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Agile for Medical Software:
Better Results Faster in FDA
  Regulated Environments
             April 26, 2011
           Michael Walkden
           Tavi Scandiff-Pirvu




                                 Agile for Medical Software
• FDA is not the bad guy
• FDA is not your customer
• FDA is about ensuring safety and sustaining
  life

• Protects us from focusing only on profits

                                    Agile for Medical Software
Its not what you wear...
  Its how you wear it


                   Agile for Medical Software
Very Formal




              Agile for Medical Software
Very Formal   Very Casual




               Agile for Medical Software
Formal Process: Inception




                            Agile for Medical Software
Formal Process: Step 01




                          Agile for Medical Software
Formal Process: Step 02




                          Agile for Medical Software
Formal Process: Step 03




                          Agile for Medical Software
Formal Process: Step 04




                          Agile for Medical Software
Formal Process: Step 05




                          Agile for Medical Software
Formal Process: Step 06




                          Agile for Medical Software
Formal Process: Step 07




                          Agile for Medical Software
Formal Process: Step 08




                          Agile for Medical Software
Formal Process: Step 09




                          Agile for Medical Software
Formal Process: Step 10




                          Agile for Medical Software
Formal Process: Step 11 - Done




                         Agile for Medical Software
Formal Process: Final Verdict


Dear FDA,

  We will perform these ‘11’ Formal steps
each and everyday to ensure that nothing is
              left to chance.


                      -The Formal Group


                                       Agile for Medical Software
Formal Process: The Response

Dear Formal Group,


Great!
You have defined your 11 Formal
steps now go forth and DO IT!

                                       -FDA

                                   Agile for Medical Software
Casual Process: Inception




                            Agile for Medical Software
Casual Process: Step 01




                          Agile for Medical Software
Casual Process: Step 02




                          Agile for Medical Software
Casual Process: Step 03




                          Agile for Medical Software
Casual Process: Step 04




                          Agile for Medical Software
Casual Process: Step 05




                          Agile for Medical Software
Casual Process: Step 06




                          Agile for Medical Software
Casual Process: Step 07 - Done




                         Agile for Medical Software
Casual Process: Final Verdict


Dear FDA,

We will perform these ‘7’ Casual steps each
and everyday to ensure that nothing is left
               to chance.


                          -Casual Collab


                                       Agile for Medical Software
Formal Process: The Response

Dear Casual Collab,


Great!
You have defined your 7 Casual
steps now go forth and DO IT!

                                        -FDA

                                    Agile for Medical Software
Conclusion
Very Formal                Very Casual




                            Agile for Medical Software
Conclusion
              Mash-up of
Very Formal                Very Casual
                Both?




                            Agile for Medical Software
So don’t cut
   corners and change your
  process once you define it
just to save time and money!

                      Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
        Step: 01                    Step: 01




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
        Step: 02                    Step: 02




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
        Step: 03                    Step: 03




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
        Step: 04                    Step: 04




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
        Step: 05                    Step: 05




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
        Step: 06                    Step: 06




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
        Step: 07                Step: 07 - done




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
        Step: 08                Step: 07 - Done




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
        Step: 09                Step: 07 - Done!




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
        Step: 10               Step: 07 - DONE




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
   Step: 11 - DONE!            Step: 07 - DONE!




                                        Agile for Medical Software
Formal Process: Steps 1-11   Formal Process: 7 steps
   Step: 11 - DONE!            Step: 07 - DONE!




                                        Agile for Medical Software
In the end it’s
  not the product but the
process that is the concern!



                      Agile for Medical Software
• FDA = Authoritative QA
• They are interested in sticking to a plan
• FDA lets you set rules to follow
• Need to know your team/client/
  environment/product



                                      Agile for Medical Software
FDA’s Role


             Agile for Medical Software
• Medical device:
       • Act mechanically or chemically
• Pharmaceuticals:
       • Uses the body’s metabolism

                                   Agile for Medical Software
• Medical device:
       • Act mechanically or chemically
• Pharmaceuticals:
       • Uses the body’s metabolism

                                   Agile for Medical Software
Classes of FDA Devices


                 Agile for Medical Software
Class I
• Not intended to support life
• Least regulatory controls
• 74% of devices are exempt from pre-
  market approval
• Often a few pages of documentation will
  suffice to pass pre-market approval

                                   Agile for Medical Software
Class II
• General commercial quality control and
  manufacturing practices alone may not be
  sufficient to assure safety
• Existing methods are in place to prove safety
• Project is characterized by significant
  documentation and process compared to a
  “normal” Agile project

                                      Agile for Medical Software
Class III

• General commercial quality control and
  manufacturing practices alone may not be
  sufficient to assure safety
• Project is possibly R&D, but will still require
  significant documentation and process
  compared to a “normal” Agile project


                                       Agile for Medical Software
Agile 101


            Agile for Medical Software
• In general agile is not new. It is collection
  of good software practices evolved over
  years of experience.




                                       Agile for Medical Software
• Individuals and interactions over
  processes and tools

• Working software over comprehensive
  documentation

• Customer collaboration over
  contract negotiation

• Responding to change over following
  a plan

                              Agile for Medical Software
Agile Myths
•   Agile is Working        •   Simply iterations
    Without Documentation

•   One specific
    methodology             •   “Glorified hacking”



•   A “One Size Fits All”   •   Working without a plan
    cookbook



                                             Agile for Medical Software
•   Focus on activities that add value

•   Collaborative

•   Transparent

•   Adaptable

•   Simple

•   User engagement

•   Continuous Improvement

                                         Agile for Medical Software
What to expect


             Agile for Medical Software
•   FDA isn’t necessarily interested in waterfall

•   Longer Project Inception due to documentation
    of project history

•   Longer ramp-up time than a traditional Agile
    project

    •   team must understand more process and
        bigger picture early on

•   Faster software delivery than a traditional FDA
    project

                                            Agile for Medical Software
Audit: Plan on it


                Agile for Medical Software
What we know works
     (Pathfinder’s Process)




                             Agile for Medical Software
Know Your Product -> Process -> Production
   User Needs
   + Business
      Goals
                                          User Stories
                                          (Maser Story
                                             List)




                  Software
  Software
                Requirements
   Project
                Specification
  Schedule
                                                                 Software Verification &
                                                                     Validation Plan
                                                               (code review, unit testing,
                                                                   functional testing)
  Software
                                                                                             Design History
 Development      Software                                                                    File (DHF)
  Checklist      Architecture
                  Document
                                                                                Inception




                                !"
                                                                      Test Cases
                Fully Authored
                 User Stories

                                                 Dev. Code
                                               (code review)
                                                                     SVV Protocol


                                Testing

                                                                           Final SVV Test
                                                                               Report
                                                SVV Test
                                                 Report
                                                                          Development



                                                                                                  Agile for Medical Software
Know Your Product -> Process -> Production

  User Needs
  + Business
     Goals
                            User Stories
                            (Maser Story
                               List)




 Software
  Project
 Schedule




 Software
Development
 Checklist



                                           Agile for Medical Software
Know Your Product -> Process -> Production


  Software
Requirements
Specification
                          Software Verification &
                              Validation Plan
                        (code review, unit testing,
                            functional testing)


 Software
Architecture
 Document
                                         Inception




                                              Agile for Medical Software
Know Your Product -> Process -> Production




               !"
                                          Test Cases
  Fully Authored
   User Stories

                           Dev. Code
                         (code review)
                                         SVV Protocol


               Testing

                                             Final SVV Test
                                                 Report
                          SVV Test
                           Report
                                             Development



                                                        Agile for Medical Software
Know Your Product -> Process -> Production




                                   Agile for Medical Software
Know Your Product -> Process -> Production
   User Needs
   + Business
      Goals
                                          User Stories
                                          (Maser Story
                                             List)




                  Software
  Software
                Requirements
   Project
                Specification
  Schedule
                                                                 Software Verification &
                                                                     Validation Plan
                                                               (code review, unit testing,
                                                                   functional testing)
  Software
                                                                                             Design History
 Development      Software                                                                    File (DHF)
  Checklist      Architecture
                  Document
                                                                                Inception




                                !"
                                                                      Test Cases
                Fully Authored
                 User Stories

                                                 Dev. Code
                                               (code review)
                                                                     SVV Protocol


                                Testing

                                                                           Final SVV Test
                                                                               Report
                                                SVV Test
                                                 Report
                                                                          Development



                                                                                                  Agile for Medical Software
After Release


                Agile for Medical Software
• Change management strategy
• 501K Updates
• Bugs/defects
• Labeling

                               Agile for Medical Software
Questions?


             Agile for Medical Software

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Agile Software Development and the FDA

  • 1. Agile for Medical Software: Better Results Faster in FDA Regulated Environments April 26, 2011 Michael Walkden Tavi Scandiff-Pirvu Agile for Medical Software
  • 2. • FDA is not the bad guy • FDA is not your customer • FDA is about ensuring safety and sustaining life • Protects us from focusing only on profits Agile for Medical Software
  • 3. Its not what you wear... Its how you wear it Agile for Medical Software
  • 4. Very Formal Agile for Medical Software
  • 5. Very Formal Very Casual Agile for Medical Software
  • 6. Formal Process: Inception Agile for Medical Software
  • 7. Formal Process: Step 01 Agile for Medical Software
  • 8. Formal Process: Step 02 Agile for Medical Software
  • 9. Formal Process: Step 03 Agile for Medical Software
  • 10. Formal Process: Step 04 Agile for Medical Software
  • 11. Formal Process: Step 05 Agile for Medical Software
  • 12. Formal Process: Step 06 Agile for Medical Software
  • 13. Formal Process: Step 07 Agile for Medical Software
  • 14. Formal Process: Step 08 Agile for Medical Software
  • 15. Formal Process: Step 09 Agile for Medical Software
  • 16. Formal Process: Step 10 Agile for Medical Software
  • 17. Formal Process: Step 11 - Done Agile for Medical Software
  • 18. Formal Process: Final Verdict Dear FDA, We will perform these ‘11’ Formal steps each and everyday to ensure that nothing is left to chance. -The Formal Group Agile for Medical Software
  • 19. Formal Process: The Response Dear Formal Group, Great! You have defined your 11 Formal steps now go forth and DO IT! -FDA Agile for Medical Software
  • 20. Casual Process: Inception Agile for Medical Software
  • 21. Casual Process: Step 01 Agile for Medical Software
  • 22. Casual Process: Step 02 Agile for Medical Software
  • 23. Casual Process: Step 03 Agile for Medical Software
  • 24. Casual Process: Step 04 Agile for Medical Software
  • 25. Casual Process: Step 05 Agile for Medical Software
  • 26. Casual Process: Step 06 Agile for Medical Software
  • 27. Casual Process: Step 07 - Done Agile for Medical Software
  • 28. Casual Process: Final Verdict Dear FDA, We will perform these ‘7’ Casual steps each and everyday to ensure that nothing is left to chance. -Casual Collab Agile for Medical Software
  • 29. Formal Process: The Response Dear Casual Collab, Great! You have defined your 7 Casual steps now go forth and DO IT! -FDA Agile for Medical Software
  • 30. Conclusion Very Formal Very Casual Agile for Medical Software
  • 31. Conclusion Mash-up of Very Formal Very Casual Both? Agile for Medical Software
  • 32. So don’t cut corners and change your process once you define it just to save time and money! Agile for Medical Software
  • 33. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 01 Step: 01 Agile for Medical Software
  • 34. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 02 Step: 02 Agile for Medical Software
  • 35. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 03 Step: 03 Agile for Medical Software
  • 36. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 04 Step: 04 Agile for Medical Software
  • 37. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 05 Step: 05 Agile for Medical Software
  • 38. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 06 Step: 06 Agile for Medical Software
  • 39. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 07 Step: 07 - done Agile for Medical Software
  • 40. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 08 Step: 07 - Done Agile for Medical Software
  • 41. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 09 Step: 07 - Done! Agile for Medical Software
  • 42. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 10 Step: 07 - DONE Agile for Medical Software
  • 43. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 11 - DONE! Step: 07 - DONE! Agile for Medical Software
  • 44. Formal Process: Steps 1-11 Formal Process: 7 steps Step: 11 - DONE! Step: 07 - DONE! Agile for Medical Software
  • 45. In the end it’s not the product but the process that is the concern! Agile for Medical Software
  • 46. • FDA = Authoritative QA • They are interested in sticking to a plan • FDA lets you set rules to follow • Need to know your team/client/ environment/product Agile for Medical Software
  • 47. FDA’s Role Agile for Medical Software
  • 48. • Medical device: • Act mechanically or chemically • Pharmaceuticals: • Uses the body’s metabolism Agile for Medical Software
  • 49. • Medical device: • Act mechanically or chemically • Pharmaceuticals: • Uses the body’s metabolism Agile for Medical Software
  • 50. Classes of FDA Devices Agile for Medical Software
  • 51. Class I • Not intended to support life • Least regulatory controls • 74% of devices are exempt from pre- market approval • Often a few pages of documentation will suffice to pass pre-market approval Agile for Medical Software
  • 52. Class II • General commercial quality control and manufacturing practices alone may not be sufficient to assure safety • Existing methods are in place to prove safety • Project is characterized by significant documentation and process compared to a “normal” Agile project Agile for Medical Software
  • 53. Class III • General commercial quality control and manufacturing practices alone may not be sufficient to assure safety • Project is possibly R&D, but will still require significant documentation and process compared to a “normal” Agile project Agile for Medical Software
  • 54. Agile 101 Agile for Medical Software
  • 55. • In general agile is not new. It is collection of good software practices evolved over years of experience. Agile for Medical Software
  • 56. • Individuals and interactions over processes and tools • Working software over comprehensive documentation • Customer collaboration over contract negotiation • Responding to change over following a plan Agile for Medical Software
  • 57. Agile Myths • Agile is Working • Simply iterations Without Documentation • One specific methodology • “Glorified hacking” • A “One Size Fits All” • Working without a plan cookbook Agile for Medical Software
  • 58. Focus on activities that add value • Collaborative • Transparent • Adaptable • Simple • User engagement • Continuous Improvement Agile for Medical Software
  • 59. What to expect Agile for Medical Software
  • 60. FDA isn’t necessarily interested in waterfall • Longer Project Inception due to documentation of project history • Longer ramp-up time than a traditional Agile project • team must understand more process and bigger picture early on • Faster software delivery than a traditional FDA project Agile for Medical Software
  • 61. Audit: Plan on it Agile for Medical Software
  • 62. What we know works (Pathfinder’s Process) Agile for Medical Software
  • 63. Know Your Product -> Process -> Production User Needs + Business Goals User Stories (Maser Story List) Software Software Requirements Project Specification Schedule Software Verification & Validation Plan (code review, unit testing, functional testing) Software Design History Development Software File (DHF) Checklist Architecture Document Inception !" Test Cases Fully Authored User Stories Dev. Code (code review) SVV Protocol Testing Final SVV Test Report SVV Test Report Development Agile for Medical Software
  • 64. Know Your Product -> Process -> Production User Needs + Business Goals User Stories (Maser Story List) Software Project Schedule Software Development Checklist Agile for Medical Software
  • 65. Know Your Product -> Process -> Production Software Requirements Specification Software Verification & Validation Plan (code review, unit testing, functional testing) Software Architecture Document Inception Agile for Medical Software
  • 66. Know Your Product -> Process -> Production !" Test Cases Fully Authored User Stories Dev. Code (code review) SVV Protocol Testing Final SVV Test Report SVV Test Report Development Agile for Medical Software
  • 67. Know Your Product -> Process -> Production Agile for Medical Software
  • 68. Know Your Product -> Process -> Production User Needs + Business Goals User Stories (Maser Story List) Software Software Requirements Project Specification Schedule Software Verification & Validation Plan (code review, unit testing, functional testing) Software Design History Development Software File (DHF) Checklist Architecture Document Inception !" Test Cases Fully Authored User Stories Dev. Code (code review) SVV Protocol Testing Final SVV Test Report SVV Test Report Development Agile for Medical Software
  • 69. After Release Agile for Medical Software
  • 70. • Change management strategy • 501K Updates • Bugs/defects • Labeling Agile for Medical Software
  • 71. Questions? Agile for Medical Software

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