BonCode Drives Quality of Medtronic’s OutSystems Center of Excellence

Exec Summary  

With up to 11 concurrent development projects and 30 OutSystems developers, software quality assurance is a crucial concern for Medtronic. Many of its OutSystems apps support life-critical digital health products used by patients and clinicians. So Medtronic has rigorous requirements for the continuous performance, maintainability, and compliance of its fast-growing application portfolio. With the help of BonCode, Medtronic has turned software quality management from a reactive enforcement function into business as usual. 

THE PROBLEM 

How to Drive Software Quality Without Seeming Like a Policeman? 

Medtronic has led healthcare technology innovation for 70+ years. From a humble start as a medical equipment repair shop in 1949, it rapidly rose to the forefront of the industry, creating the world’s first external battery-powered pacemaker in 1957 and continuously developing new devices and therapies ever since. 

Its digital health division provides a wide range of integrated healthcare solutions, including remote monitoring, patient engagement mobile apps, and clinician and patient support applications. 

Medtronic’s OutSystems journey started in 2018 when the company needed to re-platform FocusOn™, a remote monitoring and triaging system for cardiac conditions. 

“We initially sought off-the-shelf, configurable products but soon realized that we needed the full flexibility of custom development,” explains Eric Philippens, Senior Principal Architect Business Platforms and Integrated Health Solutions at Medtronic. 

With a growing backlog of digital health solutions, and a quest for faster development and rapid, continuous product enhancements, Medtronic EMEA selected OutSystems as its standard low-code application development platform. Within six months, working with OutSystems partner Noesis, Medtronic released FocusOn™ 2.0, a product that it has regularly enhanced ever since. 

The success and speed with which the team delivered FocusOn led to additional digital health development projects using OutSystems. These included a patient engagement mobile app for the Dutch obesity clinic and a remote monitoring application for diabetes patients. 

Our OutSystems applications serve over 45,000 patients, thousands of clinicians, and hundreds of health organizations worldwide. That number is climbing all the time.

Eric Philippens, Senior Principal Architect Business Platforms and Integrated Health Solutions, Medtronic

With numerous life-critical applications running on OutSystems, and as many as 30 OutSystems developers spread across up to eleven concurrent projects, software quality monitoring became an increasingly important concern. 

“We wanted an objective, industry-standard, and external opinion regarding the quality of our development,” says Eric. “We met BonCode at the OutSystems NextStep conference in 2019 and decided to give them a go.” 

Why Medtronic Choose BonCode

THE SOLUTION 

Factual Insights Prove a Game Changer 

The initial one-month engagement involved analysis of FocusOn and two other applications used for remote monitoring and electronic health records. BonCode integrates with the OutSystems development environment via an API and has been fully optimized to automatically analyze and report on OutSystems visual source code quality and development productivity using function point analysis. 

BonCode provides insights and trend analysis via a web-based dashboard, enabling architects, tech leads, and developers to drill down to specific applications and modules for granular details, including: 

• Code duplication 
• Best practices violations 
• Code churn percentage 
• Details of any embedded code 

“We gained immediate insights regarding the quality of these applications and identified gaps in our approach,” says Eric. “Our focus had been the delivery of capabilities, and even though we knew a few areas needed technical improvement, we hadn’t been overly concerned with technical debt. The BonCode analysis provided an objective analysis of the quality, which helped us to prioritize where to make improvements.” 

These insights served as a powerful input to quality improvement discussions between Medtronic and its external OutSystems developers. “We use several OutSystems development partners and consultancies,” explains Eric. “Holding architecture and quality discussions with developers when you have shared access to independent, objective, and actionable facts is a game changer. Politics and opinions don’t come into it. Instead of seeming like a policing exercise, it becomes more of a joint effort, to explore where and how to improve quality.” 

Further engagements with BonCode followed before Medtronic’s IT team decided that continuous monitoring would add significant value to its OutSystems center of excellence. 

