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Smartphones provide a very easy and reliable way to have people interface with such devices. It can be done right, but you have to be careful. I'd rather that m

Smartphones provide a very easy and reliable way to have people interface with such devices. It can be done right, but you have to be careful. I'd rather that medical device manufacturers use well-known frameworks and technologies with almost two decades of engineering and UX improvements behind them than the alternative, which is them using some sort of slapdash in-house solution that will almost certainly be worse.

thejohnconway 3y ago
Yeah, seriously, the in-house solution would just be an old android phone with a 500% markup rate anyway,
- bdcravens 3y ago
  That's what Omnipod does. Their app is only approved for limited Androids, not yet for iOS, so many users depend on the device they provide which is pretty much what you're describing. Not sure what the hardware is, but it even has a camera that isn't used.
- kotaKat 3y ago
  That's what it currently is. Omnipod used to/still provides some kind of rebadged Android device. Zoll was shipping various Android handsets with the bootloader unlocked and a custom APK built to take over the device to act as a 'hotspot' for their defibrillator vests to provide remote telemetry. https://www.maxx.ca/Event/LotDetails/412535278/ZOLL-LIFE-VEST-4000-WEARABLE-DEFIBRILLATOR https://www.maxx.ca/Event/LotDetails/412535278/ZOLL-LIFE-VES... (photo's buried in the listing -- that's a Moto G4 Play. If anyone's curious, the APK was called... com.lifevest.zuul. I was amused.)
peteradio 3y ago
> slapdash in-house solution that will almost certainly be worse. Truly libelous shilling for the app store.
- lenerdenator 3y ago
  Read about the Therac 25. That's what many of these device manufacturers would try to do if they could get away with it.
  - peteradio 3y ago
    That was 40 years ago! What lessons were learned from that are even relevant to this? Should I be worried about early days development lessons today or the billion of lines code dependency for a simple medical device? You are aware of the trillion dollar target on the smartphone back? You want to incorporate that into you medical device for what possible reason?
    - lenerdenator 3y ago
      The lesson is, business people will gladly let safety lapses occur with software because 1) software is complex and they don't understand it, and 2) good software is expensive, and they would rather that money go in their bonuses than into a real testing and verification budget, so they'll get less-than-qualified people to do the job for less money. Those rules will apply to your non-smartphone device sure as any other device. Smartphones are a juicy target but they're also fairly hardened for the case of one person's use. It's a scary thought, sure, but there is a dearth of attackers who have exploited security or reliability weaknesses of these devices to injure or kill someone in the wild. Most of those guys are far happier making credit card scanners, social engineering their way into your bank account, or helping Russia evade sanctions by holding your data hostage in exchange for crypto. Contrast that with some sort of microcontroller-based device that hasn't had 15 years of security research done on it, and definitely won't at any point because the device manufacturer doesn't have the will or ability to make that sort of thing happen. And then you're going to get into the practicality of that sort of device. People take their smartphones with them everywhere. They will not forget the thing that helps them manage their medical conditions. I'm less likely to remember to put the random weird device in my pocket when I leave the house or keep it charged. It's a better solution to the problem if you do it right. Source: 10 years of personal experience in the medical software industry.
nonrandomstring 3y ago
> Smartphones provide a very easy and reliable way to have people interface with such devices. I deeply disagree with you and think this encourages reckless engineering and is a dangerous attitude to take. Ease of use and reliability have nothing to do with each other. One should not be used as a cover for defects in the other. You may enjoy "ease of use". But smartphones are extraordinarily complex devices that concentrate far too much functionality and risk in one place without safeguards. They come literally "compromised out of the box" with poor decoupling between subsystems like RF, memory and processors.
- lenerdenator 3y ago
  Counterpoint: If a medical device is not easy to use, you risk the patient not using it as a part of their therapy, or maybe even using it wrong to disastrous effects. The alternative to a smartphone connecting with one of these devices is likely a proprietary interface that's worse in every measurable way, and could be just as compromised, if not more.
  - nonrandomstring 3y ago
    Good point. So, given two equally horrific options which can lead to the tragic death of the patient, surely the correct course would be; Don't do either. Just because you can doesn't mean you should. We are not compelled by any natural law to add gratuitous digital technology to problems which are only made worse by it.
    - lenerdenator 3y ago
      If patients didn't think this added something to their lives and ability to manage insulin-dependent diabetes, they wouldn't be paying far out the ass to get them either in direct costs or through insurance premiums. That's not what people do. I'm sure plenty of patients would much rather do anything else with the money. I know I would with the money I spend on chronic health problems. Again, completely possible to do this right, but you have to be willing to put the resources into it.

