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Development Standards 

and Regulations 

in HealthTech
From substantial cost reductions to improved
patient care and monitoring, or smoother
communication and data management, tech
solutions are increasingly present in healthcare.
Even though digital health represents the crossover between technology and
healthcare, it is
not free from controversy, especially when it comes to aspects such as:


Medical devices mHealth apps
Telehealth and
health IT systems
Clinical 

decision support
Wearables and
fitness trackers
Wrap up
Digital health is a relatively new
concept that has been substantially
redesigning the healthcare
ecosystem over the past few years.
Given the continued growth of tech-based
medical solutions, the regulatory system is
still adapting as national and international
regulatory entities strive to keep up with
innovation.
Wrap up
Digital health is a relatively new
concept that has been substantially
redesigning the healthcare
ecosystem over the past few years.
Given the continued growth of tech-based
medical solutions, the regulatory system is
still adapting as national and international
regulatory entities strive to keep up with
innovation.
Elinext.com
Equity Security Data privacy
The use of tech-based solutions has been demonstrated to:
Streamline
organizational and
administrative efficiency
and productivity
Provide flexible,
interactive, accurate,
and portable tech-
based solutions
Bridge the distance
and reliability gap
between patients
and healthcare
professionals
Improve patient
outcomes
According to Grand View Research, a study conducted in 2020 by SSCG Media
Group demonstrates that the pandemic practically forced healthcare
practitioners to start using telemedicine.
During the past two years, the COVID-19
pandemic turned digital health – and more
specifically telehealth - into the backbone of
medical services. Since visiting a hospital
significantly increased the risk of infections
(for both patients and caregivers), tech-based
solutions made it possible for physicians to
provide accurate diagnosis and subsequent
treatment without the necessity to have the
patient visit the healthcare facility.
Telehealth is not only helping to reduce the risk of infections but it
also allows patients f rom underserviced areas or patients struggling
with mobility issues to gain easier access to medical services.
i
Remote monitoring devices (e.g.
IoMT, mobile apps, or wearables)
Telemedicine software
for communication
Medical data management
and storage software
Among the solutions,
we can highlight:
The use of software in healthcare
is a game-changing alternative
The report published by Grand View Research clearly shows that, in 2020, the
global digital health market had a value of $96.5 billion. According to the same
report, f rom 2021 to 2028, the annual growth rate (CAGR) is expected to be 15.1%.
18.79
2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028
22.42
Tele-healthcare
mHealth Healthcare Analytics
Digital Health Systems
The U.S. digital health market size, by technology, 2016 - 2028 (USD billion)
Some of the most notable
technological alternatives that
are currently reshaping the
healthcare ecosystem are:
Personalized health apps for self-
monitoring, self-education, and
prevention
Robot-assisted surgery
ML and AI algorithms for improved
patient care, prevention, faster and
more accurate diagnosis and
decision-making, or facilitated clinical
trials and drug design
Complex analytics for enhanced
organizational and management
purposes
Real-time communication platforms
Instant access to digital health records
Processes and tasks automation
The impressive market growth was
undoubtedly fuelled by the Covid-19
pandemic and led to an unprecedented
software demand for:
COVID19 digital health market impact 11.9%increase in revenue:
Post COVID Outlook
Pandemic Impact
In 2021 the market will witness 

a growth of 14.2% f rom 2020, owing
to increasing demand and rising
adoption of digital healtch solutions.
Consumer shift towards value-based
care and rise in demand for efficient
management of organizational
workflows in healthcare
organizations.
The rise number of strategies
undertaken by key players including
mergers and acquisitions, and
product developments will help
sustain the growth trajectory of this
market.
The digital health market grew at
a rate of 11% f rom 2019 to 2020.
The rising adoption of telehealth
services during pandemics is
increasing the safety of both
healthcare providers and patients, as
it eliminates in-person appointments.
According to the study conducted by
SSCG Media Group, in March 2020,
53% of the healthcare practitioners
were using telemedecine owing to
the restrictions imposed on account
of the pandemic.
Whereupon, the future of healthcare will more
than likely be based on concepts such as:
It almost goes without saying that digital
tools already are – and will continue to be -
the fuel that feeds change and progress
Prediction
Precision
Personalized approaches
Immediacy Streamlined communication
Intellectual rights and patentability
Quality control
Usability and accessibility control
Data protection
Risk management
These are some of the main legal problems and standards
medical software must address:
Regulatory standards meant 

