Challenges

Healthcare customers are unique in that they typically present a combination of the following challenges.

Staffing and Technical Expertise

HIT staff are typically hired based on their operational expertise and not based on technical expertise or programming knowledge.
Some healthcare systems are unfamiliar with basic principles of the software development lifecycle (SDLC).
Eggplant scripting may be handled by members of the core EMR team and, as such, may not have access to the same technical tools (e.g. repositories, admin rights to machines) that their equivalents in other verticals might have.
Many healthcare clients have no dedicated QA team or may only have a testing coordinator who is required to borrow test analysts from build/support teams.
Healthcare has been disproportionately affected by the "Great Resignation."
As with some other verticals, healthcare systems may be dealing simultaneously with great needs for testing associated with mergers and acquisitions but are compelled to do more with less.

EMR vendors will typically underemphasize the need to test what the vendor sees as a fully tested solution.
EMR vendors may undercut automation efforts, particularly in the run-up to an initial go-live.

Commercial Electronic Medical Records (EMR) systems are neither developed in-house nor are they strictly Commercial Off-the-shelf (COTS) programs.
Automated Exploratory testing may not be a goal for a system that tightly controls user workflows.
Manual testing scripts typically include 200 - 400 steps, so a visual model may be difficult.

They are required to maintain tight controls around Protected Medical Information (PMI).
Information security officers may be reticent to have a generic login appear on an audit trail for a real patient.