Xamarin mHealth Mobile Application

Any device that stores, receives or transmits protected health information or PHIs between covered entities and their business associates is subject to HIPAA security and privacy rules. This rule also applies to the apps that run on these devices and connect to covered entities. The term mHealth, which is also called m-health or mobile health, refers to the practices of medicine, psychological treatments, counseling and ensuring public health.

Using Wi-Fi connections exposes shared information to interception, so encryption and decryption algorithms are essential for protecting the information that's being transmitted. Apps and devices that provide health and fitness benefits have become extremely popular with mobile device users. 50 million health app downloads for weight loss, 26.5 million for exercise and 10.5 million for women's health make the value of health apps and their commercial potential impossible to deny [1].

Medical practices and developers can ensure better health while fostering greater patient loyalty and facilitating faster payments for services by developing mHealth apps, but the process raises some interesting development challenges. App developers must first determine if the Health Insurance Portability and Accountability Act or HIPAA rules of Privacy, Security, and Breach Notifications apply to a given app. The rules apply to protected health information and apps that are capable of storing, receiving and transmitting this protected information even if the app wasn't designed for that purpose. Developers need to ask these questions to determine if HIPAA applies:

• Who uses the app and for what purpose?
• Can the app be used to store and transmit health information?
• What sources will the app access?
• Does the app identify an individual, PHIs or the user's physical or mental health appointments and services received?
• Do medical staff members use the app to communicate with patients, other staff and covered entities?

Although developing mHealth applications challenges any ecommerce organization or covered entity that provides medical services, the cost-value benefits of developing user-friendly, secure and useful apps are substantial and increasingly essential for dealing with Medicare/Medicaid, other governmental agencies, business associates and consumers who demand increasingly sophisticated abilities from their mobile apps.

Statistical Overview of mHealth App Development

About 72 percent of physicians use smartphones to access drug information and patient histories, and 63 percent of doctors search for diagnostic and treatment research on tablets [2]. More than 44 percent of physicians discuss patients' cases with staff members on their phones. Medical practices must not only guard communications with patients but also feel free to communicate on their devices with secure apps.

On the development side, most mHealth app developers have only recently entered the market, and there are many HIPAA compliant mHealth app development opportunities in today's mobile culture and expanded health-awareness environment [3]. This kind of development tends to involve IT and ecommerce companies in about 48 percent of published apps, but medical providers also develop apps for their patients and use these apps to monitor patient health and for better office communications and efficiency. The total mHealth revenue generated by these applications are projected to reach $13.587 billion in 2016 and almost double that figure to $26.560 billion in 2017 [4].

The opportunities for revenue, better health care and fostering greater health awareness are tremendous, but even simple texting apps and emails that are used among medical staff members and patients must comply with HIPAA by encrypting and decrypting the communications. Secure apps enable communicating between multiple parties and can provide these kinds of benefits for busy medical practices:

• Send and receive patient updates while on-the-go.
• Confirm that messages have been read by stakeholders.
• Communicate securely on any device, and receive patient health or fitness data that's transmitted by wearable accessories and clothing sensors.
• Generating automatic logs of app activity ensures that information breaches can be discovered, tracked and prevented, which complies with HIPAA rules.

Challenges of Developing mHealth Applications

Developing mHealth applications generates unique challenges because patients have many clinical and personal health needs. Each app must interact with health systems and users through multiple points, service providers and medical professionals. All these communications must be HIPAA compliant while dealing with vast databases of medical information and patient-specific PHIs. Writing the code for these mHealth apps requires different strategies to supplement the traditional coding obligations of creating better graphics and more appealing user interfaces.

Choosing an App Platform

Choosing the right development platform involves choosing an option for building browser-based apps, native apps for each platform or cross-development technology. The skills of a company's development team also factor in the choice because platforms have their own coding-language requirements.

Fostering Greater Usability

Consumers care about their privacy, but they also want apps that connect seamlessly with multiple medical resources and providers while not requiring the users to enter complex codes for every transaction. Customers want user-friendly apps that balance security with usability. If any app doesn't perform up to consumer expectations, people won't use it. The negative ratings for the app will limit sales at the relevant app store.

Developing Apps for Multiple Devices

A flourishing electronics industry has created an ecosphere of proliferating device choices that's hard to sum up in a few words. Consumers have choices of laptops, smartphones, tablets, desktop computers, e-readers and medical and fitness devices that include wearable clothing and accessories. Reaching substantial market penetration requires developing apps for at least the major three operating systems: Windows, Android and iOS. Each of these systems market multiple device models, so most mHealth app developers end up making tweaks to support an average of 60 platform versions.[5]

Guaranteeing Security and Privacy

HIPAA best practices include ensuring device security and privacy of protected health information, determining whether any particular apps falls under HIPAA rules and encouraging users to follow recommended best practices such as password-protecting their devices. HIPAA cloud storage is an issue when medical records are stored in the cloud for patient and medical staff access from their mobile devices. Apps must encrypt and decrypt information, store data securely, protect information with advanced security protocols, require mandatory logins and include other built-in inducements for users to follow security best practices.

The benefits of choosing the Xamarin cross platform mobile development tools for mHealth app development include speeding apps to market faster, reducing costs, getting expert assistance from teams of engineers who are familiar with HIPAA coding requirements and preventing developers from needed to divide their coding team to work on separate operating systems.

Using Xamarin, mHealth app developers can write apps in C# that's compatible with many Web applications and share about two-thirds of the code among multiple operating systems. Programmers can share even more code with Shared Project Assets, Portable Class Libraries and Xamarin templates for common API features. Developers can deliver high performance apps with extensive usability and customized features for each device. The Xamarin platform also simplifies testing for functionality and program bugs on up to 2,000 specific devices to identify HIPAA security and privacy vulnerabilities. Writing less code for each app iteration reduces the instances of errors, and easier testing helps developers identify those errors before they cause the apps to run afoul of HIPAA regulations. The list of Xamarin mHealth development benefits include:

• Write code once in C# to develop multiple cross-platform apps.
• Using only one development tool simplifies the coding process while reducing errors.
• Xamarin templates make it easy to code for common functions such as performing text-to-voice conversions, enabling image recognition, filling out forms automatically and establishing secure data connections.
• It's easy to migrate .NET-based teams to mobile app development.