IMDRF/SaMD WG/N10FINAL:2013
Final Document
Title: Software as a Medical Device (SaMD): Key Definitions
Authoring Group: IMDRF SaMD Working Group
Date: 9 December 2013
Despina Spanou, IMDRF Chair
This document was produced by the International Medical Device Regulators Forum. There are
no restrictions on the reproduction or use of this document; however, incorporation of this
document, in part or in whole, into another document, or its translation into languages other than
English, does not convey or represent an endorsement of any kind by the International Medical
Device Regulators Forum.
Copyright © 2013 by the International Medical Device Regulators Forum
IMDRF/SaMD WG/N10FINAL:2013
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Table of Contents
1.0 Introduction ......................................................................................................................4
2.0 Scope ...............................................................................................................................5
3.0 References ........................................................................................................................5
4.0 Definitions........................................................................................................................5
5.0 Key Definitions ................................................................................................................6
5.1 Software as a Medical Device .......................................................................................6
5.2 Medical purpose ............................................................................................................6
5.2.1 Medical Device ......................................................................................................6
5.2.2 In Vitro Diagnostic (IVD) medical device ..............................................................7
5.2.3 Additional considerations for SaMD ......................................................................7
5.3 SaMD Changes .............................................................................................................8
5.4 SaMD Manufacturer .....................................................................................................8
5.5 Intended use / intended purpose ....................................................................................9
5.5.1 Additional considerations for SaMD ......................................................................9
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Preface
The document herein was produced by the International Medical Device Regulators Forum
(IMDRF), a voluntary group of medical device regulators from around the world. The document
has been subject to consultation throughout its development.
There are no restrictions on the reproduction, distribution or use of this document; however,
incorporation of this document, in part or in whole, into any other document, or its translation
into languages other than English, does not convey or represent an endorsement of any kind by
the International Medical Device Regulators Forum.
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1.0 Introduction
Software is becoming increasingly important and pervasive in healthcare. Given the availability
of a multitude of technology platforms (e.g., personal computers, smart phones, network servers,
etc.), as well as increasing ease of access and distribution (e.g., internet, cloud), software created
for medical purposes (software used to make clinical decisions) and non-medical purpose (e.g.,
administrative, financial) are being used in healthcare.
In general, existing regulations address public health risks of software when embedded in a
traditional medical device. However, the current application of regulations and controls may not
always translate or address the unique public health risks posed by Software as a Medical Device
(SaMD) nor assure an appropriate balance between patient/consumer protection and promotion
of public health by facilitating innovation.
This is the first of a collection of documents that will be developed by the International Medical
Device Regulators Forum (IMDRF) to establish a common framework for regulators to
incorporate converged controls into their regulatory approaches for SaMD..
This collection of IMDRF SaMD documents will provide regulators with the fundamental
building blocks and a common understanding of the many kinds and importance of software for
medical purposes in advancing public health. Generally medical purpose software
1
consists of:
(1) software in a medical device (sometimes referred to as “embedded” or “part of”);
(2) software as a medical device (SaMD).
This document IMDRF SaMD WG N10/Software as a Medical Device
2
: Key Definitions focuses
on a common definition for when software is considered to be a medical device and a reminder
of other key terms, some previously defined in Global Harmonization Task Force (GHTF)
documents, with relevance to SaMD. The key definitions and terms developed in IMDRF SaMD
WG N10 will be used to develop future documents that provide a common framework for
identifying types of SaMD and associated risks and controls to minimize these risks.
Some regulators have taken individual approaches to assure safety, effectiveness, and
performance of SaMD. Such approaches have common public health goals. The objective of this
effort is to promote consistent expectations for SaMD and to provide an optimal level of patient
safety while fostering innovation and ensuring patients and providers have continued access to
advances in healthcare technology.
1
Software used to make or maintain a device (testing, source code management, servicing, etc.) is not considered
software with a medical purpose.
2
This IMDRF document converges on the term SaMD to replace the term “standalone software” or “standalone
medical device software”. However the concepts of standalone software are included in this converged definition
of SaMD.
