Proving Value: What CMMI Level 5 Means for Imaging Software


Use CMMI Level 5 to achieve high-performance operations.

When it comes to software development, CMMI Level 5 is the gold standard, taking five years on average to achieve and involving the highest possible performance. Developed by the CMMI Institute, the Capability Maturity Model Integration is a process improvement framework that helps organizations achieve high-performance operations.

Development teams that have achieved CMMI Level 5 are capable of reliably and sustainably creating robust applications that meet or exceed project goals.

Development teams begin at Level 1 (initial), with processes that are typically ad hoc and chaotic. At Level 2 (managed), process discipline helps to ensure that practices are retained during times of stress. At Level 3 (defined), processes are well characterized and understood, and are used to establish consistency across the organization. At Level 4 (quantitatively managed), quantitative objectives for quality and process performance are established and are used in managing projects. At Level 5 (optimizing), focuses on continually improving process performance through incremental and innovative process and technological improvements.

Given the fast pace of change in the healthcare industry and the enormous impact imaging can have on providers and patients, high performance is quickly becoming a must for those developing imaging software. However, climbing the CMMI ladder can be a demanding process requiring a strong commitment to quality improvement, but attaining a CMMI level should never be the primary goal.

In fact, teams that become too focused on achieving the next CMMI level — rather than concentrating on improving processes to achieve higher quality and business value — often fail, according to Jim Shaver, McKesson’s senior director of enterprise quality improvement. Shaver and his team supported McKesson’s IWS Cardiology Development Group, based in Tel Aviv, in its recent successful bid to reach CMMI Level 5. Note that only 321 organizations worldwide have reached Level 5, and only a handful of those are healthcare related. IWS Cardiology Development is the first FDA-regulated medical device group to achieve Level 5, as well and one of the smallest groups to do so.

Shaver said IWS Cardiology Development’s achievement is partly due to the culture in the 60-person group, led by Tomer Levy, vice president of cardiology at McKesson Medical Imaging. The group is passionate about what they do and recognize that it directly impacts people’s lives, said Shaver. “They’re driving toward perfection and are very open to constructive criticism. They did not set out to achieve CMMI Level 5; they wanted to do their jobs more efficiently and make sure they were delivering the best possible product to their customers.”

Indeed, the group’s passion led to the decision to pursue CMMI level 5, after having previously achieved CMMI level 3 two years earlier. Once that decision was made, it took the group only 10 months to reach level 5. Another reason for the group’s success is its ability to distill CMMI requirements down to their essence, said Shaver. Treating the CMMI framework as a prescriptive “cookbook” can lead to failure, especially for small teams, he explained. (CMMI was created to standardize large systems projects for the US Department of Defense.)

Instead, Levy and his team viewed CMMI practices as tools to help them mitigate the risks associated with software development and adapted each one as needed to work for their projects. CMMI is scalable, provided you are thoughtful about how you apply the model, Shaver said.

Shaver noted that the group’s development maturity level has also enabled a move to a more agile model for creating software. Previously, the group needed the rigor provided by the traditional phase-based approach, he said. Today, the group can respond more quickly to customers’ needs, using their processes to make sure product quality does not decline during the short development cycles.

Most recently, said Levy, this methodology facilitated the development of McKesson Cardiology™ ECG Mobile, an FDA-approved iPad® app that can be downloaded from iTunes®, allowing cardiologists to read and report on resting ECG procedures from any location.

For more information on McKesson Cardiology™ ECG Management and other cardiology solutions, please visit our website.

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