Lessons Learned from an Agile Transformation in Healthcare

We are in a world where advances in technology result in rapid disruption of every industry, and healthcare is no exception. Implementation of electronic medical records and advanced hospital information systems (HIS) provides a means to reduce deaths associated with medical errors and allows for advanced analytics to improve the standard of care. However, the logistical burden of the scale of the transformation poses a significant challenge to public sector organizations.

This session will act as a case study from a recent engagement completed by our team, which was the largest HIS implementation in Canada to date. We will discuss some of the challenges encountered throughout the two year implementation, how a focus on agile values provided an avenue to overcome the challenges, and some of the lessons learned from the application of agile principles in a non-traditionally agile industry.

Attendees can expect to leave the presentation with 1) an idea of the cutting edge changes occurring in the health tech industry, as well as 2) tips in bringing the strengths of Agile such as resiliency, flexibility and transparency into your own organization.


Outline/Structure of the Experience Report

  • Background on healthcare industry and the challenges faced during technical implementations of hospital information systems (HIS)
    1. Getting clinicians and physicians to take ownership
      • Physicians are not a traditional hospital employee but the hospital will shut down without them
    2. Defining scope is a challenge – need for agile thinking
      • Inevitable ambiguity causes unease in this high risk environment
    3. Tech overhaul is never the top priority, patient safety necessarily comes first
  • Introduction to the Agile mindset and its benefits to HIS transformations
    1. Individuals and interactions over processes
    2. Responding to change over sticking to a plan
    3. Customer collaboration over contract negotiation
    4. Working product over documentation
  • The four values of Agile and how they relate to healthcare: a case study
    1. Individuals and interactions over processes
      • Consistent checkpoints and open team discussions are critical in allowing us to keep a finger on the project pulse, proactively addressing concerns before they become issues
      • Should routinely discuss the instinctual feelings of product developers and encourage interaction outside of established channels in order to mitigate risk
      • More in person meetings to discuss concerns to create and formalize them into risks in future
    2. Responding to change over sticking to a plan
      • The logistical scale of HIS implementations requires frequent adjustments to established plans, with the flexibility of team member roles and processes being of paramount importance
      • Agile mindset provides a framework for healthcare professionals to adapt to changing circumstances during the transformation
      • Vulnerability was a big part of the success of the project, being open about timelines shifting and pivoting.
    3. Customer collaboration over contract negotiation
      • Ongoing stakeholder engagement enables co-design of next steps and leads to clients championing our agreed on plans
      • Choose the correct clinical stakeholders as product owners to be continuously engaged in the delivery, though loss of resources due to constraints made it a challenge
      • Could have been done better. Frequent face to face interactions should have been made a higher priority
    4. Working Software over documentation
      • Active functionality allows iterative improvements, and prevents unnecessary rigidity in processes
      • Prioritize essential clinical workflows for the release of a small portion of the product and optimize based on feedback gained from real usage, ie. Launch Epic, then customize based on departmental needs
      • Avoid the trap of building for ideal workflow instead of what individuals are actually doing in their day-to-day

Learning Outcome

  1. Success depends on team resiliency, comfort with ambiguity, and flexibility in roles. Ie: team members routinely shift from task to task as priorities shifted.
  2. High level planning needs to be built around a dynamic day-to-day. Ie: team revised roadmap every two weeks, based on latest reports.
  3. Full transparency of reporting and timelines is critical for client input. Ie: directors and VPs were regularly updated on key metrics and involved in decision making, development of mass communications (top 5 at 5).

Target Audience

Those interested in exploring agile implementation in a non-traditional, specifically healthcare, context.

Prerequisites for Attendees

None, although a basic understanding of Agile concepts is beneficial.


schedule Submitted 2 years ago

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