Up at 5AM: The 5AM Solutions Blog

On October 26th, I attended a session on Lean and Kanban practices at AgileDC, a conference that brings together Agile software development enthusiasts. The session presenter was Jon Terry, COO at LeanKit--the namesake being a Kanban based management tool for software development projects. During his presentation he brought up the subject of EHR's, which, as a member of 5AM Solution's Health IT practice, caused me to immediately perk up my ears. He shared a story about HCA, a large hospital management company that decided to implement a new EHR management software solution at all of their hospitals and offices nationwide. In a company that utilizes a "waterfall" model, this project would be addressed by conducting a routine audition of different vendors and gathering requirements before eventually purchasing one. At HCA, however, they decided to take a decidedly more expensive approach. HCA purchased products from four vendors and had them installed at a few pilot locations at the same time. The goal here was to have the doctors and staff use the various software packages in order for them to test them out in real world situations and to have the employees provide feedback to management on which one worked the best. The Agile principle at work here is not that they did a large scale deployment of multiple systems, but rather that the users could interact and experience the products hands-on. The result was an enterprise deployment of Meditech, the "winner" of this vendor contest, which Terry said has increased productivity and employee satisfaction dramatically.  

The key to agility is constant improvement. To have improvement there are two requirements: a desire for change, and an action taken to make that change. This makes a clean delineation into how the retrospective should be divided; look at the past and then look into the future. In the development process a team either adjusts and improves, or continues to see the same problems and limitations. 

At 5AM, we use Scrum to manage our work. Scrum keeps the team highly committed and productive by making the best use of what we know now to guide the team toward developing solutions that will provide value today. It's great. What Scrum doesn’t do so well is deal with the “big picture” - At least, that’s how I felt when I first started using it.