. Applying for a debit card is a bit easier. Where there are clearly defined procedures, automated testing is simpler. If people can convince me of test automation, I would love to hear about it.
Where do you want to go with the testing process at Radboudumc?
That all information management will be included in standard operations within the next two years. We cannot allow ourselves to encounter production reports in information management that could easily have been tackled by testing.
Sometimes AI generates responses that you cannot communicate to patients.
Is Radboudumc already working with AI in a generic sense?
We use AI to summarize patient consultations. AI is still far from perfect when it comes to dealing with human lives. We are not ready for that yet. Sometimes AI generates responses that you cannot communicate to patients. That causes panic; it is not reliable enough. We certainly do not yet use it for our testing process due to the human factor we have to deal with in the hospital.
What is your advice to other hospitals regarding testing?
Ensure that user tests are set up and carried out by users. I know that all EPIC houses would like this too. We are also discussing this in our national EPIC user consultation.
What advice would you give to novice testers?
First, try to get to know the basics of your application well before you continue with testing. Once you have a good grasp of the basics, you can start talking about testing. That way, you'll know what you're talking about.
I believe that everyone working in information management should have an ITIL certificate. When I started at PinkRoccade, I had to do ITIL in my first week. With my education, I thought I knew everything, but ITIL showed me that this wasn't the case. An ITIL certificate is a good foundation.