to guarantee quality and safety
We live in the era of sensitive data and cyber-crime. And data
mishandling keeps being a matter of concern for patients,
healthcare professionals, software providers, and governments
alike. Consequently, the need for authorities such as FDA or the EU
Commission to control software medical devices has led to the
establishment of a set of standards and regulations meant to cover
crucial aspects such as risk and quality management, software
lifecycle, data protection, or software development lifecycle.
Even though we are talking about internationally recurrent issues, each
country has its own regulations and standards when it comes to digital
technology, medical devices, or personal data treatment.
If you are a medical software developer and you
intend to target a specific market, make sure 

to check all the regulations in place.
If you are a medical software developer and you
intend to target a specific market, make sure 

to check all the regulations in place.
If you intend to target the
make sure to take a closer look at the following standards:
European medical software field,
ISO 13485
ISO TS 25238
ISO 14971
IEC 62304
IEC 62366
Medical devices
Health informatics
Medical device software
Names, addresses, dates
Phone and numbers
Device and vehicle identifiers
and serial numbers
Account, certificate, 

and health plan numbers
Full face photographic images
and biometric identities
Internet protocol addresses,
URLs, and website links
Regulatory requirements 

and standards in the U.S. market
In the U.S., the regulatory system is set by the FDA
(alongside other key regulators such as the FCC or
the ONC) and covers areas such as patient care,
HIPPA privacy and security rules, or OSHA.
Healthcare software developers who wish to target
the U.S. market must make sure to comply with
two major regulatory systems: FDA and HIPAA.
To obtain the HIPAA Compliance Certificate, as amended by the HITECH
Act, software developers need not only to protect patients’ medical
records but also sensitive personal information such as:
Data security in healthcare has become a major global concern. Among the
most common Protected Health Information (PHI) violations we can highlight
deficient in place protection and unauthorized disclosure of patient records,
disclosing PHI to third parties, or patients unable to access their records.
i
i
i
This is a quick guide toward the development of HIPAA compliant software:
Acess Control
Protect Data
Data Protection 

and Encryption
Session Time Handling
Secure Authentication
Data Backup
FDA distinguishes between two device software functions:
SaMD
ISO 13485
IEC 62304
Before introducing a SaMD product in the
U.S., software developers need to apply for
clearance with the FDA and must ensure
compliance not only with Title 21 of the
Code of Federal Regulations (more
specifically with 21 CFR Part 11, Electronic
Records, Electronic Signatures and 21 CFR
Part 820 Quality System Regulation) but
also with internationally accepted
standards such as:
ISO 14971:2019
SiMD
In order to ensure transparency and prevent f raud and abuse, medical
devices must comply with a series of laws and regulations that includes
the Anti-Kickback Statute, the Stark Law, and the False Claims Act.
i
i
Is the product a ‘Software’

according to the definition

of MDCG 2019-11?
NOT COVERED

BY MDCG 2019-11
NO
YES
YES
NO
NO
NO
NO
YES
YES
YES
COVERED BY

THE MEDICAL DEVICES

REGULATIONS*
NOT COVERED BY

THE MEDICAL DEVICES

REGULATIONS*
Is the software
an ‘MDR Annex
XVI device’,
an ‘Accessory’ for a
medical
device according to Art.
2(2) of
the MDR or IVDR or
‘software
driving or influencing
the use of
a (hardware) medical
device’?
Is the software a Medical
Device
Software (MDSW)
according to
the definition
of MDCG 2019-11?
Is the software performing
an action on data different
f rom storage, archival,
communication 

or
simple search?
Is the action
for the benefit

of invidual patients?
1 2
5
3
4
Is your software a Medical Device Software?
Does the MDSW
provide
information
within the
scope
of the IVD definition?
YES
YES
NO
NO
NO
YES
COVERED BY

REGULATION (EU) 

2017/746 IVDR
COVERED BY

REGULATION (EU) 

2017/745 MDR
Does the MDSW

provide information

based on data obtained by

IVD medical devices only?
Is the intended purpose

substantially driven

by IVD data sources?
1 2 3
Is your MDSW an In Vitro Diagnostic Medical Device Software (IVD MDSW)

or a Medical Device Software (MD MDSW)
Regulatory requirements 

and standards in the EU market
Before we take a look at the main European regulatory systems, it is
important to make a clear distinction between the two main types
of software that are currently used in healthcare:
In order for the software to be considered a medical device,
manufacturers should make sure that their product not only
qualifies as an MD or IVD but also identify the class of their MDSW
and comply with the specific requirements in the EU Regulation
2017/745 (MDR) or the EU Regulation 2017/746 (IVDR).
In Europe, MDCG 2019-11 defines MDSW as:
Software for general
purposes
(for instance, software
used to store and
manage patient data).
Special software
used, for example, for diagnosis, monitoring, or
prediction, thus qualifying as either IVD (i.e. In
vitro diagnostic medical device) or MD (i.e.
Medical Device). Under European regulations,
this latter type of software is referred to as
Medical Device Software (MDSW).
Medical Device Software (MDSW) is software that is intended to be used, alone 

or in combination, for a purpose as specified in the definition of a “medical device”
in the medical devices regulation or in vitro diagnostic medical devices regulation.
i
i
i
Decision steps to assist qualification
of Medical Device Software (MDSW)

