mobile software development in the Health sector


In the age of technological innovation and globalization, mobile technology monopolizes the attention in the field of communication. This has propelled the growth of mobile applications for the suitability of its users. The past few decades has witnessed advancement made in binding mobile technology for the popular platforms which include IOS, windows, and Android. The technological revolution has brought a breakthrough in the process of business advancement across the sphere and applications are specifically developed for the specific functions (Bomarius, 2005. These applications provide the business with quick and innovative services that facilitate the process of business growth. A person is therefore presented with the chance and technology to instant access to significant information and services whenever the person needs to regardless of their physical location. These mobile app services, being cost effective, have become the feasible preference for business groups especially those in the health sector. This innovation has, therefore, set the stage for massive development in the health sector by abolishing the difficulties which have in many ways hindered the growth in the health sector (Sillitti, 2010).

Mobile software development has revolutionized in the past years. It has encouraged sociological and profitable benefits in the world by changing the way people interrelate in both personal and business settings as well as creating employment opportunities. Furthermore, developments in mobile medical technology has enabled practitioners to deliver better and convenient treatment services and monitoring their patients in more difficult and inaccessible geographic locations. The need for exchange of information is very critical in the industry of health care. There is also a need for patients and practitioners to form a partnership to maintain meaningful communication between them. Patients must have several avenues to exchange information openly with their caregivers. In an effort to improve better interaction, health care organizations are propelled to embracing new mobile technologies that will facilitate the exchange of information between patients and caregivers in an efficient, effective,  and convenient manner. The main goal of this innovation is to promote better communication between patients and caregivers through methods such as chats and messaging instead of scheduling appointments which will require them to present themselves physically. It will also help patients by increasing awareness of health risks and provide the motivation and aid required to lower these risks (Winkler, 2012).

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Trends in mobile software development in the Health sector

The most important goal of introducing mobile technology in the health sector is to enhance the access and quality of health care. M-health applications can assist patients to manage their treatments when the caregivers are unavailable or when they cannot be accessed in time of emergency. Tracking patients using m-health app facilitates the coordination and good care quality especially in inaccessible areas or where the caregiver and the patient are geographically apart. M-health applications have proved to be useful especially in the supply of medicine hence reducing shipment delay and also offering point-of-use technology where patients can verify the genuineness of medicines they buy. This app will also be of help in making human resources to be efficient in both at the point of care and in administration since it will enable patients and health workers to access medical guidance using app instead of interacting with caregivers physically. M-health app will also aid in better and secure record-keeping nullifying the outdated processes which were costly and time ineffective. They will also be able to capture the patients’ current health data. This will assist the doctors to monitor the patient and give the appropriate advice before they worsen. Monitoring the public health issues in bigger populations such as slum settings will be easier with this app. Using M-health applications will guarantee social responsibility since governments will be able to establish feedback loops which will enable patients to give feedback on the services offered by the caregivers and government. It will also help the patients get the correct information very quickly and understand the treatment better. This will make the patients more responsible as they will be complying with their prescription since they are getting user-friendly health info. M-health services will facilitate education and awareness in cases of less urgency and will also help patients embrace healthy habits and steer major health occasions such as delivery. This can sometimes be done by sending motivational quizzes sent to inform, empower, and involve patients on health matters like HIV/AIDS (Winkler, 2012).


Different mobile platforms are one of the biggest challengings to the developers when designing an app since different users use different mobile platform. Every platform is unique with respect to the end-user experience, user interface, user anticipation, Human-Computer Interaction standards, programming languages SDK or API, user interaction metaphors and supported tools. This is also known as Fragmentation across platforms (Winkler, 2012) .

Fragmentation within the same platform is also a challenge. As much as it is the same platform, most gadgets exist with dissimilar properties like the speed of the CPU, memory and display resolution. Fragmentation also occurs on the operating system level. This is most common in Android gadgets with dissimilar sizes of the screen and resolutions. This is a bigger challenge to the developers since it also pose a challenge for testing.

