Software Regulation and Validation

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Software Regulation and Validation Keiichiro Ozawa FUJIFILM Corporation 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 1

Agenda 0. Introduction 1. Qualification and Classification 2. Low Risk Software 3. Creating Certification Standards 4. Pre-market Application and Validation 5. Cybersecurity 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 2

Introduction of Keiichiro Ozawa Name: Keiichiro Ozawa Company Name: FUJIFILM Corporation Business Title: Regulatory Specialist Kenting Biography: Member of JFMDA Medical Device Software Working Group (The Japan Federation of Medical Devices Associations) Member of IMDRF SaMD Working Group (International Medical Device Regulators Forum) Chair of DITTA Medical Software WG (Global Diagnostic Imaging, Healthcare IT and Radiation Therapy Trade Association) IEC Expert of TC62/SC62A/JWG7 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 3

1-1. Qualification of Medical Device Software Revision of Pharmaceutical Affairs Law Japanese Pharmaceutical Affairs Law has been revised as PMD Act and it has been in effect since Nov. 25, 2014. One of the significant points of the revision was the implementation of revised GHTF Essential Principles (2012) which led to the introduction of standalone medical device software into the Japanese regulatory system. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 4

1-1. Qualification of Medical Device Software Software qualified as a medical device Notification on the basic concept of the qualification of medical device software, MHLW, Nov. 14, 2014 The intended use of the medical device software is based on the definition of the medical device, installed in general-purpose PC or handheld terminals. 1) Software which creates indices, images, charts for diagnosis or treatment by means of processing data from medical devices 2) Software which supports the decision of treatment plan or treatment method (including simulation software) 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 5

1-1. Qualification of Medical Device Software Software qualified as a non-medical device 1) Software which transfers, stores and displays data from medial devices used as medical records 2) Software which processes or computerizes data except image data for the purpose other than diagnosis 3) Software for education 4) Software for patient explanation 5) Software for maintenance 6) Software for hospital business support 7) Software for health management 8) Software equivalent to General Medical Device (Class I equivalent) 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 6

1-2. Classification of Medical Device Software PMD Act employs basic concept of GHTF rule for medical device classification. Principles of Medical Devices Classification, GHTF, Nov. 2, 2012 Notification on the amendment of the classification rule of medical devices, MHLW, May 10, 2013 It says on the top page, The classification rule of medical devices has been stipulated based on the rule discussed in GHTF And any other special rules has not been issued on the classification of medical device software. Therefore this rule should be applied for the medical device software. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 7

1-2. Classification of Medical Device Software General classification of Medical Device Scope of Medical Device Other device General Medical Device (Class I) Controlled Medical Device (Class II) Certification Standards Specially Controlled MD (Class III and IV) Approval Standards 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 8

1-2. Classification of Medical Device Software Scope of Medical Device Software Other device Scope of Medical Device Software Software equivalent to General Medical Device (Class I - equivalent) Controlled Medical Device (Class II) Specially Controlled MD (Class III and IV) 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 9

2-1. Low Risk Software Software equivalent to Class I medical device General Medical Device, Class I, has been eliminated from the medical device classification for software. It has little risk of affecting human life and health in case of the functional failure. This is the special classification rule only for the medical device software. Example 1. Software which performs eyesight test or color perception test by general-purpose PC or handheld terminals 2. Software which detects body motion by means of sensors of handheld terminals 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 10

2-1. Low Risk Software The approach of USA for low risk software FDASIA Health IT Report, FDA, Apr., 2014 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 11

2-2. Voluntary Standards by Private Sectors What about Japan? 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 12

2-2. Voluntary Standards by Private Sectors Good Health Software Promotion Council for GHS(Good Health Software) 1. Purpose is to develop guidelines for the non-medical device software so that software developers can provide good software to users. 2. The guidelines are applied to quality management, risk management, software product safety and software lifecycle process. (GHS Development Guidelines) 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 13

2-2. Voluntary Standards by Private Sectors Scope of Software for GHS Scope of Software for GHS Other device Software equivalent to General Medical Device (Class I - equivalent ) Controlled Medical Device (Class II) Specially Controlled MD (Class III and IV) 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 14

2-2. Voluntary Standards by Private Sectors GHS Development Guidelines - Three conformance levels Requirements All items required by medical device (ISO 13485 ) Medical Device GHS Development Guidelines Quality Management Software Product Safety Software Lifecycle Process Risk Management All requirements One or two requirements Level-1 Level-2 Level-3 Requirements depend on the country or jurisdiction. Level 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 15

2-2. Voluntary Standards by Private Sectors The list of conforming software on the website The items of the list are Level (Level-1, 2 or 3) Registration number Product name Software version Company name URL of company website The list of conforming software Product name Product name Product name Product name Product name Product name Product name Product name Product name Company name Company name Company name Company name Company name Company name Company name Company name Company name 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 16

3. Creating Certification Standards Qualification and classification rules have been stipulated. But it may take several years to have the devices reviewed by certification standards which require relatively short review term. Expediting the premarket review process by creating the certification standards. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 17

