Healthcare Application Testing: Your Ultimate Checklist

Manual Testing in Healthcare QA

Manual testing plays a crucial role in determining complex user workflows that involve patient interactions, clinical logic, variable conditions, and other factors. For instance, a medical professional who deals with medication charts, patient vitals, and alerts should experience an intuitive and smooth flow. It’s something that automated scripts cannot replicate in real-world use cases.

It’s indeed highly important in accessibility testing, especially for patients with disabilities or the elderly who rely on voice-based navigation. Manual testing and human observation often require analyzing the way visually impaired users interact with mobile health apps.

Techniques

An effective and result-driven software testing in healthcare includes the following important points:

• Exploratory Testing: Testers use the software as real users would, discovering various unexpected issues in live workflows.
• Usability and Accessibility Assessment: For persons with disabilities or older patients, many factors determine usability and accessibility. These factors include color contrast, font sizes, ease of use, and screen reader compatibility, among others.
• Test Case Documentation: Every manual test is thoroughly documented, including expected outcomes, clear steps, and detailed notes on observed behaviors. These help ensure repeatability and audit-readiness.

Automation Testing in Healthcare QA

Automation testing is crucial for ensuring consistency, speed, and scalability. It’s highly important for today’s advanced healthcare QA strategies.

Automation is ideal for high-volume, repetitive, or time-sensitive tasks that require implementation across multiple platforms and builds. Let’s understand important areas where automation brings value, including;

• Regression Testing: It involves verifying whether existing features remain unaffected by new code implementation.
• Performance Testing: It simulates a large number of concurrent users to verify load handling, whether for scheduling or telemedicine apps.
• Bulk Data Validation: This involves processing data with accuracy and displaying larger datasets, including patient histories and lab results, without requiring manual overhead.
• Repetitive Security Checks: It automates the entire process for common vulnerabilities like token expiry, sanitization, encryption protocols, etc.

Recommended Tools

Healthcare QA teams mainly depend on various top-notch automation tools, which are as follows:

• Appium: It’s apt for mobile apps across iOS and Android.
• Selenium: It’s apt for cross-browser web app testing
• Cypress: This tool is apt for advanced JavaScript-based end-to-end testing.
• Custom Frameworks: These have the potential to handle a variety of healthcare-related workflows and also compliance validations.

Integration

Automation works smoothly when integrated with a CI/CD pipeline. It triggers test suites with every code pull or push request. It offers;

• Early bug detection
• Fast regression cycles
• Scalable test environments that ensure future app growth

When you integrate automated QA with DevOps, it ensures healthcare apps remain high-performing, audit-ready, and deployment-friendly.

Security and Penetration Testing

Security is not to be optional for healthcare development. It is, in fact, critical, especially with the rising number of data breaches. Therefore, security testing has become indispensable for quality assurance in healthcare.

Criticality of Security

It cannot be denied that healthcare data is the primary target of cyber attackers. We have already seen various examples, whether it’s ransomware attacks or the theft of patient records. These are real and an increasing threat.

Many reputable regulatory bodies, such as GDPR and HIPAA, often impose heavy fines for non-compliance. You need to understand that even a single data breach can cause millions of dollars in costs and permanently damage trust.

Approach

A security testing strategy consists of multiple approaches that are as follows;

• End-to-End Security Assessments: It involves determining every point related to storage, data entry, transmission, and third-party integration.
• Penetration Testing: It aims to identify vulnerabilities before attackers can exploit them.
• Vulnerability Scans: It detects security flaws in APIs, libraries, and configurations.
• Encryption Validation: It ensures the proper encryption of data at rest and in transit using industry-standard protocols.

Best Practices

• Secure Authentication: For this, you can utilize advanced practices such as session timeouts, multi-factor authentication, and role-based access control.
• PHI Protection: This includes various activities such as anonymizing datasets for testing, masking sensitive fields, and preventing the storage of unwanted data.
• Threat Modeling: It involves simulating real-world attacks to strengthen defenses.

 Checklist for Security Test Before Launch

Let’s explore an important checklist for quality assurance testing before you conduct a thorough security test.

• Complete penetration testing
• Verify data encryption
• Implement secure logging and audit trails
• Review PHI access controls

• Integration Chaos: Healthcare apps are designed to be integrated with wearables, EHR systems, lab platforms, and third-party apps. Therefore, any communication lag or misaligned data structure can cause serious functionality issues.
• Fragmented User Data: Any fragmented or inconsistent data across various systems can lead to clinical inaccuracies, test failures, compliance violations, and other issues.
• Ever-Evolving Regulation: With changing regulatory guidelines and industry standards, QA teams face numerous challenges in keeping up.
• Device Fragmentation: A healthcare app should be functional on a range of devices with varying screen sizes, operating systems, and other specifications. Each comes with its own set of variables to test.

Mitigation Strategies to Overcome These Challenges

• Continuous Training: It’s crucial to regularly upskill your QA team on the latest tools, regulatory standards, and healthcare-specific testing scenarios.
• Regulatory Monitoring: To stay up-to-date with the latest regulatory updates, it is essential to subscribe to relevant organizations, such as HIPAA, the FDA, and the GDPR. And adjust your QA protocols accordingly.
• Robust Documentation: Always work with a version-controlled and clear record of test cases, compliance checks, and outcomes.
• Cross-Team Communication: Ensure that developers, clinicians, and QA are properly aligned through shared weekly stand-ups, dashboards, and feedback loops.

Real-world Story: Babylon Health

Babylon Health, a telemedicine company, faced major software issues in 2020. The affected software was the UK app.

What were the issues?

An app update introduced a bug that allowed users to browse consultation recordings that didn’t belong to them.

What was the risk?

It posed risks, including breaches of confidentiality and the disclosure of sensitive PHI, which constituted a clear violation under GDPR/HIPAA-like regulations.

What was the impact?

Although the issues were not malicious, they still posed significant privacy risks and became a major threat to the company’s reputation and compliance.

QA Intervention

The QA team acted fast and unveiled a vulnerability by focusing on privacy scenarios and edge cases. They identified and resolved the glitches within a couple of hours, thereby successfully mitigating a large-scale data breach.