Lecture material set for the TUT course SGN-57406 'Standards, Interoperability and Regulation in Health Informatics'.
This presentation discusses the requirements coming from regulation for the SW development process, and presents one tailored SW life cycle process suitable for medical device SW development.
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Medical SW development process - lecture material / case Movendos Oy
1. SW development process
in regulated health tech area
Course: TUT/SGN-57406
Stefan Baggstr旦m
28th Jan 2014
2. Motivation
Previous lectures were mostly
about standards, regulation and
related backgrounds
This is about practice, i.e.
development of medical products
Focus on SW development
process
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11. Front end: Responsive single page
web application
Web user interface
Index.html
- Application shell
Backbone.js / marionette.js
- MVC
- REST API communication
DOM
Cascading style sheets (CSS)
HTML templates
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12. Our team
Arto Leppisaari
Stefan Baggstr旦m
Hannu Nieminen
CEO
CTO
Research
Hannu Mikkola
SW architect
Our partners
Carlos Perez
SW developer
13. About me
20 years in SW & telco business
Various roles in Nokia SW
platforms and products
2 years in startup life
First incubating at TUT
Now startup co-founder & CTO
14. Our journey
Jan-2012
Explore
May-2012
Business models and
product concepts
Most promising 2
1st prototype
Jan-2013
Problem / solution fit
Understand
2nd prototype
Jan-2014
Product / market fit + Sales
Commercial product
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15. Key take aways
Movendos developes tools for
effective health coaching
Web application can be a
medical device based on its
intended use
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16. SW development
This section offers a glimbse into some of
the todays SW development practises.
These practises are used for developing
different kind of products for various
business fields.
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17. SW development <-> regulation
Things to keep in mind:
Its not just your own code that
matters
Development processes evolve over
time
Iterative product development with
customer collaboration is here to
stay
Directives and standards were done
some time ago based on old
mainstream best practices
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18. SW development buzz words
Agile, scrum, kanban,
Continuous
integration, deployment,
Open source
SW, libraries, frameworks,
Clouds, IaaS, PaaS, SaaS,
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19. SW development buzz words
Web, mobile, cross platform,
Licenses, patents, contracts,
Continuous updates, beta,
Customer expectations for great
UX (got used to iPhones/iPads)
New technologies are emerging
with increasing rate
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20. Basic elements of SW process
http://cloverleafsolutions.com/methods/software-development-lifecycle.html
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21. Some of the SW development
methodologies
http://cloverleafsolutions.com/methods/software-development-lifecycle.html
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26. Updates, updates, updates
Safety related regulation: A change in a product is
considered as added risk for safety
Best to develop single version, deploy it and never update?
Security and privacy related practices:
Always update the product to mitigate risks and to fix uncovered
vulnerabilities
Interworking between systems:
Best practise is to update when others update
Consider medical devices connected to hospital
networks and Internet:
Updates or not to update?
Testing always preceeds deployment of an update
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32. User experience
Some aspects of good UX:
Easy to use
Easy to navigate
Find information fast
Load fast
No crashes
But end users are expecting more!
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34. Some piece of code
public void handleMessagesFromDatabase() {
if (!applicationContextReady){
return;
}
List<NewMessage> messages = newMessageRepository.findUnsentNonPriorityMessages();
// Stop if there are no more messages
if (messages.isEmpty()){
return;
}
for(NewMessage message : messages){
if(emailIsValid(message.getToUser().getEmail())){
queueStandardEmail(message);
}
else{
onSendFailure(message, EmailSendStatus.INVALID_EMAIL_ADDRESS);
}
}
}
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35. From small code chunk to full
blown system
Multiple size by 10k, 100k or 1M
to build a sub system
Go further and integrate all
subsystems into the system
Note, the code comes into the
project also from used:
Libraries
OS, runtime,
Compiler, IDE, version control,
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36. Working as a small dev team
Source: http://www.romanpichler.com/blog/tag/teamwork/page/2/
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37. Brooks law: Putting more people
on a late job makes it later.
http://www.pmhut.com/estimating-software-effort
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39. Deliverables
(kind of a minimum set)
Requirements in product and sprint backlogs
Design documents
Test cases: unit, integration, system tests
Test reports
Bug reports
Versioned, reviewed, integrated and
running code
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40. From piece of code into product
Functional
*3 into
system
*3 with
team
*9 into
product
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41. Key take aways
SW development processes evolve
over time
Use of SOUP (software of unknown
pedigree / provenance) increases
Use of web apps increases over
native apps (many runtimes)
Users demand good usability
SW development is complex in
many dimensions
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42. Requirements from regulation
This section describes the
regulatory constraints set for SW
product development. One concrete
example case explained.
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43. Medical device
Must conform with regulation
Must not endanger the safety or
health of the patient or other persons
Manufacturer to ensure
Safety
Suitability for intented use
Performance and reliability
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44. Medical Device/SW Regulation
Depends on the
market, country, type of medical
device
Example case:
SW product with medical intended use
Targeting European market
Council Directive 93/42/EEC
There are applicable harmonized
standards, which help to comply with
the directive
In addition, the directive has
requirements for validation and
releasing
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45. Standard set (example)
IEC 62304 Medical device software Software life cycle processes
EN 62366 Medical devices. Application of
usability engineering to medical devices
ISO 14971 Medical Devices-Application of
risk management to medical devices
ISO 13485 Medical Devices. Quality
management systems. Requirements for
regulatory purposes
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46. Standards set requirements for
SW development process
Quality management system
Risk management process
Usability process
Clinical investigation
Validation
Registration
Placing on the market
Problem resolution
Etc.
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47. Regulation continued
There are directives and laws for
Privacy
Security
Language support
These may set
complementary, but also
contradicting requirements for
vendors
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48. Is medical field unlike others?
Regulation applies also to
airplane, railway, and many other
industries
SW project risks typically deal with
schedule & costs
Add safety & essential performance
risks for medical devices
Time to money: typically its
development & verification time
Add time required for validation &
approval for medical devices
Clinical validation requires its own
time & effort
49. Movendos SW development
process
This section explains how Movendos
developes SW. Its our way of applying
state of the art practices, and our way of
working with the constraints set by the
regulation.
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50. Customer development
Collaboration with customers
Iterate and verify
Problem centric as opposed to
product or technology centric
Performed in parallel with
product development
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57. Movendos - full life-cycle
Patch update/
bug fixes
Project preparation
Development
Feature complete
Release
Validation
In use
Maintenance
preparation
Validation
Release
Development in sprints
Retirement
Feature complete
Development
58. Risk management
Risk analysis
Methods: Failure Mode Effect
Analysis (FMEA), Fault Tree Analysis
(FTA), or some other feasible way
Initial analysis + incremental
Reports & reviews
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59. Risk management in more detail
Initial risk analysis
Risk analysis for each sprint
backlog item
Update risk magement report for
each major milestone
Corrective and preventive
actions based on findings
Reporting of hazards to
customers and officials
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60. Documentation
Process documentation
SW process
Quality Management System
document(s)
Project documentation
Intended use
Plans
Reports
Traceability
Requirements-implementation-testsreleases-
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61. Documents in more detail
Quality Management System
SW development process
Products intended use
Project plan
Requirement specification = product
backlog
Product architecture
Usability and UX/UI design documents
Test plans and reports
Validation documents
Problem reports (and bug reports)
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62. Project documentation
Example: 1st milestone
Project plan
Intended use
Risk management plan + risk
analysis
Initial usability analysis
Verification plan
Initial architecture
SW components plan
Initial product backlog
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63. Traceability
Full traceability is required:
Why was this SW change made and how
it was verified?
You need to have links between:
Requirements, design documents, test
plans, tests, code, test reports, change
notes
Everything should be in version control:
code, docs, tests, tools, environment
configurations, etc.
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64. Verification & Validation
Verification shall be performed to
ensure that the design and
development outputs have met the
design and development input
requirements.
Design and development validation
shall be performed to ensure that
the resulting product is capable of
meeting the requirements for the
specified application or intended
use.
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#7: Hyvinvointivalmennus on hyvin kokonaisvaltaista ja pit辰辰 sis辰ll辰辰n monenlaista valmennusta.Ravintoon ja liikuntaan liittyv辰t terveelliset el辰m辰ntavat mutta my旦skin mielenhallintaan liittyv辰t asiat, psykoterapia ja nuorten syrj辰ytyminen.N辰iss辰 kaikissa kyse valmentajan ja valmennettavan v辰lisest辰 kommunikaatiosta ja pienist辰, p辰ivitt辰isist辰 valmennus teht辰vist辰.
#15: Explored possibilities to productize research results. Explored opportunities with non-profits and commercial companies. Product concepts and business models for 20+ ideas, selected 2 most promising, and eventually carried on with 1.Very small pilot with 1st proto. Small pilot with 2nd proto.Now seeking for quantative product / market fit.
#44: SW is a medical device? Starts with the intended use,
#49: Yes, but similarities to other regulated industries. But unlike born-global, conquer-the-world-over-night, type of apps
#51: No business plan survives the 1st contact with customerDo smallest possible that solves the problem, verify need & usage, improve if needed.We are focused on solving problems the coaches have. Helping them to reach their full potential. Products and technologies come and go.
#52: What if you do the solution box last?Iterate on the segments, channels and all.