Healthcare companies are more reliant than ever on software to help them achieve good patient outcomes. Recent research reveals that the use of software as a service (SaaS) solutions is growing exponentially in health care, covering a wide range of areas including:
- Patient diagnosis
- Medical imaging
- Therapy and patient self-care
- Data collection and analysis
- Hospital management
Due to the increased use of digital products in patient care, healthcare providers recognize the need to speed innovation and fundamentally rethink how they build software. This has led many engineering teams to move toward continuous integration and continuous delivery (CI/CD) when building and deploying software.
Considering the industry’s emphasis on improving patient experiences, it makes sense that healthcare providers are keener than ever to optimize their systems. In fact, around 90% of healthcare providers are implementing or already using customized software solutions and development.
As teams look to improve these critical processes in software development, feature flagging is one way to speed up development and optimize software performance in the healthcare industry.
CI/CD Challenges for Healthcare Companies
The healthcare industry faces unique challenges when applying DevOps strategies such as CI/CD.
Intense Regulation
The main problem is that, for obvious reasons, health care faces stringent regulation and oversight. A high level of scrutiny is necessary in an industry in which one small mistake or misjudgment can cost patient lives; however, in terms of DevOps, waiting for regulatory evaluation and approval can slow down the entire software development process, which defeats the core purpose of CI/CD.
Security
Data security poses another challenge for healthcare providers, especially when dealing with cloud-based software solutions. Cloud-based systems will always have potential vulnerabilities, as they rely on infrastructure that connects a variety of devices and smart technology equipment. There will always be inherent weaknesses in remote systems, as opposed to on-premises, too. A recent survey revealed that 42% of respondents said their major security concern was unauthorized access to cloud systems through insecure APIs. Network configuration problems were a close second, with 40% of respondents citing those as a concern.
In a healthcare setting, another issue is the high volume and high velocity of data. Even a small, specialist clinic that may only see 150 patients per day will still generate vast amounts of data over the course of a month or year. Most of the data is private and sensitive, which means that data privacy and cybersecurity are top priorities for healthcare companies.
The Impact on DevOps
At first glance, because of the high level of regulatory oversight and cybersecurity concerns, it might seem that health care is a less-than-ideal environment for agile DevOps processes. How can you adopt fast-paced CI/CD cadences and innovate rapidly when there are necessary, opposing forces?
The answer is to leverage innovative software development solutions such as on-premises feature flagging.
Feature Flagging and Its Impact on Software Innovation
Feature flags are, essentially, toggles or switches that allow software development teams to turn features on or off. The main advantage of feature flagging is that it allows for faster software deployment. One or more features can be coded into the software during development and made ready to go, but it is turned off for the user and/or patient on initial deployment.
The ability to embed features within software that can be toggled on or off is perfectly suited for the healthcare industry since that approach allows for the necessary regulatory approval(s) before full deployment.
For example, look at the rapid rise of telemedicine during the COVID-19 pandemic. Doctors, hospitals and patients alike were forced, along with the rest of the world, into the “new normal” of virtual interaction to mitigate the spread of disease while still providing quality treatment.
For most industries, adding video chat/conferencing capabilities to existing applications was relatively easy. But for health care, the approval process, privacy and security concerns slowed down the adoption of these features. In our experience, typical healthcare teams are, best-case scenario, running on monthly—or, most likely, quarterly—deployment cycles to align their deployment efforts with compliance and governance review boards. Product and engineering teams work to get their updates and improvements in line with this cadence, which can make innovation difficult.
If teams wanted to deliver this capability quickly, they could adopt feature flagging to decouple the concepts of “deploy,” “approve” and “release.” To use the video chat example, here are the steps they’d be able to take:
1) Build the videoconferencing capability into their app and deploy the feature to production with the capability switched on for internal users (IP targeting, specific email addresses, etc.) only.
2) Now that the feature is in live production, they can perform actual field testing to ensure that the functionality is working well, while simultaneously moving through internal and external approval processes.
3) Once the review is complete, move to the release stage by switching the feature(s) on and allowing (external) end users to access the capability.
All this can be achieved without needing to redeploy the software, and the developers are still free to make iterative improvements to the application.
Now that the regulatory hurdles are addressed, it’s important to acknowledge that security is still an issue for healthcare companies that employ a SaaS feature flagging platform.
While most providers focus solely on SaaS, the ability to deploy feature flagging software on proprietary cloud infrastructure is important in the healthcare space. This model enables both extra security and HIPAA compliance, and also opens up important capabilities and performance results that SaaS-only providers have a hard time matching. Since this technology typically becomes deeply embedded in the fabric of an organization’s product and technology, feature flagging is well-suited to an on-premises implementation.
The implementation of on-premises feature flagging is a great way for healthcare companies to increase deployment velocity from monthly to daily. It allows their software development teams to adopt CI/CD cadences and innovate more rapidly, without the risk of breaching regulations or making sensitive data easily available to hackers.
