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移动医疗 APP 开发指南:最大化利用“自带设备”政策并最小化其安全风险。

A Mobile App Development Guideline for Hospital Settings: Maximizing the Use of and Minimizing the Security Risks of "Bring Your Own Devices" Policies.

机构信息

Innovation & Digital Health Accelerator, Boston Children's Hospital, Boston, MA, United States.

出版信息

JMIR Mhealth Uhealth. 2016 May 11;4(2):e50. doi: 10.2196/mhealth.4424.


DOI:10.2196/mhealth.4424
PMID:27169345
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4880739/
Abstract

BACKGROUND: Hospitals today are introducing new mobile apps to improve patient care and workflow processes. Mobile device adoption by hospitals fits with present day technology behavior; however, requires a deeper look into hospital device policies and the impact on patients, staff, and technology development. Should hospitals spend thousands to millions of dollars to equip all personnel with a mobile device that is only used in a hospital environment? Allowing health care professionals to use personal mobile devices at work, known as bring-your-own-device (BYOD), has the potential to support both the hospital and its employees to deliver effective and efficient care. OBJECTIVE: The objectives of this research were to create a mobile app development guideline for a BYOD hospital environment, apply the guideline to the development of an in-house mobile app called TaskList, pilot the TaskList app within Boston Children's Hospital (BCH), and refine the guideline based on the app pilot. TaskList is an Apple operating system (iOS)-based app designed for medical residents to monitor, create, capture, and share daily collaborative tasks associated with patients. METHODS: To create the BYOD guidelines, we developed TaskList that required the use of mobile devices among medical resident. The TaskList app was designed in four phases: (1) mobile app guideline development, (2) requirements gathering and developing of TaskList fitting the guideline, (3) deployment of TaskList using BYOD with end-users, and (4) refinement of the guideline based on the TaskList pilot. Phase 1 included understanding the existing hospital BYOD policies and conducting Web searches to find best practices in software development for a BYOD environment. Phase 1 also included gathering subject matter input from the Information Services Department (ISD) at BCH. Phase 2 involved the collaboration between the Innovation Acceleration Program at BCH, the ISD Department and the TaskList Clinical team in understanding what features should be built into the app. Phase 3 involved deployment of TaskList on a clinical floor at BCH. Lastly, Phase 4 gathered the lessons learned from the pilot to refine the guideline. RESULTS: Fourteen practical recommendations were identified to create the BCH Mobile Application Development Guideline to safeguard custom applications in hospital BYOD settings. The recommendations were grouped into four categories: (1) authentication and authorization, (2) data management, (3) safeguarding app environment, and (4) remote enforcement. Following the guideline, the TaskList app was developed and then was piloted with an inpatient ward team. CONCLUSIONS: The Mobile Application Development guideline was created and used in the development of TaskList. The guideline is intended for use by developers when addressing integration with hospital information systems, deploying apps in BYOD health care settings, and meeting compliance standards, such as Health Insurance Portability and Accountability Act (HIPAA) regulations.

摘要

背景:如今,医院正在引入新的移动应用程序,以改善患者护理和工作流程。医院采用移动设备符合当今的技术行为;然而,需要更深入地了解医院设备政策以及对患者、员工和技术发展的影响。医院是否应该花费数千到数百万美元为所有人员配备仅在医院环境中使用的移动设备?允许医疗保健专业人员在工作中使用自己的移动设备,即所谓的自带设备 (BYOD),有可能支持医院及其员工提供有效和高效的护理。

目的:本研究的目的是为 BYOD 医院环境创建移动应用程序开发指南,将该指南应用于内部开发的名为 TaskList 的移动应用程序,并在波士顿儿童医院 (BCH) 内试用 TaskList 应用程序,并根据应用程序试点对指南进行改进。TaskList 是一款专为住院医师设计的基于苹果操作系统 (iOS) 的应用程序,用于监测、创建、捕获和共享与患者相关的日常协作任务。

方法:为了创建 BYOD 指南,我们开发了 TaskList,要求住院医师使用移动设备。TaskList 应用程序分四个阶段设计:(1)移动应用程序指南的开发;(2)根据指南收集需求并开发 TaskList;(3)使用 BYOD 为最终用户部署 TaskList;(4)根据 TaskList 试点结果改进指南。第 1 阶段包括了解医院现有的 BYOD 政策并进行网络搜索,以找到适用于 BYOD 环境的软件开发最佳实践。第 1 阶段还包括从 BCH 的信息服务部门 (ISD) 收集主题输入。第 2 阶段涉及 BCH 的创新加速计划、ISD 部门和 TaskList 临床团队之间的合作,以了解应在应用程序中构建哪些功能。第 3 阶段涉及在 BCH 的一个临床病房部署 TaskList。最后,第 4 阶段从试点中吸取经验教训,以改进指南。

结果:为了在医院 BYOD 环境中保护自定义应用程序,确定了十四条实用建议来创建 BCH 移动应用程序开发指南。这些建议分为四类:(1)身份验证和授权;(2)数据管理;(3)保护应用程序环境;(4)远程执行。按照该指南,开发了 TaskList 应用程序,然后在一个住院病房团队中进行了试点。

结论:创建了移动应用程序开发指南并将其用于 TaskList 的开发。该指南旨在供开发人员在解决与医院信息系统集成、在 BYOD 医疗保健环境中部署应用程序以及满足合规标准(如健康保险流通与责任法案 (HIPAA) 规定)时使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/7b645fe2c408/mhealth_v4i2e50_fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/3f51c271e23a/mhealth_v4i2e50_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/dfe8128139e3/mhealth_v4i2e50_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/8c96c3071c71/mhealth_v4i2e50_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/9e5aaeeb0891/mhealth_v4i2e50_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/2255d0443a52/mhealth_v4i2e50_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/7b645fe2c408/mhealth_v4i2e50_fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/3f51c271e23a/mhealth_v4i2e50_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/dfe8128139e3/mhealth_v4i2e50_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/8c96c3071c71/mhealth_v4i2e50_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/9e5aaeeb0891/mhealth_v4i2e50_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/2255d0443a52/mhealth_v4i2e50_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beb8/4880739/7b645fe2c408/mhealth_v4i2e50_fig6.jpg

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