Nowadays, it seems everybody wants to be Agile. In reality, though, few companies do what it takes to introduce the real changes this methodology requires. Nowhere is this more obvious than in healthcare project management.
Healthcare software development is challenging due to the industry’s high stakes, regulations, and interoperability requirements. As a result, companies often move slowly, release rarely, and spend millions of dollars on project delays. Agile project management seems like the way out of this vicious cycle, but even when companies seem to transition to it, project failures often continue.
Why? Because decision-makers push for Agile while maintaining a Waterfall mindset. The real challenge isn’t in adopting the methodology — it’s in addressing the disconnect between the leaders’ vision and real-life behaviors.
Today, we’re drawing on insights from Nino Dzamashvili, a Project Manager who currently works in Revenue Attribution. She has over 11 years of experience as a Scrum Master and educator in healthcare and other regulated industries. Let’s explore how to implement Agile in your healthcare SaaS company — and when this framework is not the way to go.
The Agile project management methodology has a lot going for it. About 71% of companies use it in some form, it’s preferred by Fortune 500 companies, and it was designed with software development in mind.
Your healthcare SaaS company should hop on the bandwagon ASAP, right?
Agile’s flexibility seems like the ideal match for the healthcare landscape. After all, the industry’s in the midst of a transformation, and software must be up-to-date with the latest regulations and patient needs. As a healthcare Project Manager, you can make your life so much easier by transitioning to this method, and it shouldn’t be too hard to persuade your boss, either.
Executives are drawn to Agile project management because of its speed and adaptability. In healthcare SaaS, it offers a way to innovate faster and respond to market demands more effectively, pivoting based on customer feedback or regulatory changes. Or at least, that’s how it looks.
Nino points out that many companies adopt Agile in name only. In reality, only around 30% actually follow through.
According to research, the reasons for this failure are cultural. Here’s what workers cite as the main challenges.
Source: Radixweb
Nino noticed that executives send mixed signals — they push for Agile project management and development but expect deliverables and results in line with Waterfall. As you may guess (or have seen for yourself), this creates friction and confusion. The leadership issues trickle down, and the implementation of Agile in your company ends up a far cry from what was promised.
Consider this finding from the JCURV State of Agile report:
97% of C-suite members believe they role model agile behaviors, but only 2% of staff agree.
As Nino noted, executives revert to traditional, hierarchical organizational structure. With this top-down approach, decisions are made at the C-Suite level and handed down for execution. As a result, healthcare Project Managers and teams don’t have much space to experiment or shift priorities as needed.
Nino notes that the discrepancy isn’t about ceremonies or paperwork — it’s about the mindset. As she puts it:
‘You can teach everybody to work with methodologies and ceremonies, but without the right mindset, nobody can become really Agile: collaborative, transparent, and client-oriented.’
To make this shift, change must start at the top. Without leadership fully committing to Agile principles, the rest of the organization will struggle to follow.
What would it look like if executives had Agile expectations?
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Instead of… |
They would expect… |
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Requiring a detailed, long-term project plan with fixed milestones and deliverables. |
A flexible plan with short-term goals set in Sprints. Timelines would adjust based on the outcomes of these Sprints. |
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Making all key decisions themselves and passing them down for execution. |
Teams to make day-to-day decisions rather than waiting for executive approval. |
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Waiting for a final product after months of development. |
Regular updates in the form of working software demos at the end of each Sprint. |
It’s important to note that Waterfall project management isn’t the problem here. Trouble lies in the discrepancy between the expectations and realities of project management.
When Agile intentions clash with Waterfall practices, companies see slower progress, missed deadlines, and frustrated teams. These inefficiencies often result in burnout, poor products, and a worse work environment overall.
Consider a healthcare software company trying to adopt Agile for a patient portal, but leadership sticks to a rigid roadmap. When new regulations arise, the plan can’t adapt. Or think of a hospital implementing a new EHR module but postponing integration testing until every part is complete. Issues surface late, leading to costly delays. Then there’s the healthcare startup that can’t pivot based on user feedback because leadership demands a step-by-step process, resulting in scope creep after UAT. These scenarios show how this Agile-Waterfall conflict disrupts projects and teams.
