Testing the Reality of Apps in Physical devices

The recent pandemic has an eye opener for many of the industries and service providers to become digitally able for their beneficiaries/customers. In this line, Digital Health Mobile applications have taken a great leap and made the healthcare, labs, and pharmacies available at home in our fingertips.

Mobile health is turning into a necessity

The rapid spread of Internet use, fast Internet connections, mobile devices, social networking, etc. has made it possible for creative concepts and inventions to be made for the benefit of digital health. There was a resoundingly positive response to the electronic health record exchange between healthcare professionals and beneficiaries, including patients and their careers. Additionally, individuals with chronic diseases, older people, and those who use such applications or devices would have more control over their own health. It is widely understood and acknowledged that mobile health can enhance the overall healthcare system by offering affordable, effective, and high-quality medical services to people.

The current and future of health care apps are created with the intention of integrating mobile apps and medical devices to monitor chronic conditions in order to achieve prescription adherence, vital monitoring, and precise health alerts, despite the fact that the majority of common health-related apps are primarily concerned with fitness, lifestyle and stress, and diet and nutrition. To make sure that developed apps work well with their service capabilities and are performing as expected, businesses are looking for Quality Assurance services.

Pre-Validation of Medical Devices

Compliance Testing – In order to make a safe and effective medical device, it is every device maker/inventors’ responsibility to adhere to the various regulations and Act. It is added value for the quality team to be aware of those regulations and test the devices accordingly before delivering it in the marketplace.

Device Compatibility and Error Handling Testing – Before speaking of the compatibility of smart medical devices with the mobile apps, it is vital to test the behavior of the device under different error conditions and failures.

Wireless Medical Device Challenges

Security/Data Leak – It is a known fact that when we go for wireless devices, the data are prone to information hacking, transfer of personal/financial information to unreliable sources and may lead to security havoc.

Cochannel and adjacent channel interference – For e.g., In a physician’s waiting room, patients sitting side by side with two or more devices in or on then the Functioning of the device in the presence of other like devices without interference should be ensured.

Data Loss – There is a high chance of data lost due to Data synchronization issue, when the Bluetooth connection is lost, or device gets switched off or gets disconnected and connected to any other open wireless network.

Efforts of Quality Assurance

Testing a medical device is critical as it has a direct impact on a patient’s healthcare. QA has a huge responsibility in ensuring the optimal working of medical devices and for that end-to-end medical device software testing is essential. Here are some testing techniques that can be used:

Authentication Testing – In order to prevent anonymous sensors, clone attacks and other security threats, it is essential for the tester to understand the Authentication system and try to break or bypass it, to report any loopholes at the earliest.

Co-Existence testing – Pass-fail criteria for co-existence testing must be identified and need to be quantified in terms of the critical functions of the device under test as determined by risk assessment.

Data Sync Testing – When wearable apps get synced to each other, the data on the actions performed by the user in Apple Watch or in other devices need to be synced properly without any technical issues.

To trouble shoot this, it is important to test whether passive tracking and active tracking features are implemented.

• Passive Tracking – Periodical Data sync feature should be implemented for passive fitness health tracking. (For e.g., steps tracking)
• Active Tracking – for event-based tracking like exercises which will happen for a defined time.

End-to-end devices testing – To ensure whether patient mobile apps, medical devices software, and Patient Database management systems work seamlessly under various scenarios.

Performance testing – To check the robustness of the connectivity and performance of the connected devices in various sets of situations.

Read our Success Story on Testing a Banking App as well.

App crash Testing – There may be many issues that cause App crash. But few of them can be troubleshooting at the testing phase.

• Network Issue – During System Integration testing, by following the low network coverage testing of the Mobile application it can be captured and reported earlier and can ensure the reliability before it gets crashed in user’s hand.
• Operating System and Device Compatibility Issues – By testing the application for different configurations and operating systems, the optimization of Mobile application can be ensured at least for the device that is widely used by users.
• Memory Leak Issues – Features/functionalities that hold, retrieve, and refresh the data should be identified and tested to ensure that the memory space is released wherever it can be and no excessive use of memory.

Functional testing – To check whether all the functionalities and usability of the UI are on point and how the devices operate in all those modes while being part of the network.

Any technical glitches in medical device software may lead to false diagnosis, misleading EMR and may lead to fatal results to the patients and hence it is in QA’s hands to ensure the proper performance and functioning of the medical devices.

The Dual Strength – Emulators/Simulators and Physical Device Testing

Emulators/Simulators are virtual replications of real smart phones. In the initial stage of development, it is a smart way to run the developed application across several devices and platforms to ensure the functionality/behavior of the application in wide variety of devices and operating systems. Buying 10 to 15 phones for each application that is developed is not a reliable option and hence simulators/emulators are highly recommendable during initial unit testing and for quick debugging. Also, when we consider factors such as Accuracy, User experience, Accessibility, Wireless connections of other smart devices, Memory/Cache/ Storage defects and Security, testing on physical device ensures the stability of the application.

Using Emulators/Simulators in the initial phase and testing on Real devices during system testing provides dual assurance on the application before it is delivered for UAT.

Pre-Production Check List

To ensure nothing is missing before the App launches in Appstore/Play store, the following launch checklist can be followed to ensure that nothing is missing at the last moment.

• App Installation and Launch –To guarantee that once a mobile application is successfully implemented, it will automatically launch or start. Any application’s initial impact is created by this. Aside from the registered credentials, all data from the application should be properly deleted upon uninstalling.
• Compatibility of application for different network spectra like 2G/3G/4G/5G and so on
• Test by installing all necessary social media apps and installing the application that is developed.
• Application Ratings and reviews in Appstore/Play store
• Loading and installation time taken
• App walkthrough guide for the application for the first-time user
• When system receives incoming call – app should go to minimize mode
• Behavior of application when device receives SMS.
• Cancelling the App installation and checking the system restores to its original state and no partial/broken app should be installed.
• Behavior of application on Low battery/ weak network
• Working of the application after restart of the mobile
• Orientation of view – Behavior of Application when the Device in Landscape and in Portrait mode depends upon the business requirement.
• Auto resume of application on Network availability
• Appstore/Play store should have only an Open option instead of install option for if the Application is already installed in the device.
• Monkey test – split screen / open multiple apps / rigorously scroll app top to bottom.
• Payment / GPS functionality in other apps as well
• Uninstallation removes complete cache and other data from storage.
• Mobile device Connectivity test for – USB, Bluetooth, Wi-Fi etc.
• Localization and Time zone test

It is widely acknowledged fact that the innovative invention of these smart medical devices and digital healthcare applications are life-improving technologies, and it has immensely increased the pressure on medical devices manufacturers and health care service providers to deliver a product with greater quality that is best in performance.

This can only be accomplished through a concerted effort between solid development and unwavering Quality Assurance. Technology will always be a blessing for people because it provides health care products with life-saving features, user-friendliness, reliability, security, and high device quality standards.