Vladimir Makeew CEO of Surf

    Flutter for Doctor Appointment Booking Apps: Issues To Be Aware Of

    We are the company that develop various apps with Flutter and appointment booking apps are among them. As according to Statista the revenue in the online doctor consultation segment is predicted to show an annual growth rate (CAGR 2022-2026) of 9.90% and result in a projected market volume of US$34.63bn by 2026, we find it useful to go into details of this segment, and namely doctor appointment software development.

    Since the COVID-19 pandemic, health care delivery has been witnessing high pressure and experiencing more fast-paced changes than could have ever been predicted. Having faced rapid increases in patients, lack of equipment and workforce, employee burnout, and infrastructure issues, the industry has been accelerated on its way to digital transformation and health care delivery model (HCDM) convergence, which remains the key trend now. Medical institutions and health systems around the globe are becoming more customer-centric and turning to cloud computing, 5G telecommunications, artificial intelligence (AI), and interoperable data and analytics to meet the needs and requirements of the world today.

    healthcare digitalization moves

    In this article, our doctor appointment app development company offers you to take a closer look at the segment as currently, it is one of the most used types of healthcare apps. And still, there are numerous challenges to overcome if you decide to build a doctor booking app. 

    We are a mobile and web app development company, and since 2011, we have been developing mobile apps for various industries, fintech, banking, retail. The medical software development services are not an exclusion: we have successful projects under our belt, from pharma to telemedicine apps. All the way long, we have been accumulating cross-industry experience and best industry-specific practices, and now we are glad to share with you some useful tips related to choosing Flutter as the right tech stack, ensuring better app security, and more.

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    Why do appointment mobile app development companies prefer Flutter?

    Before we start getting to know more about Flutter, let’s  see why choosing the right set of technologies is one of the challenges for the companies building doctor appointment apps. The tech stack is expected to

    • Provide for high availability, good performance, and reliability of the app as this is what the patients and the clinic employees expect from online products,
    • Allow for a decrease in time to market as healthcare apps have been in high demand lately, and the mHealth market is highly competitive,
    • Be of a reasonable cost to help save budget but without negative impact upon the end product quality,
    • Ensure security of the app for long-term, and easy scalability in the future to keep up with market needs. 

    For the Surf team and our clients, Flutter cross-platform framework has become the solution that matches the above criteria. We have been developing Flutter-powered projects since it was first released by Google in 2018.  For example, the Surf team created apps for a pharmacy chain (3 cross-platform apps for 3 different brands), and with Flutter we succeeded in saving almost 40% of the client’s initial budget for developing 6 native apps for iOS and Android, accordingly. More detailed comparison of Flutter vs native development you can find in our blog article

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    And in this article we want to explain a bit about the eventual issues of logic and architecture of Flutter mobile apps that we are often asked about.

    The point is that Flutter provides greater freedom in choosing an approach to the architecture, which, with further project growth, may lead to insufficient elaboration followed by increased debugging time and accumulated technical debt.

    From this point of view, the most common problems are

    mixing business logic and displaying visual components: this can lead to much more  lines of code and poorer quality, and violates at least one of the SOLID principles, namely, Single Responsibility Principle. The code becomes difficult to test and maintain.

    To solve the above problem, the Surf team developed an Elementary approach to Flutter apps architecture that allows to separate app layers based on their responsibilities. As a result, responsibilities become more transparent and the code is more readable and testable.

    no separation into main layers: the logic is described in one class/service or in a block, which also violates the SRP principle and makes testing more complicated.

    Our solution is to use a clean architecture approach with its main layers: domain layer (describes the data to be worked with and the operations to be done), data layer (describes implementation of the classes described in the domain), and presentation layer divided into presentation logic and display.

    Such an approach ensures flexibility, compliance with the principle of sole responsibility, and we can always be sure that changes in one component will not affect any others.

    pharmacy app templates

    Ensuring appointment app security

    Today, users have already gotten used to having all required services in their smartphones: mobile banking, m-commerce, mobile travel booking, and more. The same refers to the access to their medical data. And this is the point where the first challenge lies, and namely, how  medical software providers, including doctor appointment apps development companies, can protect health information.

    In the course of one of the recent assessments of some popular mobile healthcare apps 85% of Covid-tracking apps were found to leak data.

    The reasons behind can be of different levels

    security-related issues and vulnerabilities in apps themselves

    To minimize the risks, the key points in building a doctor appointment app are to ensure strictcompliance with regulatory requirements (Health Insurance Portability and Accountability Act (HIPAA) in the USA or the European Union’s General Data Protection Regulation, and other applicable requirements), to apply proven development practices related to access management, data storage, and code quality, to provide for thorough testing at the appropriate development stages, to engage security experts into the process.

    users’ awareness of security risks and their behavior

    The next two points actually refer both to users and clinics’ employees. The preventive measures include security training of end-users. The clinics’ employees should receive proper onboarding, implemented security policy, clearly-set requirements to follow, and any other company-internal recommendations.

