EHR testing: How to validate new workflows before go-live

Before launching a new EHR system, every workflow, user role and system connection should be tested in a safe environment. Effective EHR testing helps practices identify workflow issues, documentation errors and integration problems before they affect patient care. By the time testing begins, staff should already have completed the training required for their individual responsibilities so they can carry out realistic testing scenarios

The importance of EHR testing

You should have established new workflow processes so that each department knows its responsibilities regarding patient input, clinical documentation, billing, scheduling, and patient follow-up. It is critical to thoroughly test your EHR implementation before you face actual patients.

This will confirm that the above processes run smoothly while allowing you to identify areas of confusion, workflow breakdowns, or data issues before they affect patient care. It is far better to test and retest in a controlled environment than to encounter problems during live consultations.

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As part of your integration-specific testing, verify that information is passed correctly between connected systems, such as billing software, laboratories, pharmacies, imaging systems and patient portals where applicable. Test both successful transactions and situations where information is incomplete or unavailable so staff understands how the system behaves.

Assign testing to staff who have been involved in creating the new EHR workflows and who have great attention to detail and patience. You want your staff to identify issues or breakdowns in the system so they can be corrected before implementation with real patients.

Test patients

Your EHR system should allow you to create “test patients” so you can practise every aspect of clinical documentation, billing, ordering prescriptions, printing patient education handouts and scheduling appointments.

Creating realistic EHR testing scenarios is one of the most effective ways to validate both workflows and system functionality. Create a patient case scenario that your team is familiar with, like a wellness visit for an 80-year-old man. Test the system by entering every component of documentation required for a real patient, from demographic information and medication reviews to vital signs, physical examinations, referrals, prescriptions, follow-up appointments and patient education handouts.

Include a range of scenarios rather than relying on a single patient case. Testing routine appointments alongside referrals, repeat prescriptions, chronic disease reviews, laboratory orders and cancelled appointments helps confirm that staff can complete common tasks accurately across different workflows.

Variables to test before go-live

• Patient registration and demographics
• Clinical documentation
• ePrescribing
• Laboratory and imaging orders
• Referrals
• Billing and coding
• Appointment scheduling
• User permissions and role-based access
• Interfaces with third-party systems
• Patient portal functionality
• Reporting and data accuracy

Real-time EHR testing

Next, take this testing a step further. Ask a staff member to represent a real patient. Have each individual in the department carry out their role in caring for that patient.

The receptionist gathers identification and consent forms before entering the information into the system. The nurse records the patient's history and vital signs, while the physician performs the examination and documents the findings. Follow the process through the plan of care, prescriptions, referrals and scheduling.

This validates how staff, workflows and integrated systems perform together in a real-world setting and often highlights issues that are not obvious during individual task testing.

Once you have identified any areas of discontinuity, work to correct the issues. This may require additional staff training or support from the EHR vendor. After making the necessary changes, test and test again until no further issues are identified.

Final thoughts

Successful EHR testing is an ongoing process rather than a single exercise before implementation. Each issue identified should be corrected, retested and documented until workflows, integrations and user tasks can be completed consistently.

You can then present the results to administration and senior management with greater confidence that your practice is ready to go live.