Software as Medical Device

Decoding SaMD: A Step-by-Step Guide to Medical Software Development

Decoding SaMD: A Step-by-Step Guide to Medical Software Development

Developing Software as a Medical Device (SaMD) is a meticulous process, blending technological expertise with regulatory understanding. This guide delves into the various stages of SaMD development, highlighting the importance of market research, design precision, expert validation, and regulatory navigation. This blog offers a comprehensive roadmap for those looking to venture into or refine their approach to SaMD.

Introduction 

$23.26 billion – that's the potential valuation of the global market for connecting medical devices with healthcare IT platforms by year's end. With a robust CAGR of 25.2%, the surge in software development for medical devices is undeniable. 

“From standalone medical devices to integrated software-device solutions, we're experiencing more streamlined care delivery and operations,” says Dr Aakash Doshi, CEO of Montar Healthtech.

But the potential of these medical devices isn't just in their standalone capabilities. Collaborating with device manufacturers and digital partners can lead to a more holistic approach to healthcare delivery. 

By developing digital pathways, we can ensure that medical device usage integrates seamlessly into operations. This integration allows for a powerful combination of remote monitoring, real-time data analysis, and in-person consultations, ensuring that technology truly enhances patient outcomes.

Before we look at software development for medical devices, let’s start with the basics! 

Digital Dynamics: Medical Device Software vs. SaMD 

Terms like "medical device software" and "software as a medical device" often get used interchangeably. However, understanding their nuances is important for healthcare software product development.

Medical Device Software 

Medical device software is a component or accessory of a medical device. Its primary role is to enhance the device's functionality, control, or monitoring capabilities. The safety, effectiveness, and regulation of medical device software are intrinsically tied to the overall medical device. It's not just about the software but how the software and the device function as a cohesive unit.

These devices have components like microcontrollers, microchips, microprocessors, and built-in memory, which can be programmed. Medical devices that use embedded systems, powered or configured by this intricate coding, include:

  • Pulse oximeters
  • Electronic defibrillators
  • Intelligent biosensors
  • Automated infusion devices
  • Glucometers
  • Digital thermometers
  • Electronic blood pressure monitors
  • Medical imaging tools: X-ray, ECG, EEG, MRI, CT, and more.
  • A wide range of laboratory instruments.

Software as a Medical Device (SaMD) 

On the other hand, SaMD stands out as software that functions independently without being part of a physical medical device. It holds medical significance in its own right for diagnosis, prevention, monitoring, treatment, or disease alleviation. In other words - the software itself is the primary medical tool. It's designed to run on standard computers and infrastructure.

SaMD can utilise various tools, from specialised medical sensors to webcams or microphones. Its versatility allows developers to employ various programming languages and technologies, from web-based to mobile development. 

Such software typically handles tasks like:

  • Visualising and representing medical data
  • Processing and interpreting medical information
  • Managing and storing medical data
  • Configuring and diagnosing specific medical devices

Regulating the development of SaMD  

  1. Unlike medical device software, SaMD is regulated as a standalone entity, with its safety and effectiveness evaluated independently. 
  2. The FDA's Digital Health Pre-Cert Program is a testament to the growing importance of SaMD, aiming to foster innovation and ease market access.
  3. The International Medical Device Regulators Forum classifies all SaMD based on the severity of patient conditions they address
  4. The Central Drugs Standard Control Organization (CDSCO) expanded the range of devices governed by the Drugs and Cosmetics Act. For Software as a Medical Device (SaMD) to be sold in India, it now needs to adhere to:
  • Medical Device Rules, 2017
  • ISO 13485:2016 - Focusing on Quality Management
  • ISO 14971:2019 - Emphasizing Risk Management for Medical Devices.

Examples of Software as a Medical Device (SaMD) include

  1. Imaging Analysis: Software that sifts through patient data to identify patterns or trends, aiding doctors in spotting subtle health changes. For instance, it can assist in distinguishing between ischemic and hemorrhagic strokes, influencing treatment decisions. Example: Aidoc's AI solutions for radiologists.
  2. Sleep Apnea Sound Monitoring: Devices that use microphones to detect irregular breathing during sleep, sounding an alarm to wake the individual or alert emergency services for solitary or elderly patients. Example: ResMed's SleepScore App.
  3. Remote ECG-monitoring: Sensors, whether adhesive or implantable, remotely track cardiac patients, recording heart patterns and spotting concerning ECG events like arrhythmia. Example: AliveCor's KardiaMobile.
  4. Medical Data-viewing Apps: Software that allows us to access, visualise, and interpret health data from bioelectronic sensors or devices, covering metrics such as heart rate and blood pressure—for example, Apple's Health App.

The SaMD market, growing at a CAGR of 51.88%, highlights its potential, driven by the industry’s adoption of IoT, or the “internet of things.” Within a healthcare ecosystem, there is potential to use a large number of software at any given time. These systems and devices should work seamlessly together for operations to run smoothly, as disjointed networks could be chaotic - ultimately harming patient outcomes and, of course, the bottom line. 

