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The Need for More QA: 5 Key Elements for Quality Assurance Success

“We installed quality control.” No. You can install a new desk, or a new carpet, or a new dean, but not quality control. Anyone that proposes to “install quality control” unfortunately has little knowledge about quality control.
– W. Edwards Deming

My visits to the doctor have not changed very much over the years. I still sit longer in the waiting room than I want to, but now instead of flipping through magazines I can flip through emails on my smartphone. When the nurse greets me in the exam room, things haven’t changed much there either; instead of scribbling notes on paper, she starts tapping away on a tablet. I imagine that she is being more accurate, but then I start getting calls from the doctor about some condition I don’t have. It turns out that there has been a mix up with the software – they have confused me with some other patient!  It seems the office has higher quality data entry with the tablet, but now they have a quality issue with keeping their patient data organized.

Health care is rapidly becoming more digitalized, and, theoretically, it is going to get much better moving forward. Patients, providers, and payers across the US and around the world are adopting the new digital wave. Powered by this digital trend you can fill your prescription from your phone, and make an appointment for the lab, while providers can instantly submit claims, and payers can approve or deny the claim in real-time based on automated approval rules.

However, simply because everything is going digital doesn’t mean that our quality of care will automatically increase. As I saw firsthand at my local doctors office, going digital can cause even greater quality challenges. Unfortunately, despite the hopes of many well-meaning politicians and consultants, W. Edwards Deming was absolutely right – quality can’t simply be installed into the health care system like a new desk or new carpet.

As digital health initiatives proliferate, quality assurance success is achieved by creating a robust, reliable, engaging digital experience for customers. However, quality assurance is not just about finding bugs in the software. To truly institute high levels of quality, the QA team needs to be positioned so that they can prevent and anticipate flaws in the first place. The following five key elements are essential to help achieve high quality digital healthcare products and improved patient outcomes:

1). Shift Left
In the past, software QA was positioned at the very end of the project, just a few days before the release – on the far right of the project timeline. However, QA at the last minute is not a good practice! Adopting the “shift left” approach means that QA needs to be involved earlier in the project – toward the left side of the project timeline. Ideally, quality experts should be involved at the project kickoff, not just brought in at the very end of the project to check for problems.

2). Accurately Define Requirements
As digital tools become more complicated and powerful, accurate requirements are essential. Prevent flaws by carefully capturing the client’s business, functional, and device requirements. Today’s patients and providers are using more devices than ever before. To produce a quality digital product we need to accurately capture the client requirements of their supported browsers, mobile and tablets. This is critical for any organization, especially those that need to support responsive websites.

Quality Assurance

3). Plan, Test, Anticipate
Responsive web design is becoming the preferred method for developing websites, which provides a seamless digital experience on any device, browser, or orientation. In this environment quality assurance needs to include all supported digital platforms, such as smartphones, tablets, smart watches, browsers, and desktop environments in their documentation apart from the traditional functionality test cases. Functionality particular to the mobile/tablet/wearable needs to be documented, and specific use cases need to be tested and anticipated.

4). Test in the Real World
To test the actual digital user experience we have to consider the real-time scenarios rather than just adopting the happy path of thinking we know how customers will behave. For example, while testing mobile devices and tablets, it’s critical to consider parameters such as network limitations, apps running in the background, load performance, installation issues, etc. As testing issues arise, carefully categorize and prioritize your issues for each device in the defect log system.

5). Keep Current
In today’s rapidly changing technology environment, the quality assurance team needs to take the lead in tracking the latest trends, innovations, and software updates. Teams also need to be aware of the latest mobile and web traffic analysis to track the latest and greatest popular devices, browsers, and other trends. This information should be revised regularly and then used to inform ongoing project design needs.

Conclusion
As digital tools become more powerful, the need for quality has increased. This means that quality can no longer be installed at the end of the project as an afterthought. Instead, teams need to weave a quality mindset throughout the entire design and build process. These five elements for quality assurance success will help to raise the quality level at every point in the project flow:

1). Shift Left
2). Accurately Define Requirements
3). Plan, Test, Anticipate
4). Test in the Real World
5). Keep Current

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Shamala Annaya

Shamala Annaya

Shamala has 14+ years of experience in Business analysis and quality assurance. She has also worked on care, utilization and disease management technology solutions in her previous healthcare jobs. At Cadient, Shamala is responsible for delivering quality branded and unbranded content /products. As a BQA lead at Cadient, Shamala successfully delivers many provider and training portals. She has a certification in Six-Sigma Green Belt and MS in Physics, and has also participated in Senn Delaney Leadership workshops.
Shamala Annaya

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