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Executing and Automating Application Testing for a Healthcare Payer Organization

Healthcare | QA and Testing, Managed Services

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With a steady stream of internal application upgrades, the client partnered with TEKsystems to develop an effective, cost-efficient and flexible delivery model for quality assurance (QA) and testing services to keep up with its release schedules.

Founded in 1929, the client is a national association of 38 independent, community-based and locally operated healthcare payer organizations, operating and offering healthcare coverage in all 50 states, the District of Columbia and Puerto Rico. The client covers more than 100 million Americans and serves 85 percent of Fortune 100 companies as well as 76 percent of Fortune 500 companies. TEKsystems has partnered with this client since 1998.

Organizations across all industries are turning to data warehousing to take advantage of the massive amount of information that technology has allowed us to collect and analyze for trends to support more informed decision making. While the potential value of this information is indisputable, data that isn’t quality-tested could potentially do more harm to an organization than good. Implementing an effective, repeatable quality assurance (QA) and testing process can help mitigate risk by confirming that data is accurate and that decisions being made on this information are valid.

Healthcare payer organizations are turning to data solutions to help them better understand the populations they serve, optimize operations and improve better health outcomes and predictability. As the industry moves away from a fee-for-service model and towards an outcomes-based model, it is imperative that payers aggregate data and make decisions based on real-time, accurate information. In terms of producing better health outcomes, payers can position themselves to be ahead of wellness and disease trends and prepared to recommend the appropriate course of action per customer.

With the growing demand for data services, leveraging outsourced solutions for QA services is an emerging industry trend to ensure data integrity, conserve internal resources and improve QA processes.

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In recent years, the client had experienced an increase in demand for data services from its member groups. From business intelligence (BI) to procurement applications, its members wanted to implement data-fueled decision making. To ensure all of the client’s applications were high-quality, scalable and repeatable, and outputting accurate data, a solid QA process was required.

In the client’s business, there were ebbs and flows in testing cycles. Although the client’s internal QA team was meeting its demands and quality standards at a reasonable rate, they felt like the organization was not efficiently utilizing resources. The client realized a fluctuation in the volume of QA resources which was challenging to manage. It was costly to retain too many resources, while too few resources provided less room for unanticipated and unique skill set needs.

If the client did not adjust its approach to QA and testing, it would face delayed projects, cost overruns and inefficient resource utilization. Overall, the business would not be running at an optimized level and the quality of its applications—used for business-critical processes such as claims, patient reviews and reporting—would suffer.

The client chose to move to a managed services model where it could even out the peaks and valleys of the testing cycle and more efficiently meet demand. The client decided to outsource this skill set to a near-shore solution and decrease its reliance on higher-cost on-shore QA contractors and improve scalability of the team as the business dictates.

It was imperative that the quality of the products did not suffer, as increased software quality would be critical for the client to continue growing in high-profile accounts. The client needed its testing efforts to be effective to guarantee that the data its members would be basing decisions on was valid. By turning to a managed services model, the client was looking to improve retention among testing talent and lower their overhead costs, while at the same time releasing all its applications on time, defect-free and with the same level of effectiveness.

TEKsystems would create a scalable team using a blended delivery model of on-site and near-shore resources. We would leverage expertise and management support from our QA and Testing Center of Excellence at our Montreal Innovation Centre in delivering responsibilities such as planning and strategy, test suite and defect management, test execution oversight, and reporting.

At the beginning of each testing project, the client would prioritize and direct all project efforts per the project team model jointly defined with TEKsystems. The TEKsystems team would train on site at the client and then work remotely at the MSC, supplementing the client’s project teams. We would utilize its processes and offer recommendations for joint review and approval from the client.

We would provide a delivery model that complemented the client’s existing capabilities in order to meet overall QA objectives. We would provide:

  1. Knowledge management. We would participate in a requirements gathering meeting with the client’s QA team. We would analyze the requirements, do a walk-through and prepare a high-level test plan. The knowledge management portal would be used as a mechanism for capturing continuous process improvement activities.
  2. Communication management. We would present the high-level test plan to the client and receive client sign-off. We would provide daily status reports to ensure that the client’s internal QA team and project leads were aware of the progress of the TEKsystems MSC team.
  3. Test case development. We would develop test cases for each new enhancement. We would then establish and maintain a regression bed of testing per each application’s requirements. We would also take the regression test bed and automate the test cases using Quick Test Professional (QTP). This would be part of a high-level automation strategy for each application.
  4. Test execution. We would then perform various types of testing, including automation, data load, data warehouse and BI testing. We would manage and report on all defects. We would also provide post-implementation support, including release weekend support when the client typically rolled out its upgrades.
  5. Process improvements. Throughout the testing process, we would provide test status, test results and other quality-related metrics to stakeholders and management to identify performance or quality improvement opportunities.

