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iPhone App Development Lessons Learned Project Type: Brief Review | Start Date: 05/01/2012 | End Date: 07/06/2012 The Lab's experience developing mobile applications for the iPhone platform using existing and new processes within CDC. Mobile computing is a growing component of CDC's interaction with the public. This review shares the lessons learned by the Lab and its partners in designing, developing, testing and releasing a clinical guidance app for use by physicians. Although the processes followed are specific to CDC, the lessons learned may be useful to any group working within a public health organization. Overview: The R&D Lab, in cooperation with LSPPPO developed an iPhone app, PTT Advisor, to assist clinical providers with management of patients requiring complex coagulation testing. The functionality of the app can be experienced by downloading the app from the R&D App Lab and the specific functionality of the app will be described in a forthcoming manuscript. This article seeks to capture the lessons learned by the project team to develop a process that can be reused by other public health programs, both within and outside CDC, to develop new smartphone applications for use by the public health community.
Software development process: The Lab and its partners used an iterative, agile approach to developing the iPhone app. We used this approach as this was a fairly unknown development area with our group so we wanted to use a method that allowed for flexibility yet still met the needs of the CDC program sponsoring the app. The application was written in Objective C (source code available here) following Apple's Human Interface Guidelines for iOS User review and beta testing: LSPPPO gathered a set of 22 volunteer beta testers including 8 practicing physicians. These beta testers received a link to download the app on their personal devices to test functionality. Based on feedback collected from this beta test, the developers made minor revisions to prepare it for release to the Apple iTunes App Store. Legal review: Prior to release to the App Store, legal counsel within CDC's Office of the General Counsel (OGC) reviewed the app from a legal perspective to make sure that the terms of the App Store as well as the expectations of users was properly met. After multiple discussions with OGC and program staff, an end user license agreement (EULA) was developed for the application using similar language from other mobile apps created by the federal government. Security and privacy review: Security was a prime requirement for the app design, especially since this was the first app developed for release by the Lab and its partners. To protect the privacy of the app users, the app does not store any data nor does it use any sensitive data. The algorithms themselves are currently in the process of being published in the peer-reviewed literature and do not contain sensitive information. In the application, the user does not store any settings, nor does the app access any patient data. Because the app does not use any sensitive data, the security design was limited to developing an incident response plan, in the case that the Apple iTunes Store became compromised. In addition, a required privacy impact assessment (PIA) was completed. Please email This e-mail address is being protected from spambots. You need JavaScript enabled to view it for examples of how we developed these documents. Scientific review: Our final review, prior to publishing the app was to use CDC's scientific clearance process to assure the quality and integrity of the science involved in the mobile app. As is standard at CDC, communication and policy review was also included in this overall clearance process. Because the app was clinical guidance issued by CDC, scientific review was performed by not only the two C/I/Os involved in the process (PHSIPO and LSPPPO), but also by OSELS' and CDC's associate directors for science. Since CDC's e-clearance system, at the time of submission, did not have a preset configuration for clearing mobile phone apps, the Lab team created a document containing all material used within the app: screenshots, language, license agreements and metadata. This document was then reviewed and revised to achieve clearance by the associate directors for science and the associate directors for communication. App Store publication: Once we achieved all reviews and had made the appropriate modifications, the app was ready for publication to Apple's iTunes App Store. CDC's Office of the Associate Director for Communication (OADC) has an established iTunes account for CDC and manages the team that packages and submits all iPhone apps on behalf of the agency. The Lab coordinated with this team to prepare our app according to the metadata requirements set by Apple (working with Icons and iOS Developer Library). Conclusion: While the development of the Lab's first production iPhone app may seem arduous, many of the policy and scientific pieces can now be reused by other programs. The Lab and LSPPPO have a repeatable process where the legal, security, policy and scientific review process can now be "templated" and reused for future programs. Other programs can now develop additional apps for the iPhone and other mobile platforms- either independently or in collaboration with CDC's Informatics R&D Lab.
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