The Impact of Regulatory Changes on the Development of Mobile Medical Apps

Mobile applications are being used to perform a wide variety of tasks in day-to-day life ranging from checking email, to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage, plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibly face criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation. Keywords—Medical, Mobile, Applications, Software Engineering, FDA, Standards, Regulations, Agile.

[1]  Paul T. H. Kim FDA and the regulation of medical software , 1993, [1993] Computer-Based Medical Systems-Proceedings of the Sixth Annual IEEE Symposium.

[2]  Antonio Coronato,et al.  IEC 62304: medical device software - software life-cycle processes , 2018 .

[3]  Victor Rodrigues,et al.  Agile Development in a Medical Device Company , 2008, Agile 2008 Conference.

[4]  M C Emre Simsekler,et al.  The regulation of mobile medical applications. , 2014, Lab on a chip.

[5]  A. Govardhan,et al.  A Comparison Between Five Models Of Software Engineering , 2010 .

[6]  James G Kahn,et al.  'Mobile' health needs and opportunities in developing countries. , 2010, Health affairs.

[7]  Weiguo Lin,et al.  Software Development Practice for FDA-Compliant Medical Devices , 2009, 2009 International Joint Conference on Computational Sciences and Optimization.

[8]  Medical devices; Medical Device Data Systems. Final rule. , 2011, Federal register.

[9]  Bakul Patel The regulatory perspective: Q&A with FDA's Bakul Patel. , 2012, Biomedical instrumentation & technology.

[10]  Fergal Mc Caffery,et al.  Med-Trace: Traceability Assessment Method for Medical Device Software Development , 2011 .

[11]  Paul Rook,et al.  Controlling software projects , 1986, Softw. Eng. J..

[12]  W. W. Royce,et al.  Managing the development of large software systems , 1970 .

[13]  Jon W. Spence,et al.  There has to be a better way! [software development] , 2005, Agile Development Conference (ADC'05).

[14]  Robert C. Martin Agile Software Development, Principles, Patterns, and Practices , 2002 .

[15]  Fergal McCaffery,et al.  An agile V-model for medical device software development to overcome the challenges with plan-driven software development lifecycles , 2013, 2013 5th International Workshop on Software Engineering in Health Care (SEHC).

[16]  David A. Vogel,et al.  Agile Methods : Most are not ready for prime time in medical device software design and development , 2022 .

[17]  Kevin Forsberg,et al.  The Relationship of Systems Engineering to the Project Cycle , 1992 .

[18]  James Cadle,et al.  Project Management for Information Systems , 1996 .

[19]  Fergal McCaffery,et al.  Risk Management process improvement for the Medical Device Industry , 2005 .

[20]  Kelly Weyrauch,et al.  What are we arguing about? A framework for defining agile in our organization , 2006, AGILE 2006 (AGILE'06).

[21]  Will Venters,et al.  Software engineering: theory and practice , 2006 .

[22]  Heather Wharrad,et al.  Smartphone and medical related App use among medical students and junior doctors in the United Kingdom (UK): a regional survey , 2012, BMC Medical Informatics and Decision Making.

[23]  Orit Hazzan,et al.  The Agile Manifesto , 2014 .

[24]  Bernhard Rumpe,et al.  Limitations of Agile Software Processes , 2014, ArXiv.

[25]  Amy J Barton,et al.  The regulation of mobile health applications , 2012, BMC Medicine.

[26]  Tim Hughes,et al.  Adopting Agile in an FDA Regulated Environment , 2009, 2009 Agile Conference.

[27]  Donald J. Reifer,et al.  How good are agile methods? , 2002, IEEE Software.

[28]  Kathryn Cormican,et al.  An Ontology Model for Systems Engineering Derived from ISO/IEC/IEEE 15288: 2015: Systems and Software Engineering - System Life Cycle Processes , 2016 .