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2.0 Scope
This document IMDRF SaMD WG N10/Software as a Medical Device: Key Definitions focuses
on a common definition for when software is considered to be a medical device and a reminder
of other key terms, some previously defined in Global Harmonization Task Force (GHTF)
documents, with relevance to SaMD.
Software intended as an accessory to a medical device is not in the scope of this document,
unless the software meets the definition of SaMD in this document.
This document focuses on the definition of the SaMD irrespective of software technology and/or
platform (e.g., mobile app, cloud).
3.0 References
GHTF/SG1/N55:2008 Definition of the Terms Manufacturer, Authorised Representative,
Distributor and Importer
GHTF/SG1/N70:2011 Label and Instructions for Use for Medical Devices
GHTF/SG1/N71:2012 Definition of Terms Medical Device and In Vitro Diagnostic
Medical Device
ISO/IEC 14764:2006 Software Engineering Software Life Cycle Processes
Maintenance
4.0 Definitions
This section is intentionally left blank as the definitions are contained within the body of this
document.
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5.0 Key Definitions
5.1 Software as a Medical Device
The term “Software as a Medical Device” (SaMD) is defined as software intended to be used for
one or more medical purposes that perform these purposes without being part of a hardware
medical device.
NOTES:
SaMD is a medical device and includes in-vitro diagnostic (IVD) medical device.
SaMD is capable of running on general purpose (non-medical purpose) computing platforms
3
without being part of” means software not necessary for a hardware medical device to
achieve its intended medical purpose;
Software does not meet the definition of SaMD if its intended purpose is to drive a hardware medical
device
.
SaMD may be used in combination (e.g., as a module) with other products including medical
devices;
SaMD may be interfaced with other medical devices, including hardware medical devices and
other SaMD software, as well as general purpose software
Mobile apps that meet the definition above are considered SaMD.
5.2 Medical purpose
The following two terms as defined in GHTF/SG1/N71:2012 (italicized below) identify medical
purpose applicable to SaMD:
5.2.1 Medical Device
‘Medical device’ means any instrument, apparatus, implement, machine, appliance,
implant, reagent for in vitro use, software, material or other similar or related article, intended
by the manufacturer to be used, alone or in combination, for human beings, for one or more of
the specific medical purpose(s) of:
diagnosis, prevention, monitoring, treatment or alleviation of disease,
diagnosis, monitoring, treatment, alleviation of or compensation for an injury,
investigation, replacement, modification, or support of the anatomy or of a
physiological process,
supporting or sustaining life,
control of conception,
3
“Computing platforms” include hardware and software resources (e.g. operating system, processing hardware,
storage, software libraries, displays, input devices, programming languages etc.).
“Operating systems” that SaMD require may be run on a server, a workstation, a mobile platform, or other general
purpose hardware platform.
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disinfection of medical devices,
providing information by means of in vitro examination of specimens derived from
the human body;
and does not achieve its primary intended action by pharmacological, immunological or metabolic
means, in or on the human body, but which may be assisted in its intended function by such means.
Note: Products which may be considered to be medical devices in some jurisdictions but
not in others include:
disinfection substances,
aids for persons with disabilities,
devices incorporating animal and/or human tissues,
devices for.in-vitro fertilization or assisted reproduction technologies.
5.2.2 In Vitro Diagnostic (IVD) medical device
‘In Vitro Diagnostic (IVD) medical device’ means a medical device, whether used alone
or in combination, intended by the manufacturer for the in-vitro examination of specimens
derived from the human body solely or principally to provide information for diagnostic,
monitoring or compatibility purposes.
Note 1: IVD medical devices include reagents, calibrators, control materials, specimen
receptacles, software, and related instruments or apparatus or other articles and are used,
for example, for the following test purposes: diagnosis, aid to diagnosis, screening,
monitoring, predisposition, prognosis, prediction, determination of physiological status.
Note2: In some jurisdictions, certain IVD medical devices may be covered by other
regulations.
