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Quality Sense Podcast: Alan Brande – Testing in Healthcare

Welcome to another episode of the Quality Sense podcast! Today’s guest is Alan Brande. He’s the CEO and co-founder of Light It. Combining his two passions, software and medicine, he helps healthcare start-ups and organizations build successful software products and scale their development teams.

In today’s episode, we’ll discuss the challenges that working in the healthcare industry entails, the importance of testing software in this field, and more.

Get comfortable, relax and let’s get into the episode

Episode Highlights

  • How Alan merged both his passion for software development and healthcare in his current company
  • The changes he perceives since focusing on quality
  • The challenges of working in the healthcare industry

Relevant Links:

Follow Alan on LinkedIn
Light It’s Blog
Alan’s Book Recommendation

Listen Here

Episode Transcript

Federico:  

Hello, Alan, how are you doing today?

Alan:  

Hey Federico, how are you? I’m doing great. How are you?

Federico:  

I’m fine. I’m really glad to have the opportunity to talk with you today. And having you here in the show. It’s a pleasure for me also to share this space with some, some more Uruguayan souls.

Alan:  

Thank you for having me.

Federico:  

Yeah, sure. Would you like to start telling us about yourself, telling us your story? And also, maybe some idea of what you’re doing today in your company?

Alan:  

Yeah, of course. Well, my name is Alan. And I’m 27 years old. I’m the CEO of Light It, I have two main passions. One is software development, and the other is medicine. So about 10 years ago, I had to make the hard decision, which was if I was going to study software engineering, or if I was going to study medicine, I ended up studying software. But now, I had the chance to combine both of my passions, because at Light It. We build software products for the healthcare industry.

Federico:  

Oh, interesting. So there was that possibility in your options to study medicine as well?

Alan:  

Yeah, yeah, that’s something I was considering. Actually, when I was younger, I thought I wanted to be a doctor. But then, when I started to grow, I started to get interested in electronics at first later in robotics, and ultimately in software. And well, that’s what I ended up studying. 

Federico:  

Yeah, today, technology is embedded in all fields. So particularly in the healthcare industry, there are lots of technology embedded. For instance, a couple of weeks ago, I had a chance to go to the office of one of our customers, and they are working with a robotic arm to do some surgeries. And I got amazed by how technology can impact the lives of so many people, thanks to these types of innovations. Right?

Alan:  

Yeah. And it amazes me too, how fast the innovation is growing on the healthcare field, and how much they are leveraging technologies that technology, which is kind of recent, I guess. So it’s an exciting moment, we’ll be working and collaborating with this industry. For sure.

Federico:  

Yeah, absolutely. Tell me, what’s your relationship with software testing and software quality?

Alan:  

Well, I studied software. So it’s one of the areas that my degree covered. But to be honest, my work experience is more as a developer, not as a tester. But when we first started the company, I have to confess that we didn’t have any testers on the team. And our first projects were conducted with almost no testing processes. So the bad and I guess, also, the good thing is that we learned the hard way how important software testing is, and the impact on on the project outcomes and results. So we didn’t take too long to hire our quality experts to help us build our quality department at Light It. And I think it was one of the things that helped us take the company to the next level and start working in more exciting and more challenging projects. But ultimately, it made everyone on our team happier. I guess. Nowadays, I work very closely with the quality department, and we are now working on our playbook on how to approach quality activities in healthcare projects of different natures, which is quite a challenge.

Federico:  

Interesting. I always complain how in the different universities all around the globe, right? We have like a subject or two maybe related to software testing, and it’s at the end of the of the degree. And also, it’s optional in most of the cases. So this is like giving us professionals an idea of how testing is, is at the end and option. Right. But then we learn in the field, that it’s something that we should take into account since the beginning and different stages of our job, right. So, but yeah, I agree that in many cases, we have to learn that in the hard way.

Alan:  

Yeah, absolutely.

Federico:  

Nowadays, how do you consider the quality activities or the testing activities and related to medicine, is that a pain relief or a vitamin?

Alan:  

I think it’s a bit of both. It could be considered a vitamin because it can be used to prevent software failure, you know, that feeling when you say, we were likely to catch this bug before deploying it to production. So, and then also it helps boost the efficiency in the process of developing software, and the happiness and morale of the team. But I also think it’s a pain relief because it helps stabilize and rescue problematic projects. Many times we inherit projects from clients who switch dev agencies, there are many different reasons for this, but many times it’s related to the poor quality. So the first thing we do is an audit of the quality of the project, perform tests, see where it’s failing. And after that, we can start with the development phase. 

Federico:  

So as I see you as a consumer, like, testing is a key activity, right?

Alan:  

Yeah, absolutely. Absolutely. I think that if we want our clients to thrive, if we want them to provide the most value to their users, and we want them to work with us, in the long term, we can’t achieve any of these if we don’t take quality very seriously.

Federico:  

Yeah, right. So do you recognize an inflection point in the history of your company when you or your team has started to put more focus on the quality side of things?