    While the patients should take care of their own security and follow the security-focused recommendations, both general (for example, download apps from authorized app stores only) and app-specific (for example, use a strong password, update to the latest version).

    devices themselves as they can be lost or stolen

    No one is immune to situations where we can lose control of our mobile devices. And again, there are two sides of the challenge. On the one hand, patients risk their private information that can be used for fraud. Here, the patients are themselves responsible for their devices and should take generally accepted caution measures (for example, do not use jailbroken devices).

    On the other hand, the pandemic has caused growth in popularity of remote work, and employees use their own devices for working tasks. In such a case, loss of theft of a mobile device can put sensitive medical information of many patients at risk.

    According to the Endpoint Ecosystem study about using devices in high-risk and highly regulated industries, including healthcare, 64% of employees use a personal device for work but only 43 % of those devices have BYOD (Bring Your Own Device) securely enabled, and 36 % admit to find ways to work around security policies that restrict them in work.

    One of the ways to prevent the above danger is to implement the Bring Your Own Device concept, but do it carefully with regard to all eventual risks. The issue  is common across industries. IBM Security offers 10 rules for BYOD starting from being proactive in creating policies, making enrollment simple to measuring the economic benefit from BYOD implementation.

    We at Surf have had a positive experience with the KFC project. We provided the restaurant general and local managers with the possibility to install the app on their personal devices in the frames of the Bring Your Own Device concept. To exclude any data leakages, we thoroughly thought over security, authorization, and user authentication issues as well as distribution of builds. The app successfully passed a security audit carried out by KFC.

    KFC app screens

    Creating human-centric UX\UI for booking doctor appointments

    The next specific challenges faced by doctor appointment app development companies relates to creating apps accessible, easy-to-understand and use for people with different backgrounds and different devices. First, the doctor appointment app is designed to be used by patients and by doctors this means that UX/UI designers shall bear in mind needs and preferences of both categories. Second, healthcare apps are used by different people around the world, and like any other healthcare software they shall be clear, simple, and user-friendly to the greatest possible extent. Any complexity or ambiguity in this case may cause danger to patients’ health, which is the key risk to be avoided, and lead to low retention rates and high level of support enquiries.

    For the problem to be solved, development of a doctor appointment booking app should start with a clear identification of the app users, their needs, and expectations. This will help make the app that they will eagerly use and show what features you do not need to waste your money for, at least, at the MVP stage. This is highly recommended for the developer team, to involve clinicians and specialists practicing in relevant domains, to learn specific demands and processes, and to collect the end-users’ feedback at the various stages of development to make timely adjustments.

    At Surf, we create for our clients a CJM (Customer Journey Map) to identify users’ needs and to study the user’s journey in the app. This helps create a user-friendly app and optimize project expenses. As a result, our client receives a Customer Journey App tailored specific to their app, a table with app features for MVP and subsequent versions, and a backlog with ideas and insights.

    three tables with data

    Achieving interoperability

    According to Statista, 58% of young healthcare professionals worldwide believe that improved interoperability between platforms would allow for the full utilization of digital patient data.

    And ensuring interoperability is the next challenge for out-of-the-box and custom medical software development.

    Interoperability means access, seamless exchange, integration, and joint usage of data by different information systems, devices, and apps within and across organizational, regional and national boundaries. Despite the fact that digitalization is well underway in the healthcare industry, the interoperability between a variety of medical data sources remains an issue for healthcare providers. We will not go into details of the interoperability issues related to operational, political, and philosophical differences, but want to highlight that at the technology level there are international standards developed to facilitate interoperability between legacy and new healthcare systems and delivery of information to healthcare providers and patients on various devices, and to allow third-party app developers to easily integrate their products into existing systems.

    Health Level Seven, or HL7, is a set of international standards for the transfer of clinical and administrative data between software applications used by various healthcare providers focused on the application layer. HL7 uses ASCII text-based messages to communicate between different systems (systems for patient management, healthcare information, electronic medical records, and others). 

    The Fast Healthcare Interoperability Resources (FHIR) standard describes data formats, elements, and an application programming interface (API) for exchanging electronic health records (EHR). FHIR is based on previous data format standards from HL7, but employs RESTful web services and open web technologies, such as JSON and RDF data formats. This makes the learning curve shallow as most developers have relevant experience with these technologies. Besides, the RESTful API approach allows one-to-many interfaces, so data exchange is easier and onboarding of new data exchange partners is faster. The RESTful approach facilitates the interoperability between various devices and systems but not just electronic health record (EHR) systems.

    Summing things up

    All the above challenges of making a Flutter doctor appointment app can be successfully overcome in case you find and hire the best team for your healthcare app development

    In this context, ‘the best’ means not only a team with comprehensive knowledge of and expertise with secure and reliable mHealth app development but with high motivation, transparent processes, and people-centric approaches.