Google could make Android 17 work better with life-saving medical devices

Hundreds of millions of people live with diabetes or other chronic conditions that require continuous monitoring. Fortunately, modern medical devices make it significantly easier for people to track their glucose levels, blood pressure, and other key vitals. Some even connect directly with smartphones, sending crucial data and alerts via Bluetooth to the mobile devices we carry every day.

Despite the importance of these medical devices in many people’s lives, Android doesn’t treat them any differently than other Bluetooth peripherals. The operating system is designed to maximize privacy and battery life, which forces medical device makers to jump through hoops to ensure their apps operate reliably. These apps must request a host of permissions during setup and then hope the OS doesn’t terminate their background processes — a dangerous possibility, since any lapse in reporting can become a life-or-death situation for users.

Fortunately, Android may finally treat medical device apps with the importance they deserve. Next year’s Android 17 release may bring a new companion device profile for medical device apps. This profile will not only streamline the setup process for new medical devices but also help their companion apps stay active in the background. Here’s how.

When a user taps “Allow,” the system associates the device with the app and grants it a predefined set of permissions for that profile. Furthermore, Android elevates the app’s process priority whenever the companion device is nearby or connected. This makes it much