IV. Build and Test

Local Information Systems Teams at each site will have accumulated considerable expertise in programming and incorporating decision support into their respective EHR systems. Therefore, systems development and testing will typically follow the methods and approaches in place at each EHR development location.

Developer Specifications

Where appropriate, CDS intervention specifications should be translated into a programming specification for developers. This should provide all appropriate information necessary to develop the intervention as specified in the intervention design. Using the documentation provided and EHR-specific programming tools, the implementation teams will create a variety of decision support interventions appropriate to the information being delivered and the assessed workflow patterns.

Testing Approaches

Each proposed intervention should undergo unit testing of each software module and integration testing to highlight potential defects in the interfaces and interactions between modules to assure conformance with the specification. The accuracy of the decision support interventions should be verified using test scripts that exercise the software, particularly at extremes of decision variable content.

Members of each user community should participate as testers to judge the usability and acceptability of each intervention. An iterative process of programming refinement is anticipated. An iterative approach to testing is strongly recommended, in which users are frequently engaged in reviewing and testing the usability of the CDS application as it develops.