Agile is Eating the World: Bringing Agile Development to Healthcare

By Catherine Ulrich, Managing Director, FirstMark Capital

Catherine Ulrich, Managing Director, FirstMark Capital

In 2001, a group of tech leaders, who at the time were labeled ‘organizational anarchists,’ gathered at a remote ski resort in Utah. The result of their weekend was The Agile Manifesto, a philosophy that dramatically changed the way in which almost all technology teams work. For context, the agile manifesto states:

Individuals and interactions over processes and tools

Working software over comprehensive documentation

Customer collaboration over contract negotiation

Responding to change over following a plan

That is, while there is value in the items on the right, we value the items on the left more.”

This manifesto became the backbone behind agile development. IT, for the most part, replaced the previous generation of ‘waterfall’ software development processes, which relied on requirements being passed from department to department.

Agile development first spread and changed how technology teams worked, but it has also spread into numerous other functions from marketing to sales teams. Essentially, for any business or function where customer needs to evolve quickly, agile development processes prove to be the most effective technique for meeting those evolving needs.

There are many resources that outline the team structure and processes for agile development, but here are a few common threads:

• A small team with diverse skill sets who have everything and everyone they need to develop a working piece of product
• Teams should be kept together at all costs. Like any team, it takes time to develop the best working relationship
• Dependencies break the ability to be agile

It is time for the agile revolution to reach to healthcare.

It is also the right time for this change. We have seen a dramatic shift in the last 100 years with respect to healthcare. Now our top challenges are not acute conditions, but chronic conditions. 70 percent of Americans live with a chronic condition. One in four live with multiple chronic conditions. And many of these conditions are driven by lifestyle choices—choices that are driven by constantly evolving consumer needs.

"Agile development first spread and changed how technology teams worked, but it has also spread into numerous other functions from marketing to sales teams"

I am not talking about using agile to deliver healthcare software, I am proposing that we take the agile principles and adapt them for how the entire care-delivery system operates.

So what would an agile healthcare system look like? It begins with a couple key components:

• Small, multidisciplinary care teams with a diverse set of skills, who consistently work together. The key here is gathering the right set of skills into a single team. Too often, our healthcare system is structured around referrals. Referring patients to a variety of independent specialists. This is the definition of the outdated model of waterfall development.

• In the case of healthcare, shipping product is about delivering outcomes for a specific set of conditions and symptoms. The care teams should be organized accordingly.

• These teams should have a deep and intimate understanding of their customers/patients. This is something that is certainly missing in primary care and many healthcare interactions today where time with patients is limited and volume has (historically) been rewarded.

Many of the authors on this site are experts in the healthcare field. I have spent most of my career leading product and technology teams having previously been the Chief Product Officer at Weight Watchers and Shutterstock. There is an opportunity to create a step change in healthcare by bringing together these two disciplines and developing a new manifesto for how healthcare should be delivered.