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Building mHealth Apps

By Neil Polwart, Group Head of Mobile, BBI Group

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Neil Polwart, Group Head of Mobile, BBI Group

The surge in mobile health apps is generating an industry worth in excess of $75BN USD, and so it is understandable that mobile technology is attracting the attention of some of the world’s largest pharmaceutical and diagnostic companies. Initially many of the mHealth apps that were attracting significant user adoption and financial investment were really wellness apps and fitness trackers which fell outside the interest of regulators. Increasingly however apps are being developed which make specific medical claims or are intended to sit alongside existing regulated medical devices. Such apps are likely to prick the interest of regulatory bodies globally to ensure that their safety and performance has been properly controlled. When your social media app crashes it is an inconvenience, when your mapping app insists you are in the Atlantic off the coast of Africa (0,0 lat and long) rather than a stuck in traffic it is frustrating but if a diabetic’s blood glucose meter reports values in the wrong units it is potentially life threatening. Anyone building mobile medical applications must keep the implications of an error, by the software or the user, right at the top of their mind throughout the development lifecycle.
Of course, most software developers will tell you that test driven development is the latest in a long line of supposed improvements to software methodologies over the last few decades which see the creators of software write the testing criteria before they write the actual code. Whilst in theory this help produce code that does exactly what is required, it simply moves the risk from bad software to bad test cases, it may be more efficient but it doesn’t automatically result in better applications. As a result significant effort is required in both the design and execution of the tests. If the software is written separately for iPhone and Android platforms this can amplify the effort required to build robust applications. In steps Microsoft’s Xamarin platform, a C# .net based development framework specifically designed to work across different operating systems. By abstracting as much of the code, and the necessary unit tests away from the platform specific development languages developers are able to build tests and applications with a common, robust, well tested underlying structure that help to reduce the risk of error. Xamarin is now an integral part of the Visual Studio offering, reassuring developers it is here to stay.

The Xamarin team at Microsoft recognize that testing doesn’t stop with backend testing of software modules and so have a warehouse full of actual mobile devices together with an interface allowing developers to deploy and test their code across the net on thousands of different mobile devices. This allows pre-designed test scripts to be run on many devices simultaneously with all the results tracked and recorded (an essential feature for any developer working in the medical environment where FDA inspectors can turn up unannounced and demand to see your technical files). This capability which used to be a standalone offering (called Test Cloud), has now been integrated into “App Centre” a sort of back end prototyping and deployment hub providing the ability to get apps into the hands of real users–the ultimate test of whether the software does what you expected. By the time it reaches real patients any medical app should already have gone through robust testing of each of its independent software units, been tested as an integrated product and then been trialled by real users in typical use environments. Microsoft’s tools provide a useful suite to help diagnostic and pharma companies and their development partners to follow this path, although of course the same strategies.
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