By Eric Andrew Kristof, RN, CAHIMS | Healthcare IT Professional | HIMSS Arkansas Chapter Member
About This Series: The HIMSS Word of the Day is a running blog series drawing from the HIMSS Dictionary of Health Information and Technology Terms, Acronyms, and Organizations, 6th Edition (2025) — the authoritative reference for healthcare IT professionals and the primary study resource for CAHIMS and CPHIMS certification. Each post paraphrases the term in plain language, grounds it in real-world healthcare IT context, and adds a bedside nursing perspective you won’t find in a textbook.
📖 The Term: Systems Development Life Cycle (SDLC)
Source: HIMSS Dictionary of Health Information and Technology Terms, Acronyms, and Organizations, 6th Edition (2025)
🔍 Plain-Language Definition
The systems development life cycle (SDLC) is a structured way of moving an information system from an initial idea to a working system and, eventually, to retirement. It breaks the work into phases so that needs are understood before anything is built, testing happens before go-live, and the system is maintained after it is in use.
The HIMSS Dictionary, which spells it lifecycle, describes the SDLC in two ways. First, it is a project management model that lays out the stages and tasks for creating and deploying software. Second, it is the process a systems analyst follows to develop an information system, covering requirements, validation, training, and user ownership as the work moves through investigation, analysis, design, implementation, and maintenance.
| Phase | Key Question | Healthcare Example |
|---|---|---|
| Planning | What problem are we solving, and is it worth doing? | A business case for replacing a legacy nursing documentation system |
| Analysis (Requirements) | What must the system do, and for whom? | Workflow sessions with nurses, pharmacists, and providers |
| Design | How will the system meet those requirements? | Designing flowsheets, order sets, and interfaces |
| Build (Development) | Construct or configure the system | Analysts configure the EHR; developers build interfaces |
| Testing | Does it work correctly and safely? | Unit, integrated, regression, and user acceptance testing |
| Implementation | Put it into use | Training, cutover, Go-Live, and at-the-elbow support |
| Maintenance (Operations) | Keep it working and improving | Upgrades, fixes, optimization requests |
| Retirement (Disposal) | Decommission safely | Archiving legacy data and shutting down old servers |
⚠️ Exam Alert: The SDLC describes the life of a system. The project life cycle describes the life of a project (initiating, planning, executing, monitoring and controlling, closing). Waterfall runs phases in sequence, while agile delivers in short, repeated cycles. Questions often ask which phase a task belongs to; for example, gathering workflow requirements is analysis, and user acceptance testing happens before implementation.
🌐 Why It Matters: Real-World Healthcare IT Context
Healthcare organizations usually buy software rather than write it from scratch, but they still follow the SDLC. Selecting an EHR, designing its configuration, building interfaces, testing workflows, training staff, going live, and maintaining the system through years of upgrades is an SDLC on a very large scale.
Skipping phases is expensive. Requirements gathered without frontline input lead to designs that do not fit the work. Inadequate testing allows errors into production, where they can affect patient care. Poor planning for maintenance leaves organizations unable to absorb vendor upgrades or regulatory changes.
Approaches vary. Waterfall methods complete each phase before moving to the next, which suits large implementations with fixed deadlines. Agile methods, shaped by the 2001 Manifesto for Agile Software Development, deliver smaller increments in repeated cycles with frequent user feedback, which suits optimization work and custom applications. Many health IT programs blend the two.
Security belongs in every phase. NIST’s Risk Management Framework, SP 800-37, integrates security and privacy risk management into the system life cycle, and NIST’s Secure Software Development Framework, SP 800-218, describes practices for building software securely from the start.
Retirement is often overlooked. Legacy systems contain records that must remain accessible for legal and clinical reasons, so retiring a system usually means archiving its data in a way that clinicians and health information management staff can still search.
Common SDLC failures in healthcare:
- Requirements written without observing real clinical work
- Compressed testing to meet a fixed Go-Live date
- User acceptance testing done by IT staff instead of clinical users
- No budget or staffing for post-Go-Live optimization
- Upgrades applied without regression testing of local build
- Legacy systems retired without an accessible archive
Practices that support a strong life cycle:
- Clinical involvement in requirements, design validation, and testing
- Formal test plans with realistic scenarios and patient safety checks
- Change control for every modification after Go-Live
- Security and privacy reviews at each phase
- Planned optimization cycles driven by user feedback
- Documented retirement and data retention plans
🏥 The Nurse’s Perspective: Clinical, Bedside, & Workflow
Nurses contribute to nearly every phase of the SDLC, often without the title of analyst or developer.
At the Bedside
Requirements begin at the bedside. When a nurse explains how a medication pass really works, which assessment items are actually used, or why a certain report is needed at shift change, that information becomes a system requirement. Nurses who participate in workflow sessions help ensure the design reflects reality rather than policy alone.
After Go-Live, bedside nurses drive the maintenance phase. Their enhancement requests and safety reports are often the first signs that a design needs to change.
In Clinical Workflow
Testing is another place where nurses make a difference. In user acceptance testing, nurses walk through realistic scenarios, such as admitting a patient, documenting an assessment, and giving medications, to confirm that the build supports safe care. Nurses are good at spotting problems IT testers may miss, such as a missing field that matters only in a specific clinical situation.
Super users are a bridge between phases. These nurses receive extra training, help test, support peers at Go-Live, and continue to collect feedback afterward.
In EHR Implementation (Go-Live Perspective)
An Epic implementation follows the SDLC closely: planning and readiness, workflow and design sessions, build, multiple rounds of testing, training, cutover, Go-Live, and stabilization, followed by ongoing optimization. At-the-elbow support analysts work at the implementation phase, where design decisions meet real users for the first time.
Issues logged during Go-Live feed directly into the maintenance phase. Clear documentation of each issue, including what the user expected, what happened, and the workflow affected, helps teams decide whether the fix is education, a build change, or a future enhancement.
🎓 CAHIMS / CPHIMS & HIMSS Perspective
CAHIMS Exam Domain Mapping
The SDLC is one of the most heavily tested concepts in systems management:
| CAHIMS Domain | How the SDLC Appears |
|---|---|
| Healthcare & Technology Environments | Buy versus build decisions; vendor relationships; regulatory changes that drive upgrades |
| Clinical Informatics | Clinical requirements, workflow design, user acceptance testing, optimization |
| Healthcare Information & Systems Management | Phases of the SDLC, testing types, change control, maintenance, retirement and archiving |
| Management & Leadership | Project planning, resource allocation, governance, risk management across the life cycle |
Key Terms to Know Alongside SDLC
- Requirements Analysis — identifying and documenting what a system must do for its users
- User Acceptance Testing (UAT) — testing by end users to confirm the system meets their needs before implementation
- Regression Testing — retesting existing functions after a change to confirm nothing broke
- Agile — an iterative approach that delivers work in short cycles with frequent feedback
- Waterfall — a sequential approach in which each phase is completed before the next begins
- Change Control — a formal process for reviewing, approving, and tracking changes to a system
HIMSS Organizational Position
HIMSS addresses the system life cycle through its focus on implementation, optimization, and digital maturity. Its maturity models, such as EMRAM, reflect how organizations progress after implementation, and the CPHIMS credential tests systems analysis and project management knowledge. Members can find related education and research through the HIMSS Resource Center.
🔗 Explore Further: External References
- NIST — SP 800-37 Rev. 2, Risk Management Framework for Information Systems and Organizations https://csrc.nist.gov/pubs/sp/800/37/r2/final
- NIST — SP 800-218, Secure Software Development Framework https://csrc.nist.gov/pubs/sp/800/218/final
- Manifesto for Agile Software Development https://agilemanifesto.org/
- ONC — SAFER Guides https://healthit.gov/clinical-quality-and-safety/safer-guides/
- HIMSS — Certifications (CAHIMS and CPHIMS) https://www.himss.org/certifications
- HIMSS — Electronic Medical Record Adoption Model (EMRAM) https://www.himss.org/maturity-models/emram
Term source: HIMSS Dictionary of Health Information and Technology Terms, Acronyms, and Organizations, 6th Edition (2025). All definitions in this series are paraphrased for editorial purposes. Readers are encouraged to consult the primary source for exact language.
Eric Andrew Kristof, RN, CAHIMS is a Healthcare IT professional and HIMSS Arkansas Chapter member based in Hot Springs Village, AR, with hands-on Epic Go-Live experience and a diverse healthcare and IT background. He writes at kristof.org at the intersection of clinical care and healthcare technology.
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