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May 4: Today on the Conference channel, it’s an Interview in Action live from ViVe 2023 with Mark Scruggs, President and COO at SureTest & Chris Scanzera, VP and CIO at AtlantiCare Health System. How does the automation process of regression testing for EHR upgrades work at Suretest? What benefits does it offer compared to the manual testing process used before? What unintended benefit did Chris find from using recordings of their testing processes? What other use cases are there for the automation tool besides testing EHRs?

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Welcome to this week, health my name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week Health. A set of channels dedicated to keeping health IT staff current and engaged. Today we have an interview in action from the 2023 Spring conferences, vibe in Nashville and hymns in Chicago.

Special thanks to our cDW, Rubrik, Sectra and Trellix for choosing to invest in our mission to develop the next generation of health leaders.

You can check them out on our website this week,, now onto this interview.

All right. Here we are from the VI conference. We're on the floor another interview in action. And I'm joined by two gentlemen today mark Scruggs with shortest and Chris Scan with Atlanta Care. Good morning. Which is awesome. I'm looking forward to the conversation. One of the things I was looking for as I came into this was companies that were doing ai, companies that were doing automation.

And shortest is one of those companies that's doing automation. Give us a little idea of what shortest does, mark.

Sure. So we are essentially automating the regression testing associated with upgrades for ehr. So, epic and Cerner and other vendors are usually rolling out quarterly upgrades.

The vendors inevitably fixed 10 things that, you know, didn't work before, but break three or four things that might have worked before. So it's always good hygiene to regression test. Have a standard test bed of. Test scripts to regression test the new version of those applications and we can automate that process.

That's today a very manual process.

Chris, how did we do that before? Short test. A lot of people, lot of hours, a lot of paper. And this is really helpful. Did, did, Did a bunch of that fall on the clinicians themselves?

It did. It did. We used to have to pull people out of the day jobs and set 'em up in a room and then just continue to run and run and run through the processes.

So, your client of shortest. We are. Give us an idea of what it looks like to automate this process.

So basically going through from the old way to the new way,

it's, it truly is automation. We basically take

the old broken down workflows, automate 'em, and then just kind of run 'em through in cycles.

And I can tell you to keep people in their native workspaces and not have to pull 'em out and bring 'em into test rooms has been unbelievably helpful. We've really cut down on the labor requirement. I don't know, in some instances, by as much as 80% and we've gotten more accurate results by using the test solution.

How big is the library? I mean, how much can you test? I mean, I'm sure that's what people are thinking. They're like, Okay, we're talking about a very large system here, right? How much of it can actually be automated?

So we break down those integrated test scripts into what we call workflow.

So workflow is a clinician signs onto the system, does a transaction, logs back out. So they place an order, they room a patient that would be considered a workflow. So we're up to 2,500 different workflows across both Epic and Cerner. And so we leverage that library to jumpstart that next client's build.

So we understand their workflows. We look at our library, see which workflow is the closest to what they're doing, and that really jumpstarts the development of their own personal library.

So your team now looks different than it looked before? So you're gonna take the next release of whatever EHR you're on.

We're a Cerner shop. Cerner shop. So you take the next release of Cerner? Yep. How has it impacted the timeframe? How has it impacted their workload?

So, it's done a couple of things. Code set upgrade's a big deal. We actually work with Cerner now in terms of the time commitment, both inside of it and outside of it.

It's reduced. And by basically

incorporating this,

we're reducing the risk of taking the code set. So in terms of running through the cycles, we can do more cycles and we can do them faster so that as we find things. That need to be fixed, we can fix and go back at 'em again.

It's interesting. I was talking to a CIO who had to do what I would consider draconian cuts to his IT staff.

I mean, they're a smaller health system, but they still,, we were talking about testing and he said, we're just gonna do an all, we're gonna do a lot less testing. Right. And I thought to myself as a cio, I'm like you know, are you gonna take less releases? It's like, well, we're sort of required to take certain releases.

We are. And this is probably the kind of solution that somebody who's looking at cuts this makes a lot of sense.

It does. I mean, we've done some time motion studies with some of our larger clients and people are spending on the low end, 10,000 hours a year just doing manual testing on the high end up to 40,000 hours.

So if you think about giving back 80% of that time, that's. A lot of FTDs,

you don't wanna do the math on the fly, do you?

No, I, I can, I can. I think that's about 8,000 hours of 32,000. Eat to 32. There you go. Four to 16 people. you know, Those are some big reductions in terms of the time that we're giving back to the staff.

So whether it's not replacing attrition, whether it's not hiring, there's new hires because now that staff can be deployed on more strategic projects, but we think there's some huge benefits to giving back those hours.

So as a cio, my next question comes to implementation, right? So I'm sitting there going.

All right. This sounds like a system. I'm gonna have to do a fair amount of work to get implemented. Mm-hmm. And I want to know how heavy is the lift. For my organization. What does it look like to bring this online?

Yeah. It's a really small lift. What we ask is we want you to capture your current testing process, your manual process.

So we'll get on a Zoom call or teams call, have them walk through

so you just capture it with a screen recording.

Yeah. So we just record the record that session. And in fact, we can even leverage an existing testing event. So if you've got an upgrade coming and you're already doing the testing, It's already scheduled.

Let's just set up a teams call and coordinate that. So once we capture that manual test effort, that's the artifact that we use to then go do the development of our scripting. So our developers then go do the scripting in the tool. Once the scripting is done, you can run the script in the client's environment and report it.

It's a video recording. We send it back to the analyst, say, Hey, watch this MP4 video file and confirm that we've captured the script appropriately. So it's probably an hour or two on the front end and probably a half hour, an hour on the back end to do the manual capture and to validate the video recording.

