This was the first time that agile methodology was applied in Croatian Government. We already knew examples of other Governments using agile methods to deliver e-products but we were not aware of any example where it was used to unlock a reform agenda as in the example of our Agile Health team. Strong focus on the learning, has made PDIA methodology particularly good because it has allowed us to bypass the usual instant and/or partial solutions. Agile approach kept our focus on the user, which in turn helped steer the immense amount of data and analysis that the team delivered through their activities toward conclusions.

We are in the process of drafting the Digital Croatia Strategy 2022-2032. In this strategy, we rely heavily on restructuring the way we manage digital transformation in Croatia and how the results are delivered operationally. Agile teams are now embedded, not only in the Standards for the development of e-services but also in delivery of our digital policy through an improved project management model. Finally, it will be interesting to see whether teams will continue to approach their work with such ambition and success once they are formalized.

• Agile Health team involved: Office of the PM, Ministry of Health, Croatian Health Insurance Fund, Croatian Institute for Public Health, University Hospital Center Zagreb, Croatian Medical Association, Croatian Association of Patients, all companies that produce software for hospitals.
• Agile Public Administration team: Office of the PM, Ministry of Justice and Administration, Central State Office for Digital, Student of IT, citizens, representatives of employers, etc.

In both agile teams, the primary beneficiaries were citizens. Secondary beneficiaries were civil servants, health workers, owners of companies, parents of minor children, companies, etc.

Results: The Agile team provided evidence that the Government should stop generating 13 million paper referrals/year. All of the paper referrals had to be archived in paper form which meant 65 million referrals in the past 5 years. All Croatian hospitals proved ready to transfer to e-referrals only. This had a positive impact on citizens and their access to hospital care. It also had a positive impact on the nurses who did not have to deal with two systems (both electronic and paper system).

The PA Agile team delivered e/Citizens portal that replaced four different websites and two registries. It became a central place for both citizens and business entities. The new e-authorization system allowed for services to be offered for all life situations. For example, parents of minor children are automatically offered to use e-services on behalf of their minor children, business owners are automatically offered to use business e-services, etc.

There have been numerous challenges in agile methodology implementation in a system that is not designed to support or understand such an iterative approach. After several months of work, when we compiled and analysed a lot of data, the teams realized the magnitude of work and two members quit. It has become difficult to juggle agile work alongside our usual work and this has taken a toll on the entire team. We have gone through these challenges together, sharing more about our deadlines and obligations and started to rely on each other for support.

There needs to be a sense of urgency. A feeling that a problem has not been resolved for a while and that it has become a problem. Then there needs to be a champion of change that has the right values, motivation and skill set to see the proposed experimentation from the beginning to the end. Personal values and motivation of individual members of the team is of great importance because when the motivation is low, personal motivation will provide the fuel. The experiment has to have the political support from the top so that when unconventional approach is recommended it can be implemented. Finally, the experiment has to bring an added value to the community of practitioners and to the leadership in order to continue receiving support for further development.

Yes, it has been replicated within Croatian Government again to develop new e-services and functionalities for the e-Citizens portal.

Team’s key findings led to the team writing a proposal for five rapid interventions to improve system use by practitioners in the country’s largest hospital, KBC Zagreb. These interventions were developed in a faster period than is typical to Croatian policy making, at lower cost than is normal, and enjoyed more ownership and acceptance than is common (in the various entities represented on the agile team and in their user collaborators). The ideas were directly targeted at solving users’ problems, and slated to be introduced through an iterative, adaptive process centered on garnering and then adapting to user feedback (where ideas would be activated quickly with the involvement of users, users would then be asked if the action solves their problem, the idea would then be adapted based on user feedback, and a newly adapted idea activated in a repeated iteration—until the user expresses satisfaction that the ‘problem is solved’).

Part of this material is an excerpt from the case study written by prof. Matt Andrews for the purposes of teaching it in the "Implementing Public Policy" course, Harvard Executive Education Program.