3. Creating Certification Standards Scope of Medical Device Software Other device Scope of Medical Device Software Software equivalent to General Medical Device (Class I) Controlled Medical Device (Class II) Specially Controlled MD (Class III and IV) Certification Standards Software for generalpurpose imaging diagnostic workstation Software for stationary digital general-purpose diagnostic X-ray system 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 18

3. Creating Certification Standards Current innovative progress of medical device software is so drastic. Creating every possible certification standard from hardware medical devices even though some standards may not be used. Certification Standards, 108 (total ~1370): Name, applied standards, intended use and etc. All medical device software are Class II. JMDN (Japanese Medical Device Nomenclature), 150 (total ~4258): Generic name, definition and etc. All medical device software with the certification standards are Class II. * The numbers are as of 2014. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 19

3. Creating Certification Standards [Example] The corresponding hardware medical device JMDN Code: 70030000 Name: General-purpose imaging diagnostic workstation Applied standard: JIS C 6950-1 (IEC 60950-1) Intended use: Medical device software It computerizes human image information from image diagnosis medical devices and provides processed image information for medical care (excluding those with automatic diagnostic functions) JMDN Code: 70030012 Name: Software for general-purpose imaging diagnostic workstation Applied standard: JIS C 6950-1 (IEC 60950-1) Intended use: It computerizes human image information from image diagnosis medical devices and provides processed image information for medical care (excluding those with automatic diagnostic functions) 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 20

4. Pre-market Application and Validation PMD Act employs basic concept of GHTF for essential principles of safety and performance of medical device. Essential Principles of Safety and Performance of Medical Devices, GHTF, Nov. 2, 2012 Notification on the essential principles of safety and performance of medical device, MHLW, Nov. 5, 2014 One of the new requirements of the amendment is the introduction of medical device software and it requires to ensure the repeatability, reliability and performance according to the intended use. And the requirement in the event of a single fault condition is described. These requirements are also described in B8 of GHTF document. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 21

4. Pre-market Application and Validation Essential Principles Conformity Checklist is required for any medical devices. Essential Principles Conformity Checklist is in tabular format of Essential Principles dedicated for the medical device with its related information such as applicability, applied standards, documentation information, etc. And it is required to be included in the pre-market application document. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 22

4. Pre-market Application and Validation Requirement for performance Essential Principles (Benefits of the medical devices) Article 6 All known or foreseeable risks and undesirable effects shall be minimized as far as reasonably practicable and be acceptable when weighed against the intended benefits of medical devices under normal conditions of use. Each application is required to describe the performance specification, standard, etc. related to this article in the checklist. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 23

4. Pre-market Application and Validation V&V in pre-market application document (Software for general-purpose imaging diagnostic workstation, Class II) Performance evaluation Processing of images and information image flip (vertical, horizontal), image rotation, image enlargement, gradation processing Displaying images I/O with external devices Evaluation report accompanied with the application document 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 24

4. Pre-market Application and Validation V&V in pre-market application document (Software for radiation treatment planning system, Class III) Performance evaluation Outlining Displaying geometric parameter Evaluation report in Dose distribution calculation the application document Safety evaluation Distance and length (JIS Z 4715: 2011, Sec. 7.1) Radiation dose (JIS Z 4715: 2011, Sec. 7.2) Format of date and time (JIS Z 4715: 2011, Sec. 7.3) 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 25

4. Pre-market Application and Validation Requirement for development lifecycle of software Essential Principles (Consideration of medical devices using programs) Article 12 2 For devices which incorporate software the software must be validated according to the state of the art taking into account the principles of development lifecycle, risk management, verification and validation to operate properly. It will be mandatory that each application describes the conformity to the article in the application from Nov. 25, 2017. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 26

4. Pre-market Application and Validation Requirement for development lifecycle of software How to describe the conformity to Article 12.2 in the application document (Now in progress of discussion within JFMDA to suggest MHLW) Report as the implementation status of development lifecycle 1. Summarizing the conformity to JIS T 2304 with its implementation status. 2. Picking up some significant requirements of JIS T 2304 with its conformity. 3. Listing up all the requirements of JIS T 2304 in a tabular form. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 27

5. Cybersecurity Notification on cybersecurity, MHLW, April 28, 2015 1. Fundamental policy MAHs should ensure cybersecurity by necessary risk control measures 2. Specific measures (i) perform protective risk management to evaluate and reduce the risks limiting the scope of connection and limiting the software, system or services to those that are confirmed (ii) which necessary cybersecurity is not ensured, the users should be clearly informed of this issue (iii) In accordance with Guidelines for the Security Management of Health Information Systems, provide HDOs with necessary information * Translated from Japanese to English by JIRA (Japan Medical Imaging and Radiological Systems Industries Association) and all rights reserved. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 28

5. Cybersecurity Guidance on how to implement the cybersecurity notification (Now in progress of discussion within JFMDA to suggest MHLW) Scope Necessary consideration of cyber risk including network environment, intended use, operational environment, etc. Cybersecurity measurement Manuractures shall conduct risk management and demonstrate it is acceptable. Post-market safety assurance Manufactures are responsible for the cybersecurity of pre-owned devices. Providing information to users Manufactures shall provide necessary information to users to assure the safety of the device. 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 29

THANK YOU! 12/07/2016 4th Joint Conference of Taiwan and Japan on Medical Products Regulation 30