📍  all right, we'll get back to  our show in just a minute. We're excited. We have a great webinar for you in May on May 4th at one o'clock Eastern Time. It is part of our leadership series on modern data strategies in healthcare. In this webinar, we're going to explore data driven approaches to healthcare and how they can improve patient outcomes, increase efficiency and reduce cost, which are also critical at this time.

In this juncture in healthcare, our expert speakers will explore data governance, analytics, strateg. anything that can help healthcare providers gain actionable insights from healthcare data. We would love to have you there and we're excited about it. You can register on our website.

Just hit the leadership series, modern Data Strategies. It's gonna be in the top right hand corner of our website this week, you can discover how we are going to use data to be more efficient, effective in the modern healthcare system. we would love to have you join us again.

Hit the website this week, Top right hand corner. Sign up today. Hope to see you there. Now back to the show,



It's interesting that you describe that. Do you end up. Having a library that is standard like regression testing and then client specific regression testing. Cause I'm thinking my build's different than your build. Yes. Right.

You know, We find that about 80% of the build is very similar. But there's 20%, probably 10 to 20% variation.

So we have our global library that we draw from, but then we develop a client specific library that we deploy to their environment.

I'm thinking about as a cio. Platforms. Yep. Right. I'm trying to rationalize my applications and it's nice to have this platform for automated testing for my ehr.

What else can I do with it?

I mean, the solution really is an enterprise solution. So whether it's all those third party applications that you want to do roundtrip testing with in Chris's case, we have a lot of use cases where we're doing some robotic process automation. So they go by a new physician clinic, they want to convert all those telephone encounters.

We can use the automation tool to actually create all those phone encounters. Today they're doing it with, You know, hands on keyboards. So there's a number of use cases outside just, testing of the HR that, you know are possible. Yeah.

There's one other, you know, it's kind


like an,

unintended benefit that we picked up out of this, and it started with going through the workflows and automating that, and that's, it's a regeneration of training materials,

so that as you go through the process Oh, interesting.

Right, because you're recording all this,

because you're recording all that. So as, and again, dealing with the turnover that we're experiencing in healthcare right now. You have a refresher your training materials, and you didn't really realize it was gonna happen until after you went through the whole process, so that you can actually do a refresh on all your documentation at the same time as you're automating your process.

So unintended benefit, very valuable to us. Also, as part of this,

I assume as a CIO you're looking for automate, you're looking for solutions to the financial pressures you're looking for solutions to staffing shortages. Time pressure, Time pressure as well. What are you seeing at the conference?

Are you seeing a lot of new automation solutions, AI solutions and those kind of things?

Seeing a lot of things to take workout, to take time out. Really things that can, we can find the economic levers.

Yeah. And I'm looking at these numbers again. This is how you had the numbers so quickly.

They're right there, right here on this thing.

I couldn't read it upside down though.

Yeah, actually, and you know this highlights ROI and I wanna talk to you about roi. Cause ROI is huge right now, right? A bunch of CIOs I was talking to said, look, I mean, the ROIs almost have to be right around that 12 months timeframe.

It can be a little longer than that, but that's the, seems to be the magic mark right now of let's see what solutions we can bring in to have an almost an immediate impact. What kind of ROI are you talking about with this solution?

Yeah, so we typically measure over three to five years.

It's usually, you know, in the triple digits in terms of return investments. But what we do is we don't wait to develop all the automation before we deploy. We begin to deploy pieces of the automation as soon as it's developed. So we start deploying automation within. Four to six weeks of kicking off the project.

The entire library is usually delivered within six months. So we are typically seeing ROIs under a 12 month timeframe.

ROI is interesting because you have a challenge and the challenge is us. That's right. Right. It's so, it's the, I so funny. My team would be like, we're not gonna hit the ROI on a certain project.

I'd be like, Oh, okay. Why is that? Well, we, we didn't sign the contract for six months. We didn't assign a project manager for another three months. We didn't. But I feel like healthcare is now really cognizant of those roi. And like, what do you need for this to be successful, like right outta the shoot?

Like, what's a great case study of somebody who did this right?

Yeah. So I think the clients who've really done this right, have dedicated a project manager on their side to kind of manage the, you know, all the different, the,

the operational and the,

exactly. So it's everything from system access, it's setting up their appropriate, virtual hardware software.

It's coordinating their employees to do the video capture and the review. So I think that's really key is if there's someone on the client side who can help coordinate all the. Resources and activities. That seems to help a lot.

That may not happen at your health system, but it happened at our health system.

It's, we're seeing like anywhere else, the convergence of time to solution and time to value, right? It used to be this wide, now it's this one, right? So, and to, to Mark's point, it's about the IT resources and the ops resources converging at that, at that rate of play, at that speed of play.

Yeah. Actually, as cio I spent a lot of time, first of all, in the contracting process. We took it from like six months down to a couple of months, and we had pilot contracts that we could actually get done in like two weeks because we weren't giving 'em access to our production and those kind of things.

Right. Right. And so it sped up, we looked at every part of that process to speed it up Right. To get there. And that's, you know, one of my encouragements to CIOs is don't neglect that part of it. And if you're looking to get a return on a solution like this of, you know, 18 to 32,000 hours, your health system's gonna benefit significantly.

Absolutely. you're really the gatekeeper here, you've gotta put the right resources on a project to make sure it comes out. So, Hey gentlemen, I want thank you. Thank you. Great seeing you again. Thank you.

 Another great interview. I wanna thank everybody who spent time with us at the conference. I love hearing from people on the front lines and it's phenomenal that they've taken the time to share their wisdom and experience with the community. It is greatly appreciated.

We wanna thank our partners, CDW, Rubrik, Sectra and Trellix, who invest in our mission to develop the next generation of health leaders. Thanks for listening. That's all for now.

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