Do I really need a test/training environment?

You may wonder why your organization would need to spin up a test environment of your current Electronic Medical Record (EMR) and/or Practice Management (PM) system.   A test environment is critical because:

1. It helps your organization prepare for upgrades,
2. It allows you to test different system configurations (hardware and software), and
3. It allows your staff to test and verify new protocols or workflows.

Imagine needing to upgrade your EMR software in a short timeframe due to important regulatory updates and not having an adequate test environment or any test environment at all. 

As the upgrade to your Production environment is happening, a problem occurs, and because the upgrade was far enough along, beyond the point of no return you could say, the system cannot be reverted or rolled back. The entire system has to be rebuilt from backups and could result in loss of data and valuable time.

If you find yourself in this situation, it can be a painstaking and time-consuming recovery, especially when there are a number of interfaces and VPN tunnels involved. If a testing environment is used, the issue could be discovered without affecting your production environment or risking the loss of data.

So, Let’s Take a Look at This for a Moment.

• Has your EMR and/or PM vendor posted several changes and/or upgrades?
• Are there new workflows that impact more than one department in your organization?
• Are there required changes either by your vendor or by the CMS?
• Where do you train new employees or test new internal protocols or workflows?

If you concluded that you have no idea where you would perform these types of activities, you may want to consider implementing an updated, relevant test environment.  Now what does it mean to be updated and relevant?  So many ideas, so little time.

Updated Test Environment

An updated test environment means your EMR and/or PM are loaded onto the appropriate infrastructure that meets your vendor’s operating system, hardware, and database requirements.  If you do not currently know what those are, contact your vendor or better yet, visit their website and look for their support section to review the information.  This will give you an opportunity to read, review, implement the approved requirements directly from their written documentation.

Once you have created or updated your infrastructure to handle the latest and greatest version of your EMR and/or PM, restore a copy of your current database, install the most up to date version of the EMR software, and then upgrade it to the latest updates and patches. 

This will put you in the right spot to be able to work through a potential upgrade, restoration, and/or possible hardware issue.  You will be able to create an SOP (standard operating procedure) to handle any future changes or updates and see how well your organization is able to handle any changes your vendor may send you.

Relevancy and Upgrades, Two Unlikely Bedfellows? But Are They Really?

Why would anyone put relevance and upgrade together? I’ll tell you why. How can you train, review changes, implement changes to workflow or protocols, or upgrade to a new version if you don’t have a test environment that matches your production environment?  It would be tantamount to working in a silo!

Bringing your test environment up to speed with your current environment helps save time and money when planning upgrades.  It gives your Technology team time to understand what would be affected and how to mitigate issues.  Not only does it allow you time to make appropriate organization choices, it also allows you to plan, plan, plan before you pull the trigger.

What If I Don’t Have a Test Environment?

Well, this is a different discussion but updated and relevance apply here as well.  The question is do you spin up your own or do you have it hosted and let someone else worry about it?  There are two options here both are valid, and both have their purposes.

• Option one – create a test environment on-premises. This option is perfect for an organization that has the equipment available to build a duplicate test/training environment and the staff to maintain it. 
• Option two – create a test environment in the cloud. This option may be available from hosting entities.  These cloud hosting entities could provide a duplicate environment of your organization’s current system.  This environment would be available to your staff via a remote desktop or a web-based connection.  This option frees up your Technology staff to continue to focus their attention on your organization’s current live environment.  There would still be some interaction between your Technology department and your hosting partner; however, not as involved as day to day maintenance might be.

“To Be or Not to Be!”

A hosted or an on-premises test environment is a necessity in today’s world.  Changes happen more often than we anticipate, and progress could be thwarted if there is not an updated and relevant test environment.  Progress is happening and we may as well be prepared and with more than one option available, there’s a solution to fit everyone!

Case in Point

Now back to the scenario mentioned at the beginning of this article. Had you proceeded to upgrade your software without testing first, and chaos ensued, your organization may have been unable to access your EMR or practice management system, requiring emergency services and possibly incurring extra costs, not to mention the loss of time, interruption to patient care, and potentially endangering patients.  The inability to track patient movement, billing, or documenting the patient’s visit.  These items translate into real costs, both physical and intrinsic.

Ending on a Happier Note

While the above case in point is an extreme, yet very possible event, there are solutions. You have options, there are always options.  You can choose to spin a test environment up on premises, ask your hosting to spin one up, or have the environment hosted for you.

There is an upside, the choice is yours and all you need to do is make one if we haven’t convinced you already!

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    Annela Aubry

Annela is the West Region Sales Engineer for Visualutions Inc, and has been with the company for the past 15 years serving both as a trainer and project manager prior to her role in Sales.  Annela began her career in practice management, project management, training, and EDI implementation on Millbrook's Practice Management system known as MPM02 and continues to learn new systems and requirements. Annela currently resides in Henderson, Nevada with her family.