title: A Mobile App Development Guideline for Hospital Settings: Maximizing the Use of and Minimizing the Security Risks of "Bring Your Own Devices" Policies.
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.
authors.affiliation: Innovation & Digital Health Accelerator, Boston Children's Hospital, Boston, MA, United States. soleh.alayubi@childrens.harvard.edu.
authors.forename: Soleh U
authors.identifier: http://orcid.org/0000-0002-0001-0036
authors.initials: SU
authors.lastname: Al Ayubi
authors.forename: Alexandra
authors.identifier: http://orcid.org/0000-0002-3463-324X
authors.initials: A
authors.lastname: Pelletier
authors.forename: Gajen
authors.identifier: http://orcid.org/0000-0003-0407-929X
authors.initials: G
authors.lastname: Sunthara
authors.forename: Nitin
authors.identifier: http://orcid.org/0000-0001-7189-7853
authors.initials: N
authors.lastname: Gujral
authors.forename: Vandna
authors.identifier: http://orcid.org/0000-0002-4836-2823
authors.initials: V
authors.lastname: Mittal
authors.forename: Fabienne C
authors.identifier: http://orcid.org/0000-0003-0937-5311
authors.initials: FC
authors.lastname: Bourgeois
keywords: BYOD; custom application; electronic medical records; guideline; hospital settings; mobile application; privacy; safeguard; security