Ultimately, Agile is about flexibility, collaboration, and responding to change — which applies to everybody, from healthcare project management to top brass. Without embracing these core values, trying to implement Agile will only lead to friction.
Ultimately, Nino suggests that your healthcare project management methodology should serve the end goal.
‘Scrum tells us to be flexible, which also means adapting the methodology itself to your needs. Whether blending different approaches or customizing processes, the focus should always be on what’s best for your team and project.’
We should start with motivation. Do executives want to adopt Agile project management because the numbers look good? Nino finds that many managers don’t fully understand the values of these frameworks. They want a silver bullet to the issues of doing tech in healthcare, but their desire is superficial, and as a consequence, so are the changes they implement.
As a rule of thumb, if the managers aren’t willing to change their vision and mindset, they’re not ready to go Agile. Nino says: ‘Transformation must be from top to bottom.’
As a healthcare Project Manager, you can offer your bosses presentations and case studies demonstrating success stories related to Agile. Show the top management why this matters and that it needs to begin with them — they need to think as Agile to make the transformation possible.
Another thing to note is that successfully managing healthcare projects isn’t about strictly adhering to Agile or Waterfall project management. Nino highlights that Scrum can be great for small, focused teams, but in big organizations, its success is limited unless it’s adapted to your company’s needs.
Nino advises against forcing a one-size-fits-all methodology on every project. Instead, she suggests building methods that align with your company’s goals and culture. ‘Think about what you want to achieve,’ she says, ‘and build your processes around that.’ This might mean, for example, using Scrum for collaboration and keeping Waterfall’s documentation principles. Another option is to adapt the SAFe Agile framework, whose built-in quality and compliance activities make it suitable for healthcare project management.
As a healthcare Project Manager, you have more power than it might seem. It’ll involve some upward management, but you can improve the entire company with strategic steps.
Before diving into a transition, understand whether Agile is genuinely necessary for your company.
Start by examining the current projects, focusing on their size, complexity, and number of stakeholders. Nino finds that enterprise-level organizations with huge projects don’t do well with Agile. Also, not all teams are built for Scrum, which is the most popular Agile framework. For example, support teams or testing teams that deal with fixed scopes benefit more from a Kanban approach.
Remember that you aren’t making a yes–no decision. Instead of fully abandoning Waterfall or Agile, consider integrating elements where they make sense. Notably, daily stand-ups and regular demos are valuable even if you don’t use the entire framework.
What if you understood that Agile project management is right for your company? Here’s what Nino suggests, packed in a neat step-by-step framework:
Pro Tip: When hiring, look for candidates who understand Agile principles to help your company transition. Even skilled professionals can cause problems if unfamiliar with Agile thinking.
One of the main concerns of taking your healthcare project management Agile is security.
But think about it. Security is a set of protocols designed to protect sensitive data and ensure compliance with regulations. These protocols don't contradict Agile but provide a framework within which Agile teams can operate.
Here’s how to adapt Agile practices to fit the unique needs of healthcare projects:
In a nutshell, it’s important to remember that healthcare software development is too complex for a one-size-fits-all approach. Not Agile or Waterfall project management alone can address the challenges of this industry.
The real solution lies in a flexible, tailored approach that takes the best from both methodologies. Think company-first instead of trying to fit a mold of a specific methodology because it sounds innovative or looks good on paper. The results will speak for themselves, and bring you much better outcomes than ‘Agile’ stamped on top of your home page ever could.
Nino is committed to enhancing project management practices, drawing on her expertise both as a seasoned professional and a key team member at Quantori Georgia https://quantori.com/, a leading software engineering company specializing in healthcare and life sciences. Through Smart Academy, she offers her valuable guidance backed by over 11 years of experience in teaching Scrum and a proven track record of helping more than 500 individuals. If you're seeking to make a meaningful shift toward Agile methodologies in these dynamic industries, Nino is the expert to support your journey.