Smartphone interfaces have changed people’s expectations for how they interact with computers and other devices, and those expectations have extended even to sophisticated medical equipment. According to Darshan Patel, director of Linux product management for Wind River, Android is starting to show up in almost any kind of medical device that includes a display, from bedside monitors to CT scanners to programming devices for pacemakers. Why? Essentially the same reasons that Android is now the dominant operating system on smartphones.

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Medical staff and patients are used to the look and feel of Android-based applications, and they want the same advantages in their professional devices as they have in their smartphones, tablets, and even in-vehicle infotainment systems.


Wind River’s Tim Skutt, senior staff technical marketing engineer, says: “The touch interface has become ubiquitous. If we’re going to push equipment out into the non-specialist realm, we need to put that equipment in a paradigm they’re used to.” Medical devices with Android-based user interfaces (UI) take advantage of people’s comfort with touching, swiping, and flipping through menus and options. This familiarity can ultimately make training and usability quicker, easier, and more efficient.


Even though legacy technologies still maintain full functionality, the ease-of-use factor is becoming more important to aid user adoption. For patients, an Android interface on a medical device looks familiar and current, in contrast to traditional interfaces that can feel outdated. This is especially important as medical equipment goes into patients’ homes or is used by other care providers such as physical therapists. With today’s pressures to reduce healthcare costs, patients may be referred to less-costly outpatient care, or may be sent home from the hospital earlier but with devices that allow their care provider to monitor them remotely. In these cases, the patient’s confidence and comfort level with the technology can be an important element in encouraging its regular use.


Even beyond the UI, Android offers advantages for developers, such as programming flexibility, robust computing, built-in sensor interfaces, and built-in communications support, such as Wi-Fi and Bluetooth. For developers who previously used Linux or a real-time operating system (RTOS) with a UI on top, Android offers a quick path to market with a fresh new look. Wind River’s director of engineering Rick Anderson explains that even if developers don’t need all of Android’s “bells and whistles” for their medical device today, the fact that those features are available lets manufacturers explore their options to address new market opportunities.


Android, security, and virtualization

Security and privacy are key issues for any kind of medical software. There’s a wide spectrum of medical device types, however, from those that are primarily designed to view information or handle records, to those that monitor or control medical processes, such as delivering medication or controlling a ventilator. For the first type of product, security is important for privacy reasons (and to meet new patient-protection laws such as HIPAA); for the second, with human lives at stake, security is a critical element. While Android could still provide an excellent UI for these safety-critical applications, virtualization gives an option to provide a rich, graphical UI, but isolate it from functions that control or monitor safety processes.


medical tablet.jpgThe typical approach to virtualization is to have multiple virtual machines running concurrently, using a certified embedded hypervisor to separate them, such as the Wind River Hypervisor that provides rich safety-certification evidence. Another approach, for non-safety-critical applications, is lightweight partitioning. This allows developers to isolate processes that don’t need to run simultaneously. For example, a doctor who uses a tablet for personal and diagnostic purposes could use lightweight partitioning to protect medical records from personal files and applications. Or a mobile device that moves with a caregiver from one patient to another could provide access only to the records for the patient in the current room, then remove access to those records when the device is taken to another room with a different patient.


Android on medical devices also brings requirements beyond the smartphone

For all its benefits, developing medical devices with Android—as with any operating system—also brings challenges. Quality assurance, compliance to medical standards, and long-life version support are all critical elements for a medical device, and developers may need to add unique market-specific functionality beyond the operating system (OS).

Anderson explains the number one misconception developers have about Android and medical device development: many believe that because Android is open source, they can grab it and they’re almost done. “Like any other operating system project, Android is a starting point, that’s all,” Anderson says. “The version that Google releases is ever-changing, and it’s not hardened well enough for critical industries like medical.”


Wind River offers a range of products and services to make Android more appropriate for medical devices, and more efficient for developers. The Wind River Platform for Android is a “hardened” OS release that has been rigorously tested for specific hardware platforms, and that will be maintained for the long lifetime of certified medical devices. This is a commercially supported OS that incorporates the latest Android open source project software and optimizes it for performance so that developers can immediately innovate to meet their application-specific needs.


Wind River also offers a set of market-specific “Solution Accelerators,” including the Solution Accelerator for Android, Medical that helps speed time-to-market, supports product differentiation, and solves challenges that are unique to the medical market. These add-on software components follow the Continua Health Alliance guidelines to help device manufacturers build personalized, interoperable, and fully compliant products. For example, the Continua Health Alliance specifies the use of IEEE 11073 as the standard format for information exchange between personal health devices. The Wind River Solution Accelerator for Android, Medical supports the IEEE 11073 stack for sensor devices that include pulse oximeters, heart rate and blood pressure monitors, thermometers, scales, glucose meters, and a range of activity, fitness, and medication monitors. The Continua Health Alliance also establishes the Bluetooth Health Device Profile (HDP) as the wireless transmission protocol between devices, which is integrated into the Wind River Solution Accelerator for Android, Medical to provide interoperability between Android devices and medical sensors.


Finally, the Wind River Professional Services Medical Practice provides a full range of services for customers to help them develop compliant, safe, and secure connected medical devices and systems. Anderson explains that medical customers need their technical problems solved, just like customers in any other segment. But because medical software has to meet stringent quality and security requirements, Wind River can add value with its established processes and tools, and long years of experience working with certification bodies such as the FDA.


Android offers opportunities for innovation

These products and services address the second misconception that developers have: that Android doesn’t have a place in medical devices. Even a year ago, that might have had some validity, but not anymore. Anderson says, “The reality is, if you do the right things with Android: raise the quality level, take out what’s not needed, and add security and isolation, you have a very robust platform for medical devices.” Anderson adds one final thought about Android misconceptions in medical: the belief that if a developer puts Android on a medical device that it has to look like phone or tablet. The reality is that Android is already present in many devices, such as automotive dashboards and wristwatches, that don’t look like a tablet or smartphone. With Android’s customization capabilities, medical device developers can take their creativity and innovation to a whole new level.


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Wind River is an Associate member of the Intel® Intelligent Systems Alliance.


Cheryl Coupé

Roving Reporter (Intel Contractor), Intel® Intelligent Systems Alliance

Freelance technology writer and editor