Planting the seeds of an agile health revolution – how executive support made this DevOps gardening project flourish

Gunther Lenz who is heading up an internal DevOps transformation within Varian Medical Systems speaks here to conference Director Dr Dale Rickert regarding his experience of ‘scaling agile’ and nurturing a culture change towards a DevOps operating model. Insights show how by starting small with a core-seed project and insuring executive support from the start, this program was able to quickly spread to effect process and operating models for software development across the entire company. Gunther Lenz will be a featured speaker later this month at the much anticipated health:CODE conference which is the first specialist conference for DevOps and agile software development in the health sector.

Gunther Lenz: First of all, thank you Dale for the invitation to contribute to in the Health:Code conference 2017, a truly exciting event.

That is a good question. If you would have asked me 3 years ago, when we started our Agile and DevOps journey, I would have answered that by implementing these concepts we can have software development become more predictable, produce software quicker, and react to customer needs more rapidly. Today, I would broaden this statement to say we optimize the value stream of our entire software product portfolio and organization. This includes not only software development, test, and deployment but also includes compliance, security, support, training, documentation, and commercialization. The impact is far beyond just software development. Within Varian we also continue a transformation from a functional- to a product- team focused organizational structure. The goal is to optimize the entire value stream of our software products and reap the full benefit of a lean software company.

Gunther Lenz: Well, in general healthcare companies are late adopters of innovative technologies and processes. Agile, as well as DevOps, does not seem to be an exception. Having said that, I also believe that it takes a perfect storm and to combine multiple concepts such as Micro-Services, Agile, DevOps, and Cloud to successfully transform a Software organization. With the average product lifetime of 10-15 years in healthcare software, it is not easy to “retrofit” existing projects, architectures, and organizational structures with such new concepts. Even more, the different government regulations were not designed for fundamental changes like we have seen them in the technology field over the last 10-20 years.

Gunther Lenz: Yes, I was lucky that I got full support from our CEO Dow Wilson, our President Kolleen Kennedy, and my manager Sukhveer Singh (GM and VP at Varian). When we started the journey, we formed a shielded team and we were tasked with defining and implementing a world class software team/organization. This approach enabled us to look at all industries for software best practices. We used a combination of the best ideas applicable to us as guidelines to defining our processes, tools, technologies, and to create a software organization that is truly agile. I strongly believe this shielding in the inception phase and during initial development was key to our success so far.

Incremental change will bring incremental improvement, and we were looking for a quantum leap. Interesting enough, now that we successfully launched our product 360 Oncology™ the rest of the organization is seeing some of the benefits of our approach and is eager to learn and implement some of the concepts we are using.

Gunther Lenz: Our current challenge is to scale the approach we implemented. One of the biggest challenges is to minimize unplanned work and to truly lean models with a single piece flow model. Today, all too often, we get pulled into unplanned activities which negatively impact the entire value stream. In addition, we expect significant increase in our customer base over the next 12 months.

Where we want to go is to provide complete self-service capabilities. I am imagining that a sales order, coming from SAP, will provide the complete configuration description which is automatically ingested into our change management system. The system is then automatically deployed, configured, and tested based on that information. Then, notifications are automatically sent to the customer to inform them the system is ready for their use with login instructions and information on what features were provisioned. Once a user logs in, they will be provided with an optional interactive walkthrough as well as embedded training.

We would also like to identify “silent sufferers” with active application monitoring. That means to identify the workflows users are having trouble to complete and reach out to them proactively. I also envision that upgrades are handled through automation e.g. before an upgrade notify the customers of the time window the system will be upgraded, then notifications are sent just before the start of the upgrade, deployment as well as smoke test are automatically run after the upgrade is finished. Once all that is done the customer is automatically informed the upgrade was successfully completed. The first time any user logs in they will get a notification of the new features and an optional walk through. Obviously, all customers can be upgraded in parallel with no downtime. I see these concepts also being implemented throughout the entire Varian software product portfolio.

Gunther Lenz: I am very passionate about this topic and we did learn a lot of lessons during our journey so far. Some of them we learned the hard way. The one advise I would give is to make sure to have the full support of the executive leadership to start this journey, not to be afraid to fight the argument “but we always did it this way” to stop you from doing the “right” thing, and to minimize unplanned work (well, it actually was three sets of advice). If there is no larger strategic project implemented for DevOps/Agile then a more gradual, bottom up approach, is another option to get at least some of the benefits.

Gunther Lenz: When I first heard about health:CODE I thought why aren’t there more venues like that already. It is an exciting and very interesting concept. I am looking forward to sharing my experience and to learn from others on the “hot” topics in software engineering and the healthcare field.

Gunther Lenz: Sure, I will be sharing war stories from our journey to a true agile organization and, in particular, the DevOps foundation to achieve that goal. Furthermore, I will present our approach to DevOps and the toolchain that enables all that.

Gunther Lenz: Thanks Dale for the opportunity to participate in the inaugural health:CODE venue. I am looking forward to meeting you in person and meet/interact with other attendees at this very informative, interactive, and educational event.