How to Perfect Performance Testing of Any EMR
Like any modern workplace, hospitals have largely adopted software to accommodate a wide set of workflows.
The emergence of — and dependence on — electronic medical records (EMR), also referred to as electronic health records (EHR), has meant that these systems are vital to the operation of the modern healthcare system. Back in 2014, all hospitals and clinics must implement and show meaningful use of an EMR system according to the American Recovery And Reinvestment Act. By 2021, about 9 in 10 of U.S. office-based physicians adopted EHR systems.
Not only is it important to conduct rigorous tests of these EMR systems, it’s also necessary to test how they handle peak load conditions. This latter set of tests falls into performance testing, and it’s something that hospitals should not overlook.
What Is EMR?
EMR, short for Electronic Medical Record, is a digital collection of a patient’s data, from medical history and medications to lab results and allergies.
You can think of an EMR system as a central station that connects to all activities, including:
- Doctor appointment scheduling
- Registering a new patient
- Billing & insurance claims
- Patient discharging
- HIPAA-compliance check
EMR system quality assurance plays a vital role in ensuring efficient communication between different providers and, more importantly, the day-to-day operations of your organization with no disruptions.
Basics of Load and Performance Testing
Load testing is a type of performance testing that helps assess a system’s ability to perform under heavy user loads. There are a number of benefits to load testing life-critical systems like EMRs or hospital websites:
- Detect errors that affect EMR functionality
- Determine how much load the hardware can handle before limits are exceeded
- Collect data for capacity and scalability planning
- Determine the adequacy of the hardware environment
More broadly, key benefits to performance testing hospital systems include:
- Determining the speed, scalability, and stability of the EMR
- Understanding the impact on the user experience of the EMR’s performance
- Identifying mismatches between user expectations and actual performance
Download this practical guide on simplifying performance and load testing for your EMR systems:
Five Key Considerations for Load Testing EMR/EHR Systems
With these benefits in mind, it’s important to be aware of factors that may complicate your performance testing efforts. There are a few things you should be mindful of:
Test environment vs. clinical environment
Because hospitals are so reliant on EMRs, tests are performed in a sandbox environment, rather than the production version. This means that you’ll need to account for different conditions that may be present in the real world. In addition, HIPAA regulations can create issues for those wishing to perform automated processes on live systems with real patient data.
However, if you manage to properly account for these considerations, performance testing in a representative, realistic test environment can help you prepare for real-world load in the clinical environment.
Configuration of EMR/EHR
- EMR systems are designed to be robust out of the box, but configuration for the unique clinical environment of each hospital is where people tend to run into trouble.
- Configurations should be performance tested to ensure the system will stand up to adjustments over time. IT teams should be aware of the potential consequences of proposed configuration changes.
Growth and scaling of the EMR
Over time, there may be a number of additions and changes to the EMR:
- More users may need access as new staff are onboarded
- Additional locations will be added if health systems acquire other hospitals or clinics
- New medical devices will be communicating with the EMR
Performance testing can help IT teams get ahead of these potential scaling issues, identifying bottlenecks ahead of time and planning adjustments to their infrastructure accordingly.
Questions that performance testing can help you answer
Performance and load testing your EMR/EHR should help you to understand some key questions:
- Under what conditions will performance start to suffer?
- If we are at peak expected load, how will the user experience (UX) be affected? Will clinicians experience a lag in the EMR? Will certain features or fields be unresponsive?
- If we overload the system, which things break and what are the consequences? Do we have the plan to restart key systems and get everything working again?
Not just for EMR
Of course, performance testing can be performed on other key systems besides the EMR.
Earlier this year, a major health system in the US used Eggplant Performance to help with the vaccine rollout. They were able to replicate peak expected load conditions to test their systems and ensure that they could accommodate high volumes of traffic from those signing up for their vaccine appointment. Eggplant Performance helped the IT department make the necessary adjustments so that their infrastructure held up and end-user performance and functionality would not be compromised.