Comparing Project Management Methodologies for Enhancing Electronic Disease Surveillance Systems: A Program Perspective

BACKGROUND:   Traditionally, state health departments have utilized the waterfall model of project management for developing and enhancing disease reporting systems. In the waterfall model, requirement gathering generally occurs upfront followed by development and then testing. In 2013, the Ohio Department of Health (ODH) switched to the Scrum methodology in an effort to improve quality and reduce costs.  Scrum is an iterative project management methodology that doesn’t utilize upfront requirements gathering and allows product owners to change direction as needed. There are benefits and disadvantages to both project management methods.

METHODS:   The relative success of ODRS projects utilizing the Scrum methodology were compared with those utilizing the waterfall methodology and a hybrid method.   Informal interviews with state-level informatics staff and epidemiologists from the state and local levels were conducted for this comparison.

RESULTS:  The results on scope, resources, and schedule varied depending on the methods utilized. In terms of scope, the Scrum method provided the most fluidity while the waterfall method allowed for the smallest amount of variation.  The hybrid method offered a middle of the road approach which users tended to like the best.  In terms of resources, it can be most difficult to determine resource allocation in terms of finances and IT resources with the Scrum method.  There can be limitations however with the waterfall method with communication between the developers and users if business analysis is completed up front.  Communication remained more consistent with Scrum and hybrid methodologies.  In terms of the schedule, the Scrum and hybrid methods are the most difficult to determine schedule.  The waterfall method allows for the greatest ability to determine a schedule ahead of time, however it allows for the least amount of fluctuation if user requirements change.

CONCLUSIONS: A hybrid methodology, incorporating both waterfall and Scrum methods, provided the best outcome for system enhancement.  As funds for surveillance system development erode, state health departments should continue to adopt and refine new project management methodologies to improve quality and reduce costs of system development.