Agile Example Healthcare

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GE Healthcare Goes AgileImaging unit takes control of its development environment and likesthe results By Andrew Deitsch and Ross Hughes

E Healthcare is a $17 billion-a-year business unit of General Electric, making every

thing from multispectralhigh-definition CT scanners to diag

nostic pharmaceutical devices. Our Im

aging Solutions unit, which has 375engineers supporting 18 products that

increase clinic!an productivity, a yearago faced several challenges meetingcommitments in this multiproduct dis

tributed environment.F irs t, we struggled with the pre

dictability of our program execution.

The cycle time on projects was toolong, taking f rom 12 to 24 months,

often with significant delays. These

long cycle times frequently caused thebusiness to push to add features be

yond the initial requirements, fearing

that the market couldn’t wait for another cycle to get those features. That,

in tu rn , often increased a program’s

scope, causing further delays and in

creasing the cycle time even more. Alonger cycle t ime puts a project at risk

since the requirements gathered at thebeginning are out of date by the time

the product hits the market.Second, our waterfall process fo l

lowed the typical phased-gate approach, which begins with gatheringrequirements, creating a high-level de

sign followed by detailed designs, andthen creating a traceability matrix

showing how those design details tie

back to the sys tem and user require

ments. At that point, a formal design

review occurs and once the various ap

provals have happened, coding begins.

Coding typically t akes s~vera lmonths, and then we release the prod

uct into a test environment where wecan collect customer feedback. This isusually the first time customers see the

new product before we begin a rigor

~ Lessons~j Learned1. Be realistic: Your organization’sunique needs will dictate what can be

accomplished in a two-week sprint.

2. overcommunicate: Don’t assumeeveryone will get It the first time.They won’t.

3, Modify: It’s OKto us e a hybrid approach to aflile. GE Imaging Solutionsneeded more up-front planning and post-sprint testing, for example.

4. Coordinate teams: They can learnfrom and help each other;the closer inalignment they are,the better.

5. Cultural change is key: People willhave problems with the changes agilebrings. Identify passionate individuals andget them to help with adoption.

ous verification and validation effortprior to release.The challenge with this approach is

that the ability to incorporate customer-requested modifications occurs so late

in the cycle that any significant missescould require complete changes to the

design, causing a lot of wasted time and

effort, and delaying the project further.

A third challenge for Imaging Solu

tions’ product development effort wasthe many artificial barriers that existed

among functions, especially marketingand engineering. These barriersweren’t any different than in mostlarge organizations, bu t it was clear

that they were becoming more prob

lematic over time.

To address these issues, early thisyear Imaging Solutions replaced the

waterfall software developmentmethodology it was using with an agile

initiative. We already had pockets ofagile development going on within various development teams around the

world, but they were run by engineer

ing groups that only used parts of agile.They used Test-Driven Development,

Continuous Integration, and ran proj

ects in sprints, but didn’t adopt otherfacets of the methodology.We liked the agile-based scrum ap

proach of having the product owner as

an integral part of the developmentteam. We hoped that adopting agilewould break down these barriers and get

the whole business working in unison torelease the right product to our customers on time. We especially liked the

idea of biweekly sprints, where productincrements were completed, and thechance to demonstrate functionality to

customers at the end of the each sprint

and get immediate feedback.

We began by visiting colleagues at

one of our joint ventures who used

I~l1about softw~e development at Dr. Dobb’s: drdobbs.com

AgileTransitiOfl

nfonnationweek.comDec.6,2010 59



AGILE DEVELOPMENT

agile methodologies from the begin-

fling of their development process andwere having great success with it. We

sent different people a number oftimes to observe sprint reviews, retrospectives, and sprint planning, as wellas to learn how they use third-partytools—like Rally’s Agile ALM platform—to create a single source ofrecord for progress and quality across

their software development teams. Wealso met with the quality and regula

tory te am to understand how it was

making agile work within its QualityManagement System.

Those conversations got us excited,

and we began to focus on getting senior leadership support. They’d seen the

results of using agile development atthe joint venture (especially the fre

quent customer feedback), and werequick to support our move.Our next step was to hire an out

side agile coach, who met with the

entire t eam to understand our products, organization, and developmentprocesses. Once he assessed our cur

rent state, he customized our scrumtraining.We decided to launch our move to

agile with one team. Then after thatteam was comfortable, roll it out to one

site. And, finally, we could take it to all

of our development sites globallyThe objective for our pilot was to

acquire scrum experience, understand how we could apply these techniques within our larger business(such as making it work within ourQuality Management System), and tobuild confidence among team members and leadership that we could be

successful.Everyone involved in the pilot—ex

ecutive leadership, managers, marketers, developers, testers, and techni

cal writers—was trained in the scrummethodology We needed the whole

crew on board ; wedidn’t

want this to

be just an engineering effort.We staffed a strong cross-functional

team for the pilot and protected it fromoutside distractions. We defined a

manageable scope with a short time re

lease horizon of about four months.We established clear success criteria so

that we could evaluate whether weachieved our goals. Yet the project was

meaty enough that t he te am couldlearn scrum skills while delivering

something meaningful t o the business.

WhatWe LearnedThe pilot identified important les

sons. First, we operate in a highly regulated environment so there are a

Our business is dependent on tight turnaround times.