Another greater challenge is the upgrading of versions since these results to the incompatibility of the existing application. Developers are faced with the challenge of having to upgrade or redesign their app due to incompatibility issues

The incompatibility issues sometimes will force the developer to make different versions of the app because of the different gadget screen sizes and because of different OS versions common especially in android platform

A challenge is also experienced in testing the app since there are no better testing and analysis support since the existing emulator’s and tools don’t support vital features for testing mobile apps.

Another challenge is exhibited is when dealing with Windows and IOS which are closed source operating systems. Developers do not have API control meaning the developer has to jump into loops so as to design the app. As much as Android is open it also have some challenges since every manufacturer adapts the source code to their own wishes and in most occasions, they don’t stick to the standards resulting to inconsistency in application development.

Developing apps with database like M-Health is so challenging since the not all the information can be stored in the gadget as the gadget can get lost and syncing the up the data using a network to another device is also challenging (Fujita, 2012).

Remaining relevant and staying up to date with the dynamic changes in the field of technology is also another challenge since soft ware’s and gadgets keep on changing daily.

Mobile app development has detonated over the last few years with IOS, Android and Windows dominating the mobile apps landscape. Designing the app in different platform will pose few challenges especially in the IOS and Windows platform. Difficulties experienced in developing the M-health app for Apple’s IOS platform are vast since its developer portal comes with an unreasonable learning curve. Designing IOS app can sometimes be time consuming since approval procedure from Apple’s App Store is as secretive as it is ill-famed. Developers can sometimes be forced wait for a very long time before getting the approval for their app. This is a great challenge especially when the developer is given ultimatum the software delivery. The worst part is that sometimes the app may be rejected.

 Developing an Android platform

Android is a Linux-based operating system established mainly for Smartphone mobile devices. To develop and improve the Android system Google established the Open Handset Alliance (OHA) in the year 2007 where the software and hardware manufacturers and network providers were accommodated.

Android operating system has dominated the market since the introduction of the smart phone mobile system. The Android OS offers a small size relational database which is built-in—SQLite for data storage. The OS supports all types of GSM, various languages, various media, various streaming media, and is also able to multi-task. Android OS can be used on the most of mobile Smartphone devices due to its portability and openness.

Java was usually used in the Android Software Development Kit (SDK) during the early times of application development. Android is also open for use with C/C++ in Android Native Development Kit (NDK). Google also released a simpler language and the Google App Inventor, which made it even simpler for the beginners.

The main Android system services like device memory management, security, and processes management hinge on the Linux 2.6 kernel, which also acts as the layer linking the hardware and software. An Android application comprises of activity, service, content provider and intent. Activity functions as the dialog box of the application whereas the content provider acts as the data storage for the application. The use of Intent is to switch between activities. The Service is tailored to enable the backstage to keep on running. Java is the main developing language for Android. The main advantage of developing an Android app is that Android SDK is unrestricted to public. The third-party or self-employed developer is free to develop Android apps conveniently without any restraint on the Android OS with respect to hardware device and the high portability of application , which nullifies the issue of incompatibility concerning the different file formats in different smartphones gadgets.

A  software  stack  is  embraced  in  the  Android  OS platform where Linux will provide the main basic  function  and  numerous  programmer  developing diverse apps.  Flexibility and openness from a service provider, plentiful hardware options, no developer limitations, Google Play support are some of the prominent benefits of the Android OS platform over the other available platforms. Android OS also permits any mobile end builders to join the developing platform, which resulted to the diversity of unique applications. Android OS platform is also not restricted to the internet service and there is a considerably plentiful choice of hardware. Developers promote  all  kinds  of  products  with  different unique features  and functionalities  but  this  has never  affected  the  compatibility  of  application  or  the  data synchronism.  Selecting the Android OS platform diminishes the many challenges that might occur during the process of programming this simplifies the whole procedure developing.