5.2.3 Additional considerations for SaMD
SaMD may also:
provide means and suggestions for mitigation of a disease;
provide information for determining compatibility, detecting, diagnosing, monitoring
or treating physiological conditions, states of health, illnesses or congenital
deformities;
be an aid to diagnosis, screening, monitoring, determination of predisposition;
prognosis, prediction, determination of physiological status.
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5.3 SaMD Changes
SaMD Changes refer to any modifications made throughout the lifecycle of the SaMD including
the maintenance phase.
Software maintenance
4
can include adaptive (e.g. keeps pace with the changing environment),
perfective (e.g. recoding to improve software performance), corrective (e.g. corrects discovered
problems), or preventive (e.g. corrects latent faults in the software product before they become
operational faults).
Examples of SaMD changes include, but are not limited to, defect fixes; aesthetic, performance
or usability enhancements; and security patches.
5.4 SaMD Manufacturer
For SaMD manufacturer the definition in GHTF/SG1/N55:2009 applies:
“Manufacturer” means any natural or legal person
5
with responsibility for design and/or
manufacture of a medical device with the intention of making the medical device available for
use, under his name; whether or not such a medical device is designed and/or manufactured by
that person himself or on his behalf by another person(s).
NOTES:
1. This ‘natural or legal person’ has ultimate legal responsibility for ensuring
compliance with all applicable regulatory requirements for the medical device in the
countries or jurisdictions where it is intended to be made available or sold, unless
this responsibility is specifically imposed on another person by the Regulatory
Authority (RA) within that jurisdiction.
2. The manufacturer’s responsibilities are described in other GHTF guidance
documents. These responsibilities include meeting both pre-market requirements
4
ISO/IEC 14764:2006 Software Engineering Software Life Cycle Processes Maintenance
adaptive maintenance: the modification of a software product, performed after delivery, to keep a
software product usable in a changed or changing environment.
perfective maintenance: the modification of a software product after delivery to detect and correct latent
faults in the software product before they are manifested as failures
corrective maintenance: the reactive modification of a software product performed after delivery to
correct discovered problems
preventive maintenance: the modification of a software product after delivery to detect and correct
latent faults in the software product before they become operational faults
5
The term “person” that appears here and in the other definitions of this document, includes legal entities such as a
corporation, a partnership or an association.
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and post-market requirements, such as adverse event reporting and notification of
corrective actions.
3. ‘Design and/or manufacture’, as referred to in the above definition, may include
specification development, production, fabrication, assembly, processing, packaging,
repackaging, labelling, relabelling, sterilization, installation, or remanufacturing of
a medical device; or putting a collection of devices, and possibly other products,
together for a medical purpose.
4. Any person who assembles or adapts a medical device that has already been
supplied by another person for an individual patient, in accordance with the
instructions for use, is not the manufacturer, provided the assembly or adaptation
does not change the intended use of the medical device.
5. Any person who changes the intended use of, or modifies, a medical device without
acting on behalf of the original manufacturer and who makes it available for use
under his own name, should be considered the manufacturer of the modified medical
device.
6. An authorised representative, distributor or importer who only adds its own address
and contact details to the medical device or the packaging, without covering or
changing the existing labelling, is not considered a manufacturer.
7. To the extent that an accessory is subject to the regulatory requirements of a medical
device
6
, the person responsible for the design and/or manufacture of that accessory
is considered to be a manufacturer.
5.5 Intended use / intended purpose
For SaMD intended use, the definition in GHTF/SG1/N70:2011 “Label and Instructions for Use
for Medical Devices” applies:
The term “intended use / intended purposeis the objective intent of the manufacturer regarding
the use of a product, process or service as reflected in the specifications, instructions and
information provided by the manufacturer.
5.5.1 Additional considerations for SaMD
Although not specifically included in the GHTF definition materials such as sales and
marketing materials may be considered as “information provided by the manufacturer
and therefore reflect the objective intent of the manufacturer. Sales and marketing
materials should be comprehensive and reflect the intended use of the SaMD.
6
See GHTF/SG1/N29 Information Document Concerning the Definition of the Term “Medical Device
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