Last week, FDA released a document outlining its policy priorities for the coming year. “Healthy Innovation, Safer Families: FDA’s 2018 Strategic Roadmap” addresses continued focus on digital health, among other priorities, as one way that the agency seeks to further its public health mission and foster innovation that benefits consumers and patients.  Consistent with this focus, the agency also announced a public workshop on January 30-31, 2018, to discuss the status of its Software Pre-Cert Program, which we wrote about here.

These announcements follow a consistent drumbeat of digital health focus from FDA during 2017, including release of two draft and one final guidance documents that are intended to implement the objectives of the 21^st Century Cures Act.  These include the following:

• The Clinical and Patient Decision Support Software (CDS) Draft Guidance. As explained by FDA, this guidance “is intended to make clear what types of CDS would no longer be defined as a medical device, and thus would not be regulated by the agency. For example, generally, CDS that allows for the provider to independently review the basis for the recommendations are excluded from the FDA’s regulation… However, the FDA will continue to enforce oversight of software programs that are intended to process or analyze medical images, signals from in vitro diagnostic devices or patterns acquired from a processor like an electrocardiogram that use analytical functionalities to make treatment recommendations, as these remain medical devices under the Cures Act.” The comment period is open until Tuesday, February 6, 2018.
• The Changes to Existing Medical Software Policies Resulting from Section 3060 of the 21^st Century Cures Act Draft Guidance.  This draft guidance updates the agency’s thinking relative to exercise of jurisdiction or enforcement discretion over low risk mobile and digital health products, as previously addressed in FDA’s Mobile Medical Application and General Wellness guidance. The deadline for public comments is Tuesday, February 6, 2018.
• The Software As A Medical Device (SaMD): Clinical Evaluation Final Guidance. This finalizes draft guidance issued in 2016 and attempts to further global regulatory harmonization efforts by establishing common principles for regulators to use in evaluating the safety, effectiveness and performance of SaMD.

Industry Releases Mobile Health App Guidance

FDA hasn’t been the only public health stakeholder issuing guidance lately, though. Xcertia, a group created to build a framework for mobile health apps founded by the American Medical Association, HIMSS, the American Heart Association, and DHX Group, released draft guidance specifically about health apps.

Xcertia published four different sets of guidelines regarding app operability, privacy, security, and content. Unlike the FDA’s guidance, these documents are specific to mobile health apps and provide specific requirements for developers. Due to the FDA’s indication that it will not pursue regulation of certain low-risk health-related mobile apps, this Xcertia guidance is a helpful reminder to the developer community that, even if FDA is not regulating a low-risk product, rules and best practices still apply. This has been the steady message that the Federal Trade Commission has delivered through numerous mobile health enforcement actions and in developer guidance released in 2016, which we wrote about here.

Comments regarding this guidance can be submitted on Xcertia’s website through the end of January.

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