Development model

There are many methods of application development models that can be implemented to successfully deliver the app to the market in fewer days. The choice of the method is based on the requirements and the urgency of the mobile app development project.  The agile method is the best simple method to achieve this. Agile project management is a method of handling the plan and builds activities for IT and a new product in a highly elastic and cooperating manner. This approach makes it easy to alter the project  and  minimizes the  general  risk  in  relation  to  the  whole  project (Winkler, 2012).

The Agile approach comprises of the following main stages. Budgeting, Project Initiation, Iterative Development, Sprint Planning, Development & Testing, and Product Demo, Training, Production Launch, Tuning, Wrap-up and Maintenance


During this stage, there are key concepts implemented which are; Sizing, End User Stories, and the Project Time box. Stories are gathered to establish the project scope. End-User Stories are high-level necessities demarcated in business terms. These explanations of what the Business Manager intends application to do are collected in days against the more traditional requirements collection processes that can go for weeks and sometimes even months. Individual End-user story is disintegrated into a set of high-level features, and then they are categorized to determine the effort needed to convey them. The magnitude of every feature depends on its calculated pattern of execution which is sorting, listing, editing, searching and many more. The estimated time box can be defined once all these features are sized. The time box for the project will depend on the group of in-scope End-user stories and the projected duration to finish every feature and the actual project team structure. The project time box will help in establishing the whole budget for the project in respect of resources and time frame to convey the defined functionality. This approach tools makes sizing calculations automated based upon the patterns, in addition to the project and application considerations. Sizing tool will therefore provide the initial project plan as defined by the agile approach immediately the sizing is complete.

Project Initiation

The Project Initiation is the beginning of the actual project. It involves collection of the End user stories and features then they are loaded into the Agile Projects module of the Agile Network. This is what is known as bootstrapping the project. These End user stories and features are then fed into the project backlog. This is the list of necessities to be conveyed. Kick-off meeting to orientate everyone on the project scope, roles, and responsibilities, risks involved, sprint demo session dates is then carried out after the project is bootstrapped. Scope analysis applied at this stage. Scope analysis consists of a more detailed analysis as well as the external interface examination for dependencies. It further involves ranking the requirements considering the output value they offer to the business. Questions like: What are the most grievous business user profiles? What are the most common user stories involving those profiles? What are the use instances and user profiles that donate most to the application?

This then results to a project backlog which has a high level list of the requirements.

Projects prints are then identified in the Agile Projects module as part of the project bootstrapping process. A sprint is repetitive cycle of the timeframe of 2-3 weeks whereby a part of the application is developed. At the close of every sprint, the project team group delivers an operational, vertically assimilated portion of the ultimate application. The duration of a sprint is established in the original plan given through the Agile Sizing’s component. In the rest part of the remaining project, the Agile Projects module will be the chief tool used for managing the daily work of the project. This component comprises of numerous tools to enhance the project initiation, preparation, controlling, implementation, reporting and termination. It involves particular tools for managing Agile projects such as sprint planning, backlog management, requirements management and many more (Winkler, 2012).

Iterative Development

The Iterative Development preparation activity that includes reviewing the project backlog and cooperating with the business team group members to come up with a decision on which user requirements will be incorporated in the existing sprint. This process is referred to as Backlog Sprint Settlement. During the process, prioritization and feature negotiation occur between the Business and Engagement Manager to come up with the priorities for sprint and balance the general project time box. The main aim of undertaking this process is to establish the crucial necessities to be incorporated in the sprints’ backlog without surpassing the sprint’s time box. The moment the sprint backlog is established, a thorough analysis of the necessities is conducted. Describing the requirements further to outline their implementation methodology and design, it will be very peculiar that some may not be possible to implement or substitute implementations will need to be identified. The effect of these variations need to be examined to establish whether there is need to move these requirements to the succeeding sprint or smaller value requirements be eliminated from the sprint backlog. It is important to hold the time box sacred for every sprint and the whole project.

Testing and Development activities commence in every sprint after the backlog sprint is stable,

Every member of the delivery team group and Delivery Manager Works to detail the design, identify the duties, finalize the anticipated effort and make delivery commitments for every assigned work items.