The biggest risk with this engagement would be data security: figuring out how to put the right controls in place to ensure data integrity and security with an outsourced team. Resources aligned to the project at the MSC would dial into the client’s network but would not have administrative rights, therefore applications would not be able to be installed by TEKsystems without client approval and nothing—like copies of test cases or screens—could be stored or saved on the MSC’s network. This would provide another layer of security for the client’s sensitive information.

Based on our recommended approach, TEKsystems was selected for this QA and testing initiative. The client chose to partner with TEKsystems due to our long-standing partnership, high-quality resources, the reputation of our MSC-based solution (i.e., a QA Center of Excellence supported by our expert Application Development practice) and our ability to mitigate costs using near-shore resources.

We provided seven QA analysts, including one team lead, and at one point ramped the team up to nine resources to meet testing demands. Notably, one of the client’s previous concerns was attrition. Seven resources have been aligned to the project for three years and we have successfully experienced zero attrition for over two years—a significant period of time considering the high-demand skill sets of QA analysts with intense data backgrounds.

We have performed testing on over 12 applications, including BI and Web-based corporate applications. We assisted the client in developing and implementing a QA automation strategy, which included establishing a test regression suite for each application. When an existing application is augmented in any way, this suite will automatically test its code to see if it still functions correctly. Our team created an automation user guide so regular QA analysts can use the automated scripts without the help of the automation engineer. This increased the automation usage and helped our client obtain a better ROI for automation.

Our team and the client team collaboratively established a workflow for increased test execution efficiency. When we were first aligned to the project, there were no standard QA processes; the client took an ad-hoc strategy toward each application’s testing. We put together a holistic structure that included more module testing and testing of the whole environment with a repeatable structure in place. We developed consistent, quality testing processes that ensured that the software products the client released were of excellent quality, rid of bugs and issues, and minimized organizational disruption.

We also saw a need for QA and testing to have a role in each application upgrade’s high-level planning process. We involved ourselves in each application’s walk-through and the client began relying on us for input on their requirements. During the client’s demo to its members, our team provided test data and scenarios to demonstrate the new feature thoroughly. This helped us gain valuable insight into their business and align our testing to their business requirements. We also established a lessons learned meeting following each application’s release which the client has begun to do for all of its applications.

The client’s primary function is leadership and providing benchmark data back to its members to formulate data-fueled solutions. With a solid, scalable and repeatable QA and testing process in place, the client can seamlessly deploy application upgrades to its 38 member organizations to help them define price strategies, create marketing campaigns, and make solid decisions based on valid data trends and tailor their offerings accordingly.

  • Relationships. As long-time partners, TEKsystems and the client have built a mature relationship built on trust and understanding. The MSC recruiting and leadership teams assembled a team of high-quality resources and its low attrition rate can be attributed to the closeness of the MSC team and the client team and how well they’ve worked together. We were able to prove to the client that we could work just as collaboratively and effectively off site as we could on site.
  • Consultative partnership. On this project, our partnership grew from an outsourced to a value-add consultative model where we’ve been able to deliver more than just quality resources to staff their QA initiatives; we’ve also helped the client improve their QA practice by actively helping them identify and implement QA best practices. For example, our team helped implement a streamlined test project structure and the defect template. This resulted in reduced redundancy, improved reporting and lowered learning curve for new project team members. For data warehousing testing, our team was instrumental in making the source-to-target document as a mandatory project deliverable. Additionally, we helped them better define their job roles and align their job descriptions to better attract and retain high-quality, right-fit resources.
  • Effective knowledge transfer. We were able to effectively support the client’s internal QA practice without any impact to productivity because of a seamless knowledge transfer and management process. At the onset of the project, our resources sent on site at the client for training; however, once we started gaining familiarity with its applications we were able to train resources at the MSC and create training documents that were saved on their network. Our alignment was so effective that the client has sent their new internal QA resources to receive training from the MSC via live training and other methods.
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