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Development Standards and Regulations for HealthTech

  • 1. Development Standards and Regulations in HealthTech From substantial cost reductions to improved patient care and monitoring, or smoother communication and data management, tech solutions are increasingly present in healthcare. Even though digital health represents the crossover between technology and healthcare, it is not free from controversy, especially when it comes to aspects such as: Medical devices mHealth apps Telehealth and health IT systems Clinical decision support Wearables and fitness trackers Wrap up Digital health is a relatively new concept that has been substantially redesigning the healthcare ecosystem over the past few years. Given the continued growth of tech-based medical solutions, the regulatory system is still adapting as national and international regulatory entities strive to keep up with innovation. Wrap up Digital health is a relatively new concept that has been substantially redesigning the healthcare ecosystem over the past few years. Given the continued growth of tech-based medical solutions, the regulatory system is still adapting as national and international regulatory entities strive to keep up with innovation. Elinext.com Equity Security Data privacy The use of tech-based solutions has been demonstrated to: Streamline organizational and administrative efficiency and productivity Provide flexible, interactive, accurate, and portable tech- based solutions Bridge the distance and reliability gap between patients and healthcare professionals Improve patient outcomes According to Grand View Research, a study conducted in 2020 by SSCG Media Group demonstrates that the pandemic practically forced healthcare practitioners to start using telemedicine. During the past two years, the COVID-19 pandemic turned digital health – and more specifically telehealth - into the backbone of medical services. Since visiting a hospital significantly increased the risk of infections (for both patients and caregivers), tech-based solutions made it possible for physicians to provide accurate diagnosis and subsequent treatment without the necessity to have the patient visit the healthcare facility. Telehealth is not only helping to reduce the risk of infections but it also allows patients f rom underserviced areas or patients struggling with mobility issues to gain easier access to medical services. i Remote monitoring devices (e.g. IoMT, mobile apps, or wearables) Telemedicine software for communication Medical data management and storage software Among the solutions, we can highlight: The use of software in healthcare is a game-changing alternative The report published by Grand View Research clearly shows that, in 2020, the global digital health market had a value of $96.5 billion. According to the same report, f rom 2021 to 2028, the annual growth rate (CAGR) is expected to be 15.1%. 18.79 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 22.42 Tele-healthcare mHealth Healthcare Analytics Digital Health Systems The U.S. digital health market size, by technology, 2016 - 2028 (USD billion) Some of the most notable technological alternatives that are currently reshaping the healthcare ecosystem are: Personalized health apps for self- monitoring, self-education, and prevention Robot-assisted surgery ML and AI algorithms for improved patient care, prevention, faster and more accurate diagnosis and decision-making, or facilitated clinical trials and drug design Complex analytics for enhanced organizational and management purposes Real-time communication platforms Instant access to digital health records Processes and tasks automation The impressive market growth was undoubtedly fuelled by the Covid-19 pandemic and led to an unprecedented software demand for: COVID19 digital health market impact 11.9%increase in revenue: Post COVID Outlook Pandemic Impact In 2021 the market will witness a growth of 14.2% f rom 2020, owing to increasing demand and rising adoption of digital healtch solutions. Consumer shift towards value-based care and rise in demand for efficient management of organizational workflows in healthcare organizations. The rise number of strategies undertaken by key players including mergers and acquisitions, and product developments will help sustain the growth trajectory of this market. The digital health market grew at a rate of 11% f rom 2019 to 2020. The rising adoption of telehealth services during pandemics is increasing the safety of both healthcare providers and patients, as it eliminates in-person appointments. According to the study conducted by SSCG Media Group, in March 2020, 53% of the healthcare practitioners were using telemedecine owing to the restrictions imposed on account of the pandemic. Whereupon, the future of healthcare will more than likely be based on concepts such as: It almost goes without saying that digital tools already are – and will continue to be - the fuel that feeds change and progress Prediction Precision Personalized approaches Immediacy Streamlined communication Intellectual rights and patentability Quality control Usability and accessibility control Data protection Risk management These are some of the main legal problems and standards medical software must address: Regulatory standards meant to guarantee quality and safety We live in the era of sensitive data and cyber-crime. And data mishandling keeps being a matter of concern for patients, healthcare professionals, software