Rally makes it easy to juggle scope, hours and resources,so we can share up-to-the-minute project information

with all of our stakehotders. Everyone can see priorities,

status and roadblocks to save time and rnoney.

See how development organizations like EriICs

are delivering software the Agile way:

www.raltydev.com/videos/

‘A]RALLY

SCALING SOFTWARE AGILITY

11.866.348.1552 I [email protected] Corp

MORE DR. DOBB’S ONLINEQual ity Management Best Practices

Is a risk-driven development approach the right one foryou?

infonnationweelccom/1286/ddj/qualfty

Q&A With Martin Fowler And Rebecca Parsons On DSLsThe nature of domain-specific languages as well as when and where to use them

infofmationweek.com/1286/ddj/dsf

Embedding Data Visualization In Rich Internet ApplicationsVisualizing complexdata facilitates rapid understanding;here’s how to adddata visualization to your apps

informotion week.com/12861ddj/rio

60 Dec. 6, 2010 informadonwetcom



AGILE DEVELOPMENT

number of addit ional quali ty and regulatory steps that must be completed

before we can accept a “user story”—that scenario written in the business

language of the user that captures whathe or she wants to achieve. Therefore,

ou r “definition of done”—that is, the

lis t o f activities that add value to theproduct such as unit tests, code coverage, and code reviews—turned out tobe lengthy. Ou r development teamsneed to plan for that when estimating

what they accomplish in a two-weeksprint.

We also learned the importance ofcommunicating, communicating, andthen communicating some more. Itcan’t be emphasized enough how important it is to make sure everyonefrom the dO to the developers knows

what’s happening. Often people don’t

hear the message after the first, second,

and even third time it’s said. So , while

it may feel repetitive, it’s valuable to

overcommunicate and keep everyone

aligned.Finally, we found that we can be ag

ile, but the rigors of being in a regulated industry require us to operate a

hybrid development model with moreup-front planning and post-sprint testing than would be found in a pure agile

environment.

Following the pilot, we brought ouragile coach back in to train everyone

who hadn’t already been trained. Weformed 10 scrum teams of seven tonine people and allowed them to self-

organize. Even the leaders got engaged

by forming their own scrum team.

With more people getting involved,

we needed to coordinate the various

teams that were all contributing toward

a common release. We instituted scrum

of scrum meetings with a representative from each of the teams to coordi

nate activities. We also scheduled oursprint reviews so that they’re all on thesame d ay . So now, every other Wednes

day, the teams conduct their sprint reviews together in the morning; after

lunch, they hold planning meetings forthe upcoming sprint. This ensuresshared learning among the teams and

visibility into what’s going on outsideany one team’s activities.

We also found we needed to identify

cross-team dependencies early in thesprint or risk teams getting in one another’s way Rally’s Agile ALM platformprovided insight into cross-team dependencies and real-time status up

dates. With these capabilities, we

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started to see teams swapping user stories and tasks. Teams that completetheir own tasks early are helping ones

that are slower. There is, indeed, an art

to balancing the decentralized controlof independent serum teams.

Cultural changes are the hardest partof adopting agile. That’s somethingwe’d heard from others prior to jumping into the methodology and it turnedout to be true. People often find it dif

ficult to change, and so it’s importantto identi~’ change agents within the organization who are passionate and canhelp with the adoption. A key aspect of

the culture change is the role of managers and individual contributors onserum teams. Managers need to avoid

a command-and-control style wherethey’re pushing work, but rather buildempowered teams.

Individual contributors need to startpulling work, make commitmentsaround that work, and then be account

able to deliver on those commitments.

Trust is an important part of people being comfortable enough to embrace

change, along with providing a safe environment where teams can learn, fail,

and bring up issues without fear ofrepemussion—this is critical for success.

While we’ve only just begun our

journey, we’ve seen positive results already Getting feedback early and fre

quently from customers has let us prioritize features correctly and, in one

example, identify a clinical workflowthat we hadn’t known about. We’veseen much more transparency and ac

countability among our teams. Teamownership has increased, and scrum

processes have brought the entireteam—from individual contributors to

leadership—together, asking the rightquestions.

The pilot project was delivered successfully with the correct features and

functionality. The release ran over bytwo sprints, so we’re stil l working onthe predictability of our execution.

Understanding a team’s velocity andusing it to predict future execution is

learning process that will take some

time—and some more sprints—to per

fect. However, we’re making progress,

and we feel that the benefits so far of

our agile adoption are worth the effort.We’re now beginning the next phase of

our transition by rolling out scrum

PresentsBug of theMonth #1563

This is just a small portidn

ofa vast computer program

being prepared by Santa and

his elves. Unfortunately

something is going wrong

and even though Jane has

been naughty, thepoor are

still ‘left with nothing’~What’s going wrong?

Visit our web site at

www - gimpel - corn -

globally to the rest of GE Healthcare.

Andrew Deitsch is VP and general man

agerfor GE Healthcare IT’s Imaging Solutions group. Ross Hughes is GE

Healthcare IT’s ScrumMaster. Write tous at [email protected].

#include <stdio.h>

const char *Jane = ‘“;

const char me Poor =

void assign_gift(bool naughty)

naughty ? the_poor Jane =

“New Bicycle”;

1’mt main()

{assign_gift(true);

printf(

‘The Poor = ‘%s’, Jane =

Thepoor, Jane );

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Dec.6,2010 63

Agile Example Healthcare

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