Leaders from Novant Health and SureTest came together for an in-depth webinar exploring the transformation of EHR testing through automation. This article distills the essential insights and key lessons learned from our discussion, providing a practical look at how Novant Health moved from more than 20,000 hours of manual testing hours each year to reliable, automated testing that runs on a schedule. For readers looking for broader context, this transformation was powered by SureManage®, a fully managed test automation solution designed specifically for healthcare.
Ready to dive deeper?
If you would like to experience the full conversation and hear directly from Novant Health and SureTest, we invite you to watch the webinar recording. It offers a closer look at the strategies, challenges, and solutions that shaped Novant’s journey to automated EHR testing.
Why Novant Needed to Rethink Testing
Transformation is a lofty goal, especially for a large, 19-facility health system like Novant Health, with hundreds of ambulatory locations and one of the largest footprints in the Southeastern U.S.
For Novant, transformation wasn’t aspirational, it was necessary. That necessity became clear when a change outside the organization prompted a deeper examination of how testing was being done.
With Novant’s EHR provider’s move to a more frequent release cadence fundamentally changed the demands placed on Novant’s testing model and created strains that had previously been manageable under an annual upgrade cycle.
The Challenge of Quarterly Epic Updates
When Annual Testing Became a Year-Round Priority
When Epic shifted from one annual release to quarterly updates, Novant’s testing workload multiplied almost overnight. Instead of preparing for a single, large testing event each year, the organization was now supporting up to three large testing cycles, each with new functionality, configuration changes, and validation requirements.
For a health system supporting nearly 7 million outpatient visits annually and 2.5 million MyChart users, this increased cadence quickly made testing more complex and resource intensive. Each update required extensive coordination, validation, and staff availability, making testing feel like a continuous operational demand rather than a discrete event.
The Human Cost of Manual Testing
More frequent EHR releases exposed the limitations of a manual testing model: inefficient, expensive, and difficult to scale.
Novant was spending between 20,000 and 22,000 employee hours a year on manual testing. Even with a dedicated, 20-person QA team working full-time on testing, Novant’s EHR analysts were routinely being pulled away from their system build work to answer questions and address and resolve issues during testing events.
Scripts were typically run a handful of times per cycle, leaving limited opportunity to catch unexpected issues. Over time, the repetitive nature of testing also took a toll on morale. Testing events meant never being too far from a phone, ready to jump in at a moment’s notice.
It became clear that this new cadence of testing was not sustainable.
Searching for a Sustainable Solution
An Inflection Point for Analysts and IT Leadership
Realizing they had reached a breaking point in their testing continuum, Novant took a hard look across its organization at how testing fit into their broader IT strategy and how to determine a sustainable path forward.
Novant analysts were spending too much time running test scripts and not enough time building, optimizing, and improving Epic, which is where their collective expertise delivered the greatest value. Any long-term testing solution needed to change that dynamic and allow analysts to work at the top of their credentials.
Why Novant Chose a Fully Managed Automation Partner
Following an informal, RFP-like process, Novant selected SureTest.
This new partnership wasn’t just about accessing testing tools. Novant had previously attempted to implement automation software products in-house, to no avail. Instead, SureTest offered a fully managed test automation solution, purpose-built and tailored to Novant’s workflows, and a SureTest team that knew Novant’s EHR inside and out. This combination of cutting-edge technology and deep expertise made SureTest a natural partner for Novant.
Laying the Groundwork for Automation
Documenting Real-World EHR Workflows
SureTest began the engagement by embedding a team of automation engineers – previously Epic-certified analysts -onsite with Novant for several weeks to document existing workflows exactly as they were used in practice.
This discovery phase ensured automation was grounded in real-world use cases and not theoretical processes.
Keeping Automation Aligned as Epic Evolves
Once workflows were documented, the engagement transitioned to a remote model. SureTest’s automation team worked closely with Novant in biweekly working sessions.
SureTest also participated in Nova Notes sessions to stay ahead of upcoming Epic changes and to keep automation scripts aligned with Novant’s evolving Epic environment. This tiered approach proved the most effective strategy for aligning SureTest’s solution with Novant’s real-world requirements.
Scaling Automation Across a Growing System
Expanding the Script Library with Confidence
As Novant grew, so did its automation footprint. The test script library expanded from 132 workflow scripts in 2020 to 425 by 2024, supporting broader coverage and more frequent testing.
Supporting M&A Without Slowing Innovation
A major driver of this expansion was Novant’s acquisition of New Hanover Medical Center, a 900 bed hospital requiring a full Epic conversion.
SureTest supported the transition by expanding automation coverage to include new workflows and running tests across both the new build and existing environments. Automation allowed Novant to scale testing without pulling Novant analysts into time-consuming manual efforts, keeping them focused on higher value build work.
Creating “Non-Events” with Scheduled Automation
Today, Novant’s test scripts run on a scheduled basis. Issues are identified early, before they reach production.
There’s no longer a need for a dedicated QA team. And when EHR upgrades occur, they don’t bring workflows to a halt and distract employees from their primary roles.
For Novant, testing has become something of a non-event. And that’s exactly the point of automation.
There are no fire drills. No late nights. No waiting by the phone. And no pulling analysts away from the work they are meant to do.
Testing remains a top priority at Novant, especially as the health system continues to grow. However, it’s now efficient, reliable, and self-contained, making it more of a blip on the radar rather than the seismic occurrence it used to be.
The Measurable Impact of SureTest’s SureManage Solution
Operational and Team Level Benefits
The shift to automation delivered immediate and lasting results:
- Thousands of hours returned to Novant analysts for build and optimization work
- Fewer testing-related incidents during major upgrades
- QA resources redeployed into other areas of the organization
- Earlier issue identification through frequent automated testing
- Improved morale as testing shifted from disruptive events to a background process
The ROI of Automated EHR Testing
Beyond operational gains, the financial impact is compelling.
SureTest clients achieve an average ROI of 244% over three years and 100% ROI in year one.
As Ryan Neaves, VP of Product Development | Digital/EHR Products at Novant, said during the webinar,
“…really through the automation itself our analysts are ever – they are only ever just engaged in the build work…so they’re building things out and if there’s a result that’s unexpected that comes up, it really becomes the type of thing where it’s a quick IM or email, and it’s caught in a lower environment before it gets to the production environment…it’s an open conversation that happens, we’re not seeing the need to pull these analysts in… ”
For Novant, what started as a response to Epic’s accelerated release cadence became a broader shift to their entire testing culture and operations. Manual processes were replaced with managed automation, freeing analysts and teams to focus on other strategic projects rather than getting pulled into the details of every upgrade.
A Blueprint for Automation and Transformation
Many health systems are facing the same pressures that Novant Health experienced with its manual testing protocols:
- Continual testing demands
- Increased time and cost burden
- Declining employee morale
- Constraints on progress
The good news, as Novant Health has shown, is that there is a path beyond the constraints of manual testing. Novant didn’t just implement a tool; they reimagined their entire approach to testing. By pairing automation with SureTest’s deep domain expertise and a commitment to change, they created a sustainable model designed to support the continued growth of their health system.
Transformation realized.
Start Your Own Transformation
SureTest helps health systems turn EHR and enterprise application testing from a manual burden into an automated advantage. If your organization is facing challenges similar to those at Novant Health, let’s discuss how our SureManage solution can help.