providers, and governments alike. Consequently, the need for authorities such as FDA or the EU Commission to control software medical devices has led to the establishment of a set of standards and regulations meant to cover crucial aspects such as risk and quality management, software lifecycle, data protection, or software development lifecycle. Even though we are talking about internationally recurrent issues, each country has its own regulations and standards when it comes to digital technology, medical devices, or personal data treatment. If you are a medical software developer and you intend to target a specific market, make sure to check all the regulations in place. If you are a medical software developer and you intend to target a specific market, make sure to check all the regulations in place. If you intend to target the make sure to take a closer look at the following standards: European medical software field, ISO 13485 ISO TS 25238 ISO 14971 IEC 62304 IEC 62366 Medical devices Health informatics Medical device software Names, addresses, dates Phone and numbers Device and vehicle identifiers and serial numbers Account, certificate, and health plan numbers Full face photographic images and biometric identities Internet protocol addresses, URLs, and website links Regulatory requirements and standards in the U.S. market In the U.S., the regulatory system is set by the FDA (alongside other key regulators such as the FCC or the ONC) and covers areas such as patient care, HIPPA privacy and security rules, or OSHA. Healthcare software developers who wish to target the U.S. market must make sure to comply with two major regulatory systems: FDA and HIPAA. To obtain the HIPAA Compliance Certificate, as amended by the HITECH Act, software developers need not only to protect patients’ medical records but also sensitive personal information such as: Data security in healthcare has become a major global concern. Among the most common Protected Health Information (PHI) violations we can highlight deficient in place protection and unauthorized disclosure of patient records, disclosing PHI to third parties, or patients unable to access their records. i i i This is a quick guide toward the development of HIPAA compliant software: Acess Control Protect Data Data Protection and Encryption Session Time Handling Secure Authentication Data Backup FDA distinguishes between two device software functions: SaMD ISO 13485 IEC 62304 Before introducing a SaMD product in the U.S., software developers need to apply for clearance with the FDA and must ensure compliance not only with Title 21 of the Code of Federal Regulations (more specifically with 21 CFR Part 11, Electronic Records, Electronic Signatures and 21 CFR Part 820 Quality System Regulation) but also with internationally accepted standards such as: ISO 14971:2019 SiMD In order to ensure transparency and prevent f raud and abuse, medical devices must comply with a series of laws and regulations that includes the Anti-Kickback Statute, the Stark Law, and the False Claims Act. i i Is the product a ‘Software’ according to the definition of MDCG 2019-11? NOT COVERED BY MDCG 2019-11 NO YES YES NO NO NO NO YES YES YES COVERED BY THE MEDICAL DEVICES REGULATIONS* NOT COVERED BY THE MEDICAL DEVICES REGULATIONS* Is the software an ‘MDR Annex XVI device’, an ‘Accessory’ for a medical device according to Art. 2(2) of the MDR or IVDR or ‘software driving or influencing the use of a (hardware) medical device’? Is the software a Medical Device Software (MDSW) according to the definition of MDCG 2019-11? Is the software performing an action on data different f rom storage, archival, communication or simple search? Is the action for the benefit of invidual patients? 1 2 5 3 4 Is your software a Medical Device Software? Does the MDSW provide information within the scope of the IVD definition? YES YES NO NO NO YES COVERED BY REGULATION (EU) 2017/746 IVDR COVERED BY REGULATION (EU) 2017/745 MDR Does the MDSW provide information based on data obtained by IVD medical devices only? Is the intended purpose substantially driven by IVD data sources? 1 2 3 Is your MDSW an In Vitro Diagnostic Medical Device Software (IVD MDSW) or a Medical Device Software (MD MDSW) Regulatory requirements and standards in the EU market Before we take a look at the main European regulatory systems, it is important to make a clear distinction between the two main types of software that are currently used in healthcare: In order for the software to be considered a medical device, manufacturers should make sure that their product not only qualifies as an MD or IVD but also identify the class of their MDSW and comply with the specific requirements in the EU Regulation 2017/745 (MDR) or the EU Regulation 2017/746 (IVDR). In Europe, MDCG 2019-11 defines MDSW as: Software for general purposes (for instance, software used to store and manage patient data). Special software used, for example, for diagnosis, monitoring, or prediction, thus qualifying as either IVD (i.e. In vitro diagnostic medical device) or MD (i.e. Medical Device). Under European regulations, this latter type of software is referred to as Medical Device Software (MDSW). Medical Device Software (MDSW) is software that is intended to be used, alone or in combination, for a purpose as specified in the definition of a “medical device” in the medical devices regulation or in vitro diagnostic medical devices regulation. i i i Decision steps to assist qualification of Medical Device Software (MDSW)