Software Testing Techniques in Mobile Healthcare Applications

Mobile healthcare applications are an alternative support for individuals with health issues like diabetes, cardiovascular diseases, blood pressure and many others. With the ongoing advancements of remote wireless systems and with a gigantic assortment of cell phones, portable healthcare applications are trending in the market. With the expanded utilization of versatile applications, quality assurance rises rapidly. Applications must have an excellent user interface (UI) experience and should give quick responses. Software testers need to ensure that challenges like patient safety, security and confidentiality are considered while testing a mobile application for healthcare. Most of the desktop software usability testing techniques, situations, and methodologies can be implemented for testing smart applications.

Mobile Application Usage in Healthcare

There are different mobile applications that are utilized in a wide range of workplaces, healthcare being one of these relevant environments. Mobile applications can be used on these gadgets and have been a result of the blend of the innovation we have had in the latest years. Smartphones support different communication techniques like, voice and video calling, text messaging, emails, multimedia messages which increases its efficiency between users.

Testing Techniques in Mobile Healthcare Applications

Many testing methods can be applied to effectively test a smart healthcare application. According to the proceedings in a conference paper on ‘Utilizing and Testing Smart Applications in a Healthcare Environment’, pilot testing methodologies are used. These include testing the applications functionality, features, usability and content accuracy. In this paper usability testing is explained in detail. There are two types of usability testing techniques: laboratory experiments and field studies. Laboratory experiments for mobile healthcare applications are conducted in a controlled environment. Field study is used to collect information from users in a real environment. In a laboratory environment the tester has full control of the tasks and procedures given by the researcher. It makes it easy to interpret the results of the testing technique. Unlike field testing, it cannot be tested in an unreliable network connection. Both these methods should be used together to get effective usability testing of a smart healthcare application (Schoffman, J. et al., 2017). Usability testing of the smartphone app for people with disabilities was studied in the iMHere application by Fairman et al. (2016).

Shaw, R. J. et al., (2015) states that financial and time constraints are major issues that are responsible for the lack of usability testing in many healthcare IT systems. However, cost-effective and efficient usability testing methods are available. Minor problems are likely to contribute to issues, errors, and user dissatisfaction. It is easier to find these by performing a heuristic evaluation. Carroll & Richardson, (2016), states that the software must be designed with user as the focal point, thus highlighting usability testing for testing smart or connected applications. Usability evaluation is an indispensable part of the product lifecycle. It ought to be conducted at each phase of the procedure to improve system usability (Bhutkar et al., 2013). Schoffman, J. et al., (2017) says efficacy testing is a basic requirement in building up whether utilization of a medical application results in significant change in conduct and clinical results.

Kedar R. et al. (2017) performed unit testing, black box testing, and regression testing for the Drive Against Stigma (DriSti) tablet-based Android app. Functional testing and end-user acceptance testing by field staff was also carried out. Carroll & Richardson, (2016) performed unit and integration testing (white-box testing) to ensure application operated as designed. System and user acceptance testing were used to examine functionality (black-box testing) to verify if the application meets certain goals.

Challenges Faced During Testing a Smart Healthcare Application

Security, performance, interoperability, feasibility, stability and reliability are several challenges faced while testing a healthcare application. A major drawback of an application is that it can be hacked. When handling patient or confidential information, security plays a major role. The VigiVU application which works on iOS platform was studied by researchers. This application is successful since it has excellent security features. Lane, J. S. et al., (2012) explains that it uses a 4-digit unique security code, a valid username and password. On syncing the device to a computer this data is not easily accessible since it is encrypted. This application also makes use of the unique device ID (UDID). Due to this feature, only the device registered with the server can access the application. Unauthorized users trying to access this application will be directed to device’s home screen. VigiVU uses measures required to keep information confident and safe. Fairman et al., (2016) claims that while testing the iMHere app, twenty-three usability testing issues were distinguished during the trials and were tended to through refinements to the application modules.

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According to Shaw, R. J. et al., (2015) heuristic evaluation identifies just potential usability issues in the current interface. Other usability testing methods can demonstrate parts of the framework that function admirably and recognize the most relevant functionalities. Bhutkar et al. (2013), state that usability problems give rise to medical errors, which can cause patient injury or death. Poor usability also affects training or support costs and leads to medico-legal cases (MLC) and liability claims. Technical issues and software corruption were faced while testing DriSti app (Kedar, R. et al., 2017). Baig et al. (2015) studied challenges of smartphone-based vital signs and blood glucose monitoring systems. Sound and image detection systems were also discussed with a critical analysis. Baig et al. (2015) came across challenges like privacy, accuracy, user-friendliness, and power consumption.

Numerous medical clinics utilize different threat management software and firewalls to monitor their cell phone applications to guarantee that they are secure and safe. This is a prerequisite of Health Insurance Portability and Accountability Act (HIPPA), USA.

Discussion

In this paper, results from a literature search on testing techniques and challenges in mobile healthcare applications was studied. About 20 journal articles and 2 conference papers were obtained. Out of which 10 journal articles and the 2 conference papers were used to carry out this literature review.

Testing a smart healthcare application is essential to calculate its success, since it enables it to be rectified if any errors occur. Disease diagnosis applications, drug reference applications, medical calculator applications, literature search applications, clinical communication applications, his client applications, medical training applications, general healthcare applications, applications for medical and nursing students and applications for patients were the different healthcare mobile applications identified by Mosa et al. (2012).

Mobile applications have been tested in laboratory environment, in field studied and in simulated environments. These strategies give vital data on the best way to upgrade the UI of an application and emphasis of the framework. The types of testing can contribute profitable understanding into how the application will work under various conditions. Testing in a simulated environment gives more effective results. Questionnaires, conducting interviews and group discussions, and collecting feedback from participants will be a powerful tool to predict how and if the application will be effective. These techniques will take into consideration the analytics of the application, which could prompt more enhancements in the innovation.

Baig et al. (2015) suggests challenges that must be investigated for future research. It includes reliability, efficiency and acceptability. “The diversity of techniques and the study audience may be an indication for the need of additional research studies” (Majikes et al, 2013, p. 6).

Recommendations

The way an application is used in a healthcare system is crucial. This will count on how fruitful the application is and how much positive change can be made in an organization. To decide how successful an application is, once developed, it must be tested in a healthcare environment properly. Software testing is essential as it causes mission failure, impacts operational performance and reliability if it isn't done appropriately. Clients anticipate 100% quality in the application. Effective software testing can make 100% quality applications. To accomplish this designing test cases efficiently during the test life cycle is required (Kumar & Geeta,2014). Regarding assessment of the privacy and security of the healthcare applications, researchers can follow whether clients hold the rights to their very own information, regardless of whether the information is protected enough amid transmission and capacity, and developer transparency (Schoffman, J. et al, 2017). Executing the ideas discovered through this literature will accomplish the success of testing healthcare applications.

References

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