So you wish to produce real quality medical device software? Testing is the time when you will show your true colors. Medical device imply that bugs can’t happen in production, because lives are at stake. As untested code never works, you have to invest a tremendous effort in hunting bugs using a variety of techniques.

Another reason why testing is of special importance for medical devices is that embedded systems are hard to update. I know of environments where it takes up to several years to manually update devices all around the world. Even if you have a good IoT solution to push updates, your clients might have a variety of good reasons to postpone them (such as their own internal, heavyweight validation process). Bugs will thus live for a long time in the wild. They shouldn’t escape. You might take more risks on a server that you can patch in a matter of hours for all your clients.

In addition, medical device regulations (IEC 62304 in particular) impose a test for every requirement and a traceability system to allow auditors to easily spot holes in the test system. But they let you a good degree of freedom about the testing techniques. Be smart in your choices.

The following diagram classifies the kinds of tests I believe should be used to achieve the level of quality and safety required in the field. They grey areas represent the composition of components into a more and more complete medical device system. The green, purple and blue rectangles represent the categories of tests applied to sub-components. Check the color code below.

Broadly speaking, the wider the test, the costlier it will be to provide the required resources (from a virtual machine to a mini-lab or hospital setting full of medical devices) and the longer it will take to run them (from 1 ms to one day). For this reason, teams need to use each kind of test to its maximum extent to lower the need of more general tests, both for cost-effectiveness and good test coverage.

In this series of posts, my goal is to provide a return on experience and a general guidance on how to tackle these tests in the context of agile medical devices development. I’ve organized my thoughts in the same 3 categories that I’ve highlighted in the diagram, and that require different kinds of management.

Automated tests that run in the build system . One they’re written, apart from maintenance of broken test and build system performance, you need no effort to run them, so they run all the time.

. One they’re written, apart from maintenance of broken test and build system performance, you need no effort to run them, so they run all the time. Automated tests supervised by a tester . Require some planning, dedicated hardware and somebody to start them and to interpret the results, but they can be highly parallelized with other activities.

. Require some planning, dedicated hardware and somebody to start them and to interpret the results, but they can be highly parallelized with other activities. Manual tests. The costliest kind, requiring a human being during execution.