thejohnconway 3y ago

Yeah, seriously, the in-house solution would just be an old android phone with a 500% markup rate anyway,

bdcravens 3y ago
That's what Omnipod does. Their app is only approved for limited Androids, not yet for iOS, so many users depend on the device they provide which is pretty much what you're describing. Not sure what the hardware is, but it even has a camera that isn't used.
kotaKat 3y ago
That's what it currently is. Omnipod used to/still provides some kind of rebadged Android device. Zoll was shipping various Android handsets with the bootloader unlocked and a custom APK built to take over the device to act as a 'hotspot' for their defibrillator vests to provide remote telemetry. https://www.maxx.ca/Event/LotDetails/412535278/ZOLL-LIFE-VEST-4000-WEARABLE-DEFIBRILLATOR https://www.maxx.ca/Event/LotDetails/412535278/ZOLL-LIFE-VES... (photo's buried in the listing -- that's a Moto G4 Play. If anyone's curious, the APK was called... com.lifevest.zuul. I was amused.)

peteradio 3y ago

> slapdash in-house solution that will almost certainly be worse. Truly libelous shilling for the app store.

lenerdenator 3y ago
Read about the Therac 25. That's what many of these device manufacturers would try to do if they could get away with it.
- peteradio 3y ago
  That was 40 years ago! What lessons were learned from that are even relevant to this? Should I be worried about early days development lessons today or the billion of lines code dependency for a simple medical device? You are aware of the trillion dollar target on the smartphone back? You want to incorporate that into you medical device for what possible reason?
  - lenerdenator 3y ago
    The lesson is, business people will gladly let safety lapses occur with software because 1) software is complex and they don't understand it, and 2) good software is expensive, and they would rather that money go in their bonuses than into a real testing and verification budget, so they'll get less-than-qualified people to do the job for less money. Those rules will apply to your non-smartphone device sure as any other device. Smartphones are a juicy target but they're also fairly hardened for the case of one person's use. It's a scary thought, sure, but there is a dearth of attackers who have exploited security or reliability weaknesses of these devices to injure or kill someone in the wild. Most of those guys are far happier making credit card scanners, social engineering their way into your bank account, or helping Russia evade sanctions by holding your data hostage in exchange for crypto. Contrast that with some sort of microcontroller-based device that hasn't had 15 years of security research done on it, and definitely won't at any point because the device manufacturer doesn't have the will or ability to make that sort of thing happen. And then you're going to get into the practicality of that sort of device. People take their smartphones with them everywhere. They will not forget the thing that helps them manage their medical conditions. I'm less likely to remember to put the random weird device in my pocket when I leave the house or keep it charged. It's a better solution to the problem if you do it right. Source: 10 years of personal experience in the medical software industry.

nonrandomstring 3y ago

> Smartphones provide a very easy and reliable way to have people interface with such devices. I deeply disagree with you and think this encourages reckless engineering and is a dangerous attitude to take. Ease of use and reliability have nothing to do with each other. One should not be used as a cover for defects in the other. You may enjoy "ease of use". But smartphones are extraordinarily complex devices that concentrate far too much functionality and risk in one place without safeguards. They come literally "compromised out of the box" with poor decoupling between subsystems like RF, memory and processors.

lenerdenator 3y ago
Counterpoint: If a medical device is not easy to use, you risk the patient not using it as a part of their therapy, or maybe even using it wrong to disastrous effects. The alternative to a smartphone connecting with one of these devices is likely a proprietary interface that's worse in every measurable way, and could be just as compromised, if not more.
- nonrandomstring 3y ago
  Good point. So, given two equally horrific options which can lead to the tragic death of the patient, surely the correct course would be; Don't do either. Just because you can doesn't mean you should. We are not compelled by any natural law to add gratuitous digital technology to problems which are only made worse by it.
  - lenerdenator 3y ago
    If patients didn't think this added something to their lives and ability to manage insulin-dependent diabetes, they wouldn't be paying far out the ass to get them either in direct costs or through insurance premiums. That's not what people do. I'm sure plenty of patients would much rather do anything else with the money. I know I would with the money I spend on chronic health problems. Again, completely possible to do this right, but you have to be willing to put the resources into it.