Delivery Manager carries out a 10-minutemeeting to harmonize the team group track daily.

Every team group member must feed their work to the Systems Platform more frequently and assimilate with the rest of team group member’s work, making sure that all work finished is availed to the rest of the team (Tsihrintzis, 2010).

At the close of each Sprint, the delivery team demonstrates how the application works to the team group members. Presentation of a vertically integrated version of the application is done to the Doctors (users) and Business Manager at this time. In this session, the patients (end

Users) and inquiry team members will then give a response.

Starting with the earlier sprint, the formal demonstration signifies what is known as the Continuous User Acceptance process (Winkler, 2012).

Since the sprints are short and recurrent, Quality Assurance engineers and the users will be frequently testing the delivered app functionality and noting issues, functional and enhancements faults. This testing significantly improves the application quality and user friendliness.

When the demonstration is finished, the features acknowledged by the Business Manager are logged off and shut. Changes or different requirements are recorded into the project backlog and deliberated on the subsequent sprint planning session. To ensure that the application delivered satisfies the needs of the intended work, constant alignment with the business is necessary


This is the stage where the ownership of the application is passed to the business. Caregivers and patients are trained on how to use the application. There are two processes involved in training; the First one is to train crucial business users and front-line people who will assist other users in leaning how the app functions. The Second one involves empowering these key individuals to collect and give feedback so as to further improve the app and to make it relevant to current changes  (Winkler, 2012).

Production Launch

In This stage of product launch, the app is published to production via the Out Systems Platform’s 1-click technology. The production launch will target the patients and the caregivers meaning the product will be launched in the hospital to get the right audience and be running concurrently with any replacement systems.

The delivery team commences tuning the application the moment the application is in production. This is the most important stage of agile approach since it also aids in orientation of the end-user and also in preparing for full rollout of the application.


The most important part of the agile approach is the turning stage since it is grounded in the accumulation of vast experiences across over 500 successful projects. In this stage, there are two critical activities carried out; Performance of the app and Functional tuning.

Functional tuning involves the resolution of unresolved concerns and assessment of any insignificance project backlog that may be remaining for delivery. Items are evaluated to establish whether they can be recommended for the functionality of adoption boosting. This feature entices the users to start liking and using the new application instantly.

Multiple productions are employed daily while the team group carries out functional tuning. The main reason why this is done is to sort out any unresolved issues and to apply multiple adoptions boosting features and consistently gathering response from the users. To obtain a 100% User Adoption developers will continue in putting latest versions to production, while the administrators carry out the performance tuning to obtain the best service levels.


The project is officially closed at this stage .it involves the signing off the application. The outstanding project backlog items are deliberated and organized for the subsequent release of the application which is the maintenance stage.


The reason why this stage is of great importance is to guarantee that the application constantly chains the business via evolutionary maintenance. Meaning the application should constantly be adjusted as the business changes. It is, therefore, necessary to conduct a 2week consecutive series of sprint depending on the new features. The following are the main functions of the application

Main functions

The caregiver’s end application will comprise the functionality for an operator to log in, check patients’  new data and new messages, get patients’ and other doctors’ contact info,  add  contacts, reply patients, manage schedule, contact patients and many more. The fundamental functionalities are shown in the figure


Log in

This will require users (doctors) to feed a unique username and password which is known to them and they have signed up in the e-health system so as to give them access to log into the system. This functionality warranties the security of patients’ information.

Obtaining patient’s data

The  information  that  the  doctor  is  able  to  receive are  the  patients’  health  info, contact information and messages. Every info will be presented in its own page independently.

Giving advises and feedback

The user (doctor’s) end side should capable to offer multi-directional data exchange between the doctors and patients. It lets doctors to offer their professional guidance after checking the information provided by the patient .The doctor is also able to reply to the messages and answer any questions asked by the patient. This information is then sent to the server where it is dispatched to the patients.