Alan:  

Yeah, I think it’s happened twice. I think I briefly shared the first one, which is when we started as a small software agency, and we didn’t focus too much on the quality in the beginning. And then we started working on more challenging projects, we hired these testing experts, and start taking it more seriously. And this opens the door for even more challenging and exciting projects. So that was for sure an inflection point. The second time is when we started focusing in healthcare, which was about a year and a half ago, we knew that if we wanted to make it into this new industry, we needed to understand how to excel in this area. Because, you know, we are dealing with people’s lives now. So it’s super important.

Federico:  

Is there anything that you’ve started to do in a different way since you change your mind or and you incorporated this type of skills or roles in the teams?

Alan:  

I mean, I think we, we keep doing the same activities just on a more exhaustive manner. It’s alright, if you’re working for an MVP of an early-stage startup, they have a limited budget. So you many times you prioritize scope and features over quality of certain features, which are not core. But you can’t think like that on healthcare. It’s much better to have a smaller scope, less features, but making sure it doesn’t fail because you’re dealing with people’s lives here on their health. So it was more like change on the approach and the mindset than in the activities. 

Federico:  

So I think Software Testing is probably seen like a very important activity because of that because you are dealing with life that the thing that is a risk is related to the life and the health of someone and the experience of many people have when they are taking care of their health. Right.

Alan:  

Excellent, absolutely. 

Federico:  

So Alan how is software testing more important in the healthcare industry or how is that different?

Alan:  

I think testing is crucial in every industry. The difference is that in healthcare, a failure can put at risk the health or even the life of a person. But it goes way beyond those extreme cases, the healthcare industry, at least in the US is highly regulated. And PHI, which stands for private health information needs to be private. So there are huge fines if a software failure for any reason allows someone who is not authorized to access that information. So the liabilities a healthcare company is exposed to are huge. So our clients and us, as their partners should take quality very, very seriously to ensure that doesn’t happen.

Federico:  

I guess if you work in that environment, you also have to be aware of these type of regulations, right?

Alan:  

Yeah, of course. We deal a lot with something that’s called HIPAA compliance, which is, what you take, you should take into consideration if you’re building software that has patient data in the US.

Federico:  

Is that something similar to the PCI that is very famous in the security area?

Alan:  

It’s kind of there’s one key difference, which is you can be PCI compliant. There’s other organizations that can provide or audit you and give you that certification. You can’t do that for HIPAA. They’re not official organizations providing you the badge of HIPAA compliant. So that makes things even more challenging, because, you know, you don’t know how much to do to be compliant. All you need to ensure is that you keep the information safe and that there’s no breach.

Federico:  

Is there any strategy for companies out there working in this field, to take into consideration these sorts of guidelines, like the HIPAA, for example?

Alan:  

So there are some published guidelines, which are official like security guidelines, but they’re very generic because they try to be suitable for every different industry, not so, sorry, for every different field, not just technology. But something many companies do is they hire somebody, an external partner to audit their technology, or to build them an internal policy, that’s something we have at Light It, we have a, an internal policy, we had to hire a consultant to build it, which explains or at least has some rules about how we are going to manage that information, not only from a technical perspective but also from an operations perspective. So if any of our employees is going to have access to PHI information, for example, their computers need to be encrypted, they need to have strong passwords. There’s also, It also states the onboarding process of what happens after we finish working for a project, how we safely discard all the information we have. So you know, there’s a lot of different rules on how we behave internally as a company to diminish the risk of this very sensitive information to get out there.

Federico:  

Yeah, it’s not only about the software that you’re building, but also how the company operates in order to build that software. And I can, I can think of many examples if you’re working in testing, and you have different environments, and you want to have data similar to production, probably you need to prepare or to take into consideration a lot of things in order to deal with that data, which is sensitive. So…

Alan:  

That’s a huge challenge for testing. But yeah, that’s true. Like, it’s not just from a technology perspective, you can have the more secure software in the world. But if one of your employees has access to that PHI information and somebody steals their computer, and it’s not encrypted, and it doesn’t have a password, then they will be able to access that information. So that’s why it’s so important to take HIPAA into consideration not just from a technical perspective, but also from an operational perspective.

Federico:  

Yeah, we as testers, are always looking to uncover and show the risks that are in the in the software that we are developing. We should also be paying attention to the risks related to the process to how we are working, or that example that you just mentioned also, It’s like, because we, as a company developing the software also, at the end, the users will be also impacted by that type of issues, right? 

Alan:  

Yeah, exactly.

Federico:  

 So another question maybe not exactly related with this. What’s your biggest challenge in testing and quality today?

Alan:  

It’s interesting, but many times clients are reluctant to invest in testing. So one of the biggest challenges is convincing them of the value that testing provides to their project. It’s kind of like a paradox, because in our experience, testing can actually save costs. Of course, now that we work for healthcare, clients are more concerned about quality. But still, many times they have more limited budget to allocate to testing in comparison to other areas. And another challenge is that many times, it’s difficult to test healthcare products for different reasons. We are currently working on a project that integrates with an implantable medical device that transfers data to the cloud. So we have no way of testing that product on life-like scenario. So we have to get really creative and Ideate workaround to represent the real use case as close as possible.

