DevOps in an ISO 13485 Regulated Environment: A Multivocal Literature Review
This addresses the problem of integrating agile DevOps methods with strict regulations for medical device developers, but it is incremental as it synthesizes existing evidence without introducing new methods.
The study reviewed the adoption of DevOps in ISO 13485 regulated medical device environments, finding that while challenges exist, potential benefits in regulatory, compliance, security, organizational, and technical areas may outweigh them, and proposed a checklist for implementation.
Background: Medical device development projects must follow proper directives and regulations to be able to market and sell the end-product in their respective territories. The regulations describe requirements that seem to be opposite to efficient software development and short time-to-market. As agile approaches, like DevOps, are becoming more and more popular in software industry, a discrepancy between these modern methods and traditional regulated development has been reported. Although examples of successful adoption in this context exist, the research is sparse. Aims: The objective of this study is twofold: to review the current state of DevOps adoption in regulated medical device environment; and to propose a checklist based on that review for introducing DevOps in that context. Method: A multivocal literature review is performed and evidence is synthesized from sources published between 2015 to March of 2020 to capture the opinions of experts and community in this field. Results: Our findings reveal that adoption of DevOps in a regulated medical device environment such as ISO 13485 has its challenges, but potential benefits may outweigh those in areas such as regulatory, compliance, security, organizational and technical. Conclusion: DevOps for regulated medical device environments is a highly appealing approach as compared to traditional methods and could be particularly suited for regulated medical development. However, an organization must properly anchor a transition to DevOps in top-level management and be supportive in the initial phase utilizing professional coaching and space for iterative learning; as such an initiative is a complex organizational and technical task.