Contact operations

Doctors will also be able to get patients’ contact info and their next of kin’s contact info including phone numbers and email addresses among other relevant contacts. The doctor is also able to edit the important info through deleting and updating.

User settings management

Important settings like username and password can be manipulated by the user at their own convenience.

Data movement and Data storage

This is the sensitive and the most important part from the doctor’s end.  It has the

Patients’ info and is important with respect to the patient—doctor data exchange.  The  application  will  execute  “obtaining  data ,——-storing data—–reading  data”  for the user.

The diagram below summarizes the functionality of the system

Testing Plan

Testing  and  evaluation of the app  is  a  very  important  part  in  the  app development. Having knowledge whether the app is of acceptable standard is of vital significance since this is the only way to identify any shortcomings in the app.

There are many techniques and tools for testing the app to obtain a perfect product at the end of the project. The following were the techniques used to

Usability testing

This involves navigation between the screens, visibility of the texts using the selected language and functionality verification when the mobile device is online and offline and feedback from users who have interacted with the app.

Compatibility Testing

Compatibility Testing entails authenticating the app for different mobile gadgets, different screen sizes, different operating system versions and also checking how the app interacts with other applications installed in the device.

Security Testing

Security Testing involves encryption techniques used for sensitive information exchange. It also checks for the support for multi user without interfering with the information between them. Access to files saved in the app is also checked by unintended user so as to ensure the integrity of the patient’s information is safe

Resource Testing

Low level Resource Testing comprises of checks for excessive use of the device memory. The app is launched when there are many running processes in the background to check whether it overuses the memory.

Operational Testing

This test involves checking of back up of essential data in the application. It also checks for save and recovery in case the phone goes off or the battery is empty. The app is also checked whether it can run concurrently with other phone functionalities such as an incoming call when the app is running or when being accessed (Matos, 2005).

Performance testing

Performance testing involves checking the connection in the server to 3G from Wi-Fi, app response time, memory leakages, battery consumption when the app is running.


M-Health care is a breakthrough in the health sector as it comprises the application of electronic machinery which has simplified the process of offering health services Things like storing  of patients’  medical  data electronically  nullifying the older methods which were time-consuming and inconvenient. The introduction of this app in the health sector has reduced the complications and inconveniences experienced between the care giver and the patient interactions. The reputation of mobile end gadgets as well as the ability to have access to the internet, information broadcast is almost instant. This is a major contribution to the patient sickness situation control and response to emergency. The M-Health app has built a good rapport between the caregivers and the patients. In the field of medical care, privacy of the patients is of great importance as it involves most ethical matters which this app has taken care of (Matos, 2005).



The Figure Below shows the General structure of the application.


The above diagram illustrates the flow of activity in the M-Health application.



The figure above shows the Data flow in the Doctors end application










The function table in the doctor’s end is shown below in Figure



Bomarius, F. (2005). Product focused software process improvement 6th international

conference, PROFES 2005, Oulu, Finland, June 13-18, 2005: proceedings. Berlin: Springer

Fujita, H. (2012). New trends in software methodologies, tools and techniques proceedings of the

            Eleventh SoMeT_12. Amsterdam: IOS Press.

Tsihrintzis, G. A. (2010). Multimedia services in intelligent environments software development

            Challenges and solutions. Berlin: Springer.

Sillitti, A. (2010). Agile processes in software engineering and extreme programming 11th

International Conference, XP 2010, Trondheim, Norway, June 1-4, 2010. Proceedings. Berlin: Springer-Verlag.


Matos, L. (2005). Emerging solutions for future manufacturing systems IFIP TC 5/WG 5.5 sixth

IFIP International Conference on Information technology for Balanced Automation Systems in Manufacturing and Services, 27-29 September 2004, Vienna, Austria. New York: Springer.

Winkler, D. (2012). Systems, software and services process improvement 19th European

Conference, Euro SPI 2012, Vienna, Austria, June 25-27, 2012. Proceedings. Berlin: Springer


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