Federico:  

Very, very interesting. I really liked the idea of… and this is a conversation that I typically have with many people, it’s not only about convincing, right, is also about showing value, and earn that trust that quality activities, or testing activities can add value to the product, can reduce risks, and is not a cost, is mainly an investment or something that you pay today, maybe in order to avoid to pay much more in the future. So I think our challenge as an industry, it’s also related to how we better provide visibility on the value that we provide, that we can provide. Right?

Alan:  

Yeah. And sometimes the challenge is that showing the return on investment of testing activities, it’s not so linear, as with other things, like adding a new feature, which you can, you know, measure how many people are using this feature? With testing, it’s, you know, avoiding problems. So it’s hard to, to prove how, how smart or how valuable that investment was?

Federico:  

Yeah. Also, another thing that I typically discuss with other founders, or people with companies offering software development services, is that you can showcase your work by showing like, captures of screens, right screenshots, or you can show or tell about the different products that you have developed, or the technology that you use, or you have experience with testing is like, Okay, this software is working without issues, or how can I show you how I prevented something to happen right?

Alan:  

 So it’s, it’s hard, to picture the lack of failure of a project. 

Federico:  

Exactly, exactly. So software per se is very different. It’s not tangible, right? And software testing is even worse, a worse case. How do you see the future of quality practices in your team?

Alan:  

We are working on improving the robustness of the products we built by introducing functional test automation, of course in projects that are mature enough. So we are adding automation to our test strategy. And one of the goals we have is to create a quality mindset or quality culture among the rest of the team. Because we want every team member to continue to contribute sorry towards increasing the quality of the products we build, not just the testers on the QA team.

Federico:  

Yeah. I’m 100% aligned with the idea that quality is the responsibility of the whole team and the tester is there to help, to coach others, to try to show where there are risks. But if we don’t have the engagement of everyone in the team is not something that is going to happen. Right? Is there something else you would like to suggest testers to do in order to learn more, to take into account if they are getting into the healthcare industry?

Alan:  

Yeah, maybe this is the same piece of advice I’ll give to any other technical role who wants to get into healthcare. But this is a very particular industry. So it’s crucial to understand how it works. We have an internal playbook on how we build software for healthcare, because there is a lot to cover, HIPAA compliance, privacy, security, etc. And this reflects on the architecture and several technical decisions. So I guess the first thing is make sure you understand the process of software development first, for this particular industry. And secondly, as a tester, you need to understand the requirements. So understanding the context of the product or building, who benefits from it, and how the industry works. It’s very important.

Federico:  

Very interesting piece of advice. Thank you Alan. And also in order to wrap up this episode, if you have to recommend a book, it could be about software or anything you like, which one would that be?

Alan:  

There is a book that have helped us a lot. It’s called measure what matters by John Doerr, which is a book about OKRs. This impacts us tremendously in our management style on how the company organizes each quarter to set goals. So if you’re unfamiliar with OKRs, it’s basically a goal-setting tool in which every individual, every department, and even the company as a whole, sets periodical objectives, and results that should be accomplished to consider those objectives as completed. And all the OKRs are transparent, so all the objectives are transparent, sorry, and everyone can see everybody’s objectives and their progress. For us, this helped us set ambitious objectives and be on the same page as a company and everyone’s aligned. We started achieving more every quarter since we started using them. And we feel like everyone’s pushing in the same direction. So this is a good starting point, if you want to implement OKRs on your organization, this book covers all the basics and teaches you on how to implement them.

Federico:  

Cool. Do you have any, okay are specifically addressing some quality aspects of the development?

Alan:  

So for us, QA is a department, so the department has, I think, this quarter, they have like three different objectives with at least 10 different key results they want to accomplish. And it’s great because everyone works together and collaborates in the QA team to not only set these objectives but working towards completing them. So it’s very collaborative.

Federico:  

Yes, they are also connected to the OKRs of different areas of their organization, right.

Alan:  

So yeah, every quarter the company sets their OKRs and all the different departments can if they weren’t somehow aligned to those OKRs. But we also give them the independence to set their own OKRs if they think there’s a good opportunity to pursue, even though if they don’t align too closely to the company’s core OKRs.  

Federico:  

Interesting. Is there something else you would like to invite our listeners to do? I don’t know, reach out on social media. Wherever you would like to invite?

Alan:  

Yeah, of course, you can. You can follow us on our social media. And also, if you like to learn more about building software for the healthcare industry, I think you should, or you could check out our blog. It covers software product building for the industry from different perspectives. The authors are our developers, testers, designers, product managers, so independently of your role if you’re into tech and healthcare, you’ll find our blog valuable, at least I hope so.

Federico:  

Yeah, I read many articles from there. I know many people that works in your team, and are always sharing very valuable information. I will share the link in the Episode Notes. So if you want to check it out. From my part just to say thank you Alan for your time. It’s been a pleasure to have you here in the show.

Alan:  

Likewise, and thank you so much for inviting me.

Federico:  

See you soon man bye bye!

Alan:  

See you soon bye!

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