As a principal architect, I need to ensure everything we build on OutSystems conforms to our architecture rule and principles, including security, data privacy, integration patterns, design, and quality. Using BonCode helps engage the entire development team with actionable facts about software quality.

Eric Philippens, Senior Principal Architect Business Platforms and Integrated Health Solutions, Medtronic 

THE RESULTS 

From Push to Pull—The Key to Quality Improvement 

Medtronic’s OutSystems application portfolio has two broad categories of applications: 

• Customer-facing products that are continuously improved. These include remote monitoring apps for cardio and diabetes patients and their physicians and an eHealth mobile app for obesity patients. 

• Internal applications that change less frequently. These include supply chain, legal, sales, marketing, and manufacturing apps, plus a new employee engagement app that over 100,000 employees will use. 

BonCode continuously monitors customer-facing apps, whereas internal apps are analyzed only after significant changes. Developers and tech leads use the BonCode web-based dashboard to interrogate the quality insights. 

“Moving to continuous monitoring has changed the dynamics of software quality management,” says Eric. “Instead of software quality seeming like a policing exercise, developers now self-serve using the BonCode dashboards and drilldowns to continually improve the quality of our OutSystems apps. There’s less push from my side and more pull from our developers.” 

Proof of the value we’re getting from BonCode came last year. Our BonCode dashboard stopped working for a few hours. Developers were straight on to me, complaining that they couldn’t access it. That’s what I mean about quality management turning from push to pull.

Eric Philippens, Senior Principal Architect Business Platforms and Integrated Health Solutions, Medtronic 

Asked about the value that BonCode provides over and beyond OutSystems Architecture Dashboard, Eric says, “We use both—Architecture Dashboard is more high-level and useful for ad-hoc queries of the current state. The difference with BonCode is that we can track our performance over time and add important narrative context. Any conversation with management about the quality and productivity of development needs that context. That’s not possible with Architecture Dashboard.” 

“For example, one of our patient monitoring apps needed refactoring to improve scalability,” explains Eric. “I can go to the dashboard and track the software quality improvement over time for independent expert validation that our investment was worthwhile. That’s powerful when managers want financial justification for the company’s outlay.” 

As the digital health team collaborates with other business units that want to bring new digital services to market, BonCode quality and productivity metrics help justify Medtronic’s OutSystems software factory. “Across the business, we use various development options,” says Eric. “Those other options and outside consultancies are unlikely to provide the same quality and performance evidence as we can, thanks to BonCode. That helps us justify the business case for a low-code approach with OutSystems.” 

Although Eric feels much less like a quality enforcement officer nowadays, there’s still one aspect that can spell trouble for developers. “Developers love to change things, like trying out new frameworks or components,” says Eric. “With continuous monitoring, BonCode tells me what has churned since the last scan. I can challenge why we’re changing things. My point of view is, if a component or module was working well, we shouldn’t be changing it without a good justification.” 

Productivity Comes from Quality 

Eric is excited about the productivity analysis features that BonCode provides, based on ISO 20926 function point analysis. “BonCode gives us the capability to measure software maintainability from an efficiency perspective,” says Eric. “Ultimately, we expect the effort and cost required to maintain our applications to reduce as we improve the quality. That kind of measurement is unique for BonCode, and we’re excited to collaborate with other OutSystems customers in the benchmarking program that BonCode facilitates. We’re already encouraged from the shared learning that other participants and we gain from benchmarking OutSystems development productivity and quality.” 

Given that Medtronic manages development teams from five or more OutSystems delivery partners, objective, transparent, and actionable quality metrics are a powerful vendor management lever. 

“We’ve added a minimum BonCode ‘Solution Score’ into our development partner contracts,” says Eric. “That becomes possible when quality is measured using irrefutable facts rather than opinions. I’ve no doubt that it helps us get the best from our partners.” 

More on productivity for OutSystems here and here.