6 lessons learned from building a complex healthcare application

Tackling complexities of highly regulated, nuanced applications

Healthcare digital solutions are among the most complex and diverse systems existing in any market. Industry-specific regulations and federal mandates add further complexity to these systems. Due to the mounting complexities, many healthcare providers, agencies, and hospitals focus their investment on keeping traditional, often outdated applications alive rather than modern tactics to maintain an evergreen, everchanging ecosystem.

Having partnered with a healthcare provider looking to transition away from a legacy platform and launch a newly built custom solution, I’ve learned firsthand how to address the many challenges associated with building highly complex applications. In addition to the functionality, ease-of-use, and efficiency, the product needed to adhere to hospital, agency, and government regulations. The multi-phase project was Agile to its core.

In this blog, I will share the lessons from a successful transformation of a healthcare system. I'll cover the steps taken to identify the vision, determine the elements for the MVP, reshape the plan, scale the build, onboard users, and drive adoption. These key lessons demonstrate the benefits of agile product development and can be applied to complex enterprise products in any industry.

Lesson 1: Identify the need

A natural first step when building products is through a workshop to determine the need. In a requirements workshop, a group of decision-makers with delivery leaders gather for a day full of discussion to understand the problem and identify the right solution. At Devbridge, our signature Lean Requirements workshops are carefully crafted and customized for each client to ensure the session is efficient, and everyone involved remains engaged.

To maximize success, come prepared and familiar with industry-specific research and questions to drive productive conversations. For example, I found that the healthcare industry is trending towards providing more transparency for patients and affordable, value-based care. Ask clarifying and pointed questions. The outcome not only provides clarity in the requirements but also often clearer direction and added credibility, furthering the relationship and building alignment.

During the workshop, it’s important to uncover industry-specific complexities (for example, healthcare requires complex logic, patient information that requires HIPAA compliance) and identify known challenges regardless of industry, from onboarding users to disclosing sensitive information, tight deadlines, diverse stakeholder interests, or multiple integration points for each application. Listen to the ask but also press, discuss, and identify the need. Healthy challenges and curiosity are major factors in the Devbridge model.

Pro tip: Miro has been a critical tool for running workshops virtually and to support working with distributed teams. Devbridge created some workshop templates to share our expertise, available to download here.

The team should leave the workshop with a short-term and long-term vision. Having a clear direction helps shape the MVP while keeping the longer-term strategy in mind. I view the vision as the North Star. Every step you take in product development can be compared and cross-checked to see whether it aligns with the overall vision.

Lesson 2: Use discovery to prototype and validate the solution.

There are countless million-dollar product ideas out there, but what makes one successful? When workshopping solutions, running a discovery effort in advance of full development helps define success. While workshopping helps surface the actual need and direction for a product, discovery sets that need at the center point of an exercise to validate the specific solution and uncover unknowns. Discovery identifies multiple risks and challenges for integrations. Talk with stakeholders about what is critical to their business and making informed decisions. Gather data and research what competitors are doing.

Pro tip: Find out what the client can do to differentiate themselves in their market to be successful. Furthermore, speak with prospective users about their needs to understand their point of view. Check out The Secret Source for more on discovery and definition.

Use the research outputs to inform a prototype. Discovery combined with prototyping is a proven practice to look deeper into the technical feasibilities. Testing the prototype with a focused group of prospective users helps validate the success of the idea and inform early low-effort adjustments.

End-user feedback is valuable and sometimes needs to be weighed against what stakeholders ask. Discovery data provides a roadmap for what users want. The prototype user data can quickly diffuse misalignment from what stakeholders want and focus on what the users need.

For example, when building the healthcare solution, we shared prototypes with a group of medical leaders to use and provide feedback. Then, we followed up the session with some questions about how to enhance the process. We used multiple designs to capture all nuances of our MVP before moving into Phase 1. The ask was to evolve existing processes, which we successfully captured through prototyping and discovery. Throughout our multi-phase project, we interviewed users often for input on the application's evolution and how else we could enhance the workflows and usability.

Lesson 3: Prioritize and build.

Once you’ve identified the MVP or the next release candidate, prioritize and build. Review upcoming priorities with stakeholders. Highlight risks and blockers.

Pro tip: Communicate delivery details clearly and transparently as the team builds and refines the product. Share details with stakeholders to ensure the collective remains aligned throughout. Get tactics on how to build alignment successfully.

Agile communication mechanisms have evolved with global distribution and new technologies, but it is still just as important to communicate frequently to maintain alignment. At Devbridge, teams communicate asynchronously with each other throughout the day by creating initiative-specific Slack channels. As needed, we increase the sync-ups to connect and discuss design and implementations. While working towards delivery for a release, teams run discovery sessions, look to adjustments based on results, and change directions when necessary. This is Agile.

In my case, the outcome of discovery provided a clear path for the MVP. We broke down features into deliverable pieces, prioritized the backlog, and tightly coupled design and development efforts to deliver. We refined the designs and estimates at least two sprints ahead of time, which meant lots of hard work at the beginning of the phase until we became a well-oiled machine.

During the implementation phase, teams at times face scope changes, delays, and challenges. Regardless of industry, many systems have to deal with integration issues and align deliverables to run the data end-to-end successfully.

Lesson 4: Pilot the solution.

Do not rush pushing the new solution into the hands of end users. Run a pilot for a fixed time (e.g., 4 weeks) and set clear expectations for everyone, including the users. Depending on the industry, you may want to shorten the timeline. For example, a week-long pilot for those in the financial sector may be sufficient.

Once concluding the pilot, the dev team should have clear goals for what’s next to get to the launch phase faster, course correct, or map out plans for adjustments. The outcome should be lots of feedback, and clarity as to whether or not the pilot was a success. Plan proactively and work with stakeholders to determine whether the feedback warrants pivots or enhancements to the product.

When targeting a large pool of end-users operating outside of the organization, plan properly, and test the application with a smaller group before turning the switch on for all. Work with stakeholders to identify multiple, small pilot user groups.

Pro tip: Try to account for variances, selecting from a diverse group of users. Users should be from varied demographics and user behaviors relevant to the product build.
Check out the 6-step product pilot launch plan for pointers.

For our team, we piloted elements of the new healthcare system while keeping the existing legacy application live throughout production to capture and compare data for old vs. new. Users provided feedback on how the new process and application would be beneficial or challenging compared to the legacy product they were using.

Lesson 5: Revisit and refine the vision.

You could easily get stuck in the loop of getting feedback and implementing. However, it is necessary to frequently assess your North Star (short-term vision) and see if you are still delivering with that in mind. Plan to revisit the vision quarterly and check-in with stakeholders, re-evaluate the goals, and adjust the path. As a product manager, identify any specific deviation from the previously set vision and ask for a workshop or a smaller meeting to review the concept.

Meet with stakeholders to set priorities for the future scope of work. If your stakeholder group is large, only invite the decision-makers. Review the original vision, upcoming regulations, and any shifts they would like to be reflected in this application.

Pro tip: Ask questions to inform decisions. Is the original vision still valid? Should the short-term vision change? How about the long-term? With insight from the pilot, are there other elements to consider for this product to help reach its full potential?

I can assure you that once you deliver on the MVP, stakeholders will have a new vision for you. They’ll see opportunities and bring fresh new ideas to the table. Access best practices for iterative product development.

Lesson 6: Launch the product.

Successfully launching a product is all about communication. Like everything else in software, there is no set formula. Work with stakeholders and users to set accurate expectations for the launch plan. Then execute the plan, targetting users on multiple channels such as email announcements, videos, live training sessions, communication hubs, etc. It is important to communicate early and often to maximize adoption success.

Pro tip: If you have a large population of users, define a multi-step launch plan. Check out how to roll out a design system that offers pointers that relate to launching and driving adoption successfully.

Regarding the healthcare system, lots of effort went into preparing, communicating, and educating the end-users about what to expect in advance of the launch. Stakeholders held multiple training sessions daily for users to understand how the transition would happen and how to use the new app.

We had a successful multi-phase launch over five months with 100% adoption by users. Previously, many end-users relied on support people, whereas now, they were doing 92% of the tasks independently. Through more training and more communication, we plan to move towards 100% of tasks without additional support.

Maintain and continually support systems

When faced with challenges aligning multiple teams' deliverables and managing the risks and dependencies of those teams on each other, identifying risks early on and over communication regarding integration points helps break down barriers. With a team aligned and committed to the project's success, and that fueled our power to push through, keep it agile and deliver results.

For the healthcare solution specifically, the approach increased efficiency by providing data-informed-decision tools to healthcare providers. The successful multi-phase approach to releasing functionality built more trust with our client and end-users of the application, strengthening our relationship with stakeholders. Furthermore, we’re not done.

The digital healthcare landscape is transforming with the industry moving toward offering comprehensive solutions that connect patient care and data. A progressive, product-centric mindset and putting users at the center is a must.

Ultimately, the effort and the lessons noted above reenforce that digital products, regardless of industry, need ongoing attention. Focus and prioritize changing needs to ensure product-market fit to further business benefits, efficacy, efficiency, and excellence, specifically around the user experience.