To delve deeper into the importance of seamless integration in healthcare and how interoperability can transform the landscape, check out our blog on Building Digital Ecosystems in Healthcare

Developing Software as a Medical Device (SaMD) requires a blend of technological expertise, regulatory understanding, and ethical commitment. So, let's dive deeper into each phase of this intricate process to provide a clearer perspective.

1. Initiation: The Groundwork  

"Market research is the bridge between what you think and what your customers truly want.”

Laying a solid foundation starts with comprehensive market research. For instance, considering the rising global diabetic population, a study might reveal a gap in user-friendly diabetes management apps tailored to the elderly. This discovery can be the spark for a new SaMD solution. The feasibility of this idea needs evaluation. Questions will arise: Will the target demographic be receptive to such a tool? Are there existing solutions, and if so, what gaps do they leave unfilled?

2. Design and Development: Bringing the Vision to Life  

At the heart of any successful digital health pathway is the user—the patient and the healthcare provider. 

(a) Designing software interfaces that are intuitive and user-friendly ensures that patients can easily navigate and use the system. 

Find out how UI/UX systems are created for digital healthcare solutions in our blog: The Role of UI/UX in Healthcare Technology

(b) The design phase is where the concept takes form. The design must stay true to the initial vision. If the primary goal was to offer a user-friendly interface, especially for seniors, the design should avoid complex navigation or jargon. 

New methodologies are available which help simplify the design process. To find out more about how you can upgrade your design process using these tools, check out our blog on Design Thinking

(c) A dynamic platform that can manage, update, and disseminate clinical guidelines and device usage instructions will bring more value to the end users. Open communication channels empower patients to seek guidance, share data, and collaborate with healthcare professionals, fostering a more integrated care approach.

Learn how devices can integrate with health systems to facilitate easy sharing and streamlined communications, with our blog that sheds light on interoperability within healthcare ecosystems.

(d) As the design crystallises, the development phase kicks in. Here, a Minimum Viable Product (MVP) can be a game-changer. Finalise a basic version of the software to start with. Early adopters can test this MVP, providing invaluable feedback that shapes the final product.

Building a prototype for your digital health product can save you time, resources and effort! Learn how interactive prototyping fits into your journey of developing a digital health solution in our latest blog

3. Validation: Expert Insights 

Before a full launch, the SaMD solution should undergo rigorous validation. This is where industry experts come into play. For an asthma prediction app, insights from pulmonologists or environmental health experts can be invaluable. Their feedback can refine the tool, ensuring it's both medically sound and user-centric.

4. Regulatory Compliance: Navigating the Legal Landscape  

Every region has its regulatory framework. For SaMD developers targeting the European market, compliance with the EU's Medical Device Regulation (MDR) is essential. Meanwhile, in the U.S., the FDA's guidelines for SaMD provide the roadmap. Beyond these, understanding global standards, such as ISO regulations, ensures the SaMD solution is universally compliant.

5. Ethical Considerations: Beyond the Code  

Patient safety and data privacy need to be well protected at a time when cybersecurity threats are on the rise.  Sensitive personal data should be encrypted and stored securely, especially when transmitted from devices.  Adhering to medical data privacy regulations ensures legal compliance and builds patient trust.

6. Technical Scalability Framework

As the number of connected devices grows, the software architecture must be robust enough to handle this expansion. Scalability ensures that the software remains efficient and responsive as more patients adopt and use the system.

The ultimate goal is to create software that places power in the hands of patients, allowing them to monitor their health actively. By providing healthcare providers with comprehensive data, they can make informed decisions, offering proactive interventions and truly personalised care.

Conclusion  

Building a Software as a Medical Device (SaMD) is more than just coding; it's a structured journey from initiation to deployment. As we've explored, understanding the market, ensuring design precision, validating with experts, and navigating regulatory landscapes are all crucial steps. But what’s the endgame? A software that stands autonomously, enhancing healthcare delivery and outcomes. The right software can turn a good digital health solution into a great one!

Ready to embark on your SaMD journey or refine your existing solution? Montar Healthtech's expertise can guide you every step of the way. Let's build something impactful together. Reach out to Montar Healthtech today!

Key Takeaway 

  1. Terms like "medical device software" and "software as a medical device" often get used interchangeably. However, understanding their nuances is important for healthcare software product development.
  2. SaMD stands out as software that functions independently without being part of a physical medical device. It holds medical significance in its own right for diagnosis, prevention, monitoring, treatment, or disease alleviation.
  3. SaMD is regulated as a standalone entity, with its safety and effectiveness evaluated independently. 
  4. Developing Software as a Medical Device (SaMD) requires a blend of technological expertise, regulatory understanding, and ethical commitment.
  5. The development journey begins with thorough market research to identify gaps and opportunities.
  6. Design and development should prioritise user needs and ensure alignment with the initial concept.
  7. Expert validation ensures the SaMD solution is medically sound and user-centric.
  8. Regulatory compliance, like adhering to FDA guidelines, is crucial for SaMD's market entry.
  9. Ethical considerations, especially patient safety and data privacy, are paramount.
  10. SaMD can run on general-purpose computers, making it versatile and widely applicable.
  11. Continuous iteration and feedback are essential for refining and improving the SaMD solution.
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Dr. Lakshmi Vaswani
Dr. Lakshmi Vaswani

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