MatrixCare QA Case Study


MatrixCare is the complete solution for growing organizations that need to successfully manage risk in care delivery across the LTPAC spectrum. Trusted by more than 13,000 facility-based care settings and more than 2,500 home care, home health, and hospice organizations, MatrixCare’s solutions help ACOs, skilled nursing and senior living provides, life plan communities (CCRCs), and home health organizations to connect, collaborate and prosper as we migrate to a free-for-value healthcare system. In addition to purpose-built EHR components for any LTPAC care-setting, MatrixCare also includes solutions to systematically increase clinical quality: Enterprise Analytics, robust Clinical Decision Support, and the industry’s first Care Coordination platform to create a true, person-centric, e-longitudinal health record and enable LTPAC providers to efficiently manage the populations under their care. MatrixCare is a business of ResMed, a leader in cloud-connected medical devices and out-of-hospital software-as-a-service (SaaS) business solutions.

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With a business spanning 30 years, MatrixCare was finding it increasingly difficult to maintain its standard of software quality. The challenges to keep up with technology and user requirements, while simultaneously integrating software from multiple acquisitions, were straining their QA resources. The healthcare domain is one with ever-increasing and stringent compliance and regulations. MatrixCare made the strategic decision to embark on a software quality improvement mission. They decided to utilize the services of software quality and process experts. The vendor would have to have deep domain expertise, understand their business, be able to assess their software quality and testing processes to see where they were vulnerable, and provide actionable recommendations on how to improve.

After evaluating multiple vendor proposals, MatrixCare selected XBOSoft.


To address MatrixCare’s current QA challenges and to establish a solid foundation for long-term software quality improvement, XBOSoft proposed a multi-phased program consisting of the following:

Quality Process Assessement:

XBOSoft’s Quality Process Assessment (QPA) is designed to improve quality throughout an entire organization, vis a vis it’s software product(s). Working in collaboration with the client, XBOSoft collects data and analyzes processes to uncover root causes of quality impediments and then provides a roadmap to software quality improvement. The QPA uses XBOSoft’s standard analysis methodologies based on the simple concepts of “understand, evaluate, and improve”. The Premise is that it is impossible to improve what is not understood. And improvement can only occur in a sustainable and continuous manner if actions are executed with measurement and evaluation as part of the overall process.

Software Quality Plan:

Building on the results of the QPA, XBOSoft prepared a Software Quality Plan. The Plan included step-by-step actions to take, in order of priority and ROI, to impact software quality. These actions included staffing levels, training, and test management practices with key factors including defect analysis and targeted regression.

Test Automation:

In an Agile development environment with numerous scrum teams supporting many platforms including the mobile environment, test automation was a necessity. XBOSoft developed a test automation framework and a complete suite of automated test cases integrated into the CI/CD pipeline. More importantly, test results were reported such that risk areas could be easily pinpointed for improvement.

Test Planning and Execution:

Because of so many products and with each product adding features and functions in each release, testing was always behind. XBOSoft wrote test cases and provided the additional manpower needed to satisfy special releases for test execution while helping to meet tight schedules.

Test Tooling and Processes:

Many organizations acquire tooling, but few dig deeply into using them optimally in their own context. XBOSoft worked with MatrixCare to examine how their tooling was supporting their existing development and test process and what improvements could be made in their configuration, implementation, and usage within their process.

Requirements Analysis:

As with many organizations that embark on an Agile transformation, requirements specifications get left behind. There are little boilerplate practices that tell organizations how to deal with Agile tenets of minimizing documentation yet having ‘some’ documentation when it’s useful. With our experience in many Agile environments, XBOSoft examined MatrixCare’s user stories and made recommendations to the content, structure, and process to reduce defects out of the gate before being coded.


The most visible result is that MatrixCare is a multi-time winner of the prestigious Best in KLAS for Long-Term Care Software award. However, under the hood and behind the scenes, this has been achievable in part because software QA has received targeted focus resulting in:

  • Hundreds of hours of manual regression test hours saved in less than a year. As each test automation suite executes with each build, that saves over 100 manual testing hours. Multiply that by serval builds per day…
  • Pinpoint reporting to increase test effectiveness. Less manual testing through automation is great, but what’s even better is being able to focus your efforts on the right areas of your software.


“XBOSoft was able to quickly understand our operating environment and make recommendations to help us improve our software quality processes. The software test automation framework they developed is still being used today, and we are continuing to expand our test case suites.”

VP, Developement, MatrixCare

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