Large Healthcare Solution Provider Cuts a Month off Time-to-Market for New Software

OverviewCountry or Region: United StatesIndustry: Healthcare

Customer ProfileCareFusion provides solutions to help reduce medication errors and identify hospital-acquired infection trends. The company has more than 15,000 employees and is headquartered in San Diego, California.

Business SituationCareFusion used multiple stand-alone tools to support various aspects of software development, resulting in isolated silos of information that made it hard to collaborate and monitor project health.

SolutionCareFusion is adopting Microsoft Visual Studio Team Foundation Server 2010 to support all aspects of the application lifecycle—including process management, tracking, build automation, and reporting.

Benefits Increased productivity and

collaboration Faster delivery times Increased code and document quality Improved visibility into project status Reduced tools-related licensing costs

“With Visual Studio Team Foundation Server 2010, we’ve been able to establish consistent monthly iterations—and easily cut at least a month off the overall development cycle.”

Scott Loebig, Director of Software Engineering, Enterprise Solutions, CareFusion

Many CareFusion solutions—designed to help reduce medication errors and identify hospital-acquired infection trends—include software components. Until recently, the company used a mix of stand-alone tools to support various aspects of software development, which resulted in lost productivity, lack of communication, limited visibility, and delays in bringing solutions to market. CareFusion selected Microsoft Visual Studio Team Foundation Server 2010 for all aspects of application lifecycle management—including process management; source code control; requirement, work item, and bug tracking; build automation; and reporting. Benefits of the company’s adoption of Team Foundation Server 2010 include reduced costs, increased productivity and collaboration, faster delivery times, improved software quality, consistent monthly iterations, and deep, real-time visibility into project status.

SituationCareFusion, which is based in San Diego California, provides products and services to help healthcare providers to reduce medication errors and identify hospital-acquired infection trends. The company’s family of solutions includes some of the most widely recognized brand names in their categories, including Pyxis for medication and supply management; Alaris for infusion; and ChloraPrep for preoperative skin preparation.

Many CareFusion solutions include internally developed software that runs on PCs or CareFusion equipment. For example, the Pyxis MedStation system, a Dispensing Technologies product, runs software that supports barcode scanning to help ensure accurate dispensing, includes functionality designed to help prevent loading of the wrong medication, and supports active alerts that serve as an added safety precaution for high-risk medications. Across CareFusion, which has more than 15,000 employees, hundreds of software engineers, quality assurance personnel, requirements analysts, project managers, and other technical professionals work to develop such software. Two such teams within CareFusion include the Dispensing Technologies group and the Enterprise Solutions group. Until recently, both development groups—and many others across the company—used a mix of stand-alone tools for various aspects of application lifecycle management. The Dispensing Technologies group had three systems for quality assurance, three for bug tracking, three for source code control (including Microsoft

Visual Studio Team System 2008 Team Foundation Server), two for build management, three for document control, and seven tools for project management and reporting. The Enterprise Solutions group had a similarly diverse set of tools—and thus both groups faced significant challenges.

“Of all the issues we faced, one of the largest was a lack of visibility into project status,” says Guy Eldredge, Director of Software Engineering for the Dispensing Technologies group. “It was hard to gather information across so many different silos of data and, without a clear ‘big picture’ view, it was difficult to prioritize projects or allocate resources. If an executive wanted an update on project status, it could take up to a week to provide an answer.”

Lack of collaboration among the different roles within project teams was also an issue. “Communication was difficult because developers, quality assurance, and project managers all used different tools,” says Scott Loebig, Director of Software Engineering for the Enterprise Solutions group. “Because of this, group meetings were our primary means of determining status and the health of projects. Our tools didn’t align with our natural workflows, which created an overall drag on productivity and the speed of development.”

Generation of a Requirements Traceability Matrix—a necessary step in complying with Food and Drug Administration (FDA) requirements for software development—is one example of the pain felt by both teams. “We need to be able to trace requirements to specifications to test cases, and we need

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“As part of the formal decision process, we considered solutions from IBM and a few other vendors, but none of them provided the capabilities or flexibility to integrate with our current workflows and development tools as well as Team Foundation Server.”

Guy Eldredge, Director of Software Engineering, Dispensing Technologies,

CareFusion

to document that traceability as part of the release process,” explains Eldredge. “In the past, it took a majority of the team two to three weeks to assemble such documentation near the end of the release cycle—always with the fear of finding missed requirements or gaps in traceability. Finding such problems didn’t happen often, but it was highly unpleasant when it did.”

SolutionCareFusion upgraded from Visual Studio Team System 2008 Team Foundation Server to Microsoft Visual Studio Team Foundation Server 2010, which the company now uses as an integrated solution for all aspects of application lifecycle management—including process management; source code control; requirement, work item, and bug tracking; build automation; and reporting. Adoption of Team Foundation Server for more than just source code management began as an informal effort within the Enterprise Solutions group. “We really liked how well Team Foundation Server integrated with Visual Studio desktop tools, enabling developers to avoid having to continually enter status updates in other systems,” says Loebig. “We then began to see how we could use its customizable work items to link requirements to specifications and so on, which solved another of our major challenges.”

At the time, Eldredge was Director of Program Management for the Enterprise Solutions group. He then took a role as Director of Software Engineering for the Dispensing Technologies group. “When I moved into my new role, I needed a tool to

help me quickly get clarity on project status,” he recalls. “We quickly began consolidating on Team Foundation Server as well, using it to give all project stakeholders a view into project data.”

As the benefits of a single, integrated solution for all aspects of application lifecycle management became clear, CareFusion formalized a charter to evolve the entire organization to Team Foundation Server. “As part of the formal decision process, we considered solutions from IBM and a few other vendors, but none of them provided the capabilities or flexibility to integrate with our current workflows and development tools as well as Team Foundation Server.”

Following the decision to adopt Team Foundation Server companywide, CareFusion set out to make sure it would get the most from its investment. A team was formed to document processes and solicit input from all stakeholders, after which two developers spent five months extending Team Foundation Server to meet the company’s unique needs. Part of that effort involved customizing the Capability Maturity Model Integration (CMMI) process template provided out-of-the-box with Team Foundation Server to support the company’s own development processes. “We added new work item types and customized work item fields, aligning them with our own processes and workflows—so that we can track at any time what’s implemented and what can be tested,” says Eldredge. “We also built custom reports using Microsoft SQL Server 2008 Reporting Services, which we use to generate the output documents for our system of record

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“Quality assurance leads used to spend 25 to 35 percent of their time maintaining documentation. Today, those documents are generated automatically, as an integral part of the development workflow.”

Scott Loebig, Director of Software Engineering, Enterprise Solutions,

CareFusion

for electronic document capture and approval. We even use Reporting Services to generate our software specifications. That task alone used to take a few days, and now it’s immediate.”

As of March 2011, the Enterprise Solutions group had fully consolidated on Team Foundation Server. The Dispensing Technologies group was well on its way, making the switch on a project-by-project basis. Both groups use a combination of Ultimate and Premium editions of Microsoft Visual Studio 2010 on developer desktops. The Enterprise Solutions group has started using the Microsoft Test Manager technology in Visual Studio 2010 Ultimate and Microsoft Visual Studio Test Professional 2010 to manage test cases, capture test data, and record and replay tests.

Since adopting Team Foundation Server, the Enterprise Solutions group has used it to support more than 50 software releases. The Dispensing Technologies group has used it for eight releases, with project team sizes ranging from a half-dozen to several dozen people. Marketing teams in both business units also use Team Foundation Server. “Marketing uses it to capture field issues and customer requests, which can then be linked to bugs, new requirements, and so on,” says Loebig. “When quality assurance is testing a requirement, they have visibility and traceability all the way back to the voice of the customer.”

Other groups across the company are starting to adopt Team Foundation Server, as well. Today, some 250 to 300 people use it on a daily basis—including employees in remote locations, who access it over the

company’s wide area network (WAN) or a virtual private network (VPN). All Team Foundation Server solution components run on the Windows Server 2008 R2 Enterprise operating system, with Microsoft SQL Server 2008 R2 Enterprise database software providing a centralized repository for all project data.

BenefitsThrough its adoption of Visual Studio 2010 Ultimate and Premium editions and Visual Studio Team Foundation Server 2010, CareFusion is moving from multiple stand-alone tools for various aspects of application lifecycle management to a single, integrated solution. Those efforts are leading to reduced costs, increased productivity and collaboration, faster delivery times, improved software quality, consistent monthly iterations, and deep, real-time visibility into project status and health for all stakeholders.

Increased Productivity and CollaborationThe move toward a single solution for all aspects of application lifecycle management has improved productivity and collaboration. “Having all work items, tasks, bugs, and milestones in one place has reduced manual data entry and communication bottlenecks, resulting in increased productivity and improved consistency of communication,” says Allen Wong, a Program Manager in the Dispensing Technologies group. “With everyone now working within the same tools, we’re able to easily stay abreast of what others are doing.”

The quality assurance team within the Enterprise Solutions group has seen measurable productivity gains. “Quality

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“In the past, meetings were not focused and often resulted in an hour of wasted time. Now they are spent on discussions acute to solving issues versus finding and identifying them. The result is a 50 to 75 percent increase in meeting effectiveness and efficiency.”Allen Wong, Program Manager, Dispensing

Technologies, CareFusion

assurance leads used to spend 25 to 35 percent of their time maintaining documentation,” says Loebig. “Today, those documents are generated automatically, as an integral part of the development workflow. That’s a timesavings of 3,600 hours per year.”

Team members in both business units are spending less time in meetings, taking advantage of concise reports to help them more efficiently identify and focus on key issues. “With an integrated environment based on Team Foundation Server, our testers, analysts, and developers are collaborating and capturing all work and issues in one place,” says Wong. “This gives us great clarity into what’s going on with the project so that, when we do meet, we can use Team Foundation Server to quickly pinpoint issues such as lacking requirements, test cases, and bug counts—so that we can discuss the solution rather than debating the problem. In the past, meetings were not focused and often resulted in an hour of wasted time,” says Wong. “Now they are spent on discussions acute to solving issues versus finding and identifying them. The result is a 50 to 75 percent increase in meeting effectiveness and efficiency.”

Faster Delivery TimesIncreased collaboration, communication, and productivity are helping reduce delivery times by at least one month per release cycle, enabling CareFusion to bring new and enhanced products to market that much faster. “One good example is the release to manufacturing process, during which we used to spend weeks assembling our requirements traceability matrix,” says Loebig. “Today, we have a custom report

that generates the document instantly. Just as important, because we can now easily monitor traceability throughout the development process, we’ve eliminated the fear of finding missed requirements that would result in further delays. With Visual Studio Team Foundation Server 2010, we’ve been able to establish consistent monthly iterations—and easily cut at least a month off the overall development cycle. A typical project involves four to six people, so that’s an overall timesavings of four to six person-months.”

Increased Code and Document QualityCareFusion also has improved code quality. “Overall unit test code coverage has increased 40 percent—made possible through a Team Foundation Server report that gives us the data we need to measure this important metric,” says Loebig. “It’s just one more way that we’re using Team Foundation Server to identify and focus on the right things.” Document quality has also improved—as evidenced by the speed at which most documents flow through the approval process. “Our electronic approval system is only as good as the documents in it,” says Wong. “In the past, the electronic approval process for a single document could take one or two weeks. Today, the process only takes two or three days.”

Improved Visibility into Project Status and HealthWith all project data captured as part of everyday workflows, stored in one place, and readily accessible through prebuilt reports, CareFusion always has an accurate picture of project status and health. “In the past, I had to dig through hundreds of

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"Overall, I’d estimate that our consolidation on Team Foundation Server has saved my group more than $28,000 in tools-related licensing costs."

Scott Loebig, Director of Software Engineering, Enterprise Solutions,

CareFusion

emails and spend hours in meetings every week to stay abreast of the status of a half-dozen or more projects,” says Eldredge. “Today, thanks to the reports we’ve developed, I can easily see blocked tasks, understand what work remains, and determine where teams need help to complete their commitments.”

Adds Wong, “It’s now much easier to capture a checklist of the remaining work to be done when we get close to the code-complete stage. As an added benefit, program managers don’t have to reinvent the wheel in creating their own reports to communicate project status.”

Reduced CostsThe company’s consolidation on Team Foundation Server is also reducing costs. “In the past, we paid to license and support dozens of different tools,” says Loebig. “Today, my group only uses Team Foundation Server, which can be downloaded and installed by anyone who has a MSDN subscription—as we all do. And a Team Foundation Server Client Access License is included for most Visual Studio 2010 editions with MSDN. The licensing model for Team Foundation Server 2010 has made it extremely cost-effective for us to adopt, which has really helped open the door to work toward

companywide adoption. Overall, I’d estimate that our consolidation on Team Foundation Server has saved my group more than [U.S.]$28,000 in tools-related licensing costs.”

Microsoft Visual Studio 2010Microsoft Visual Studio 2010 is an integrated development system that helps simplify the entire development process from design to deployment. Unleash your creativity with powerful prototyping, modeling, and design tools that help you bring your vision to life. Work within a personalized environment that helps accelerate the coding process and supports the use of your existing skills, and target a growing number of platforms, including Microsoft SharePoint Server 2010 and cloud services. Also, work more efficiently thanks to integrated testing and debugging tools that you can use to find and fix bugs quickly and easily to help ensure high-quality solutions.

For more information about Visual Studio 2010, go to www.msdn.microsoft.com/vstudio

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For more information about CareFusion, visit the website at: www.carefusion.com

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