Waterfall or Agile?

June 24, 2011
Just the other day I founds myself in the middle of a large conference room, at a meeting where the CIO was facing the COO, CXOs and a team of

Just the other day I founds myself in the middle of a large conference room, at a meeting where the CIO was facing the COO, CXOs and a team of consultants from a strategy firm. The strategy firm had been engaged to tell the hospital system what was the state of its IT and what could make it work better.

Interestingly, one of the observations the consultants made referred to an absence of methodology. It got my antenna up.. It was clearly a legitimate question in a large development shop. But in a hospital system where most projects are rather small in size, the question seemed more from the book the consultants may have read rather than an experience of the hospital systems development environment.

That said, this meeting was not alone in raising that specter. I have been witness to these arguments across IT organizations. Most of them had a sizeable IT budget, however. That prompted me to take a sample out of several projects that go on at any time in hospital IT systems. Not surprisingly, over 80 percent of them take less than 40 hrs of efforts at the most.

Methodologies were designed for really large projects where it was far from easy to keep a view of the project for any single person. At under 40 hrs, they may find it tough to justify and implement standard project management practices, let alone a methodology overarching it.

So I thought of asking our readers, what do you think hospital IT organizations should do? Invest in old, huge, unwieldy, expensive methodologies? Or should they be looking at some lower order management systems that yield the results they need to deliver? Is it waterfall? Or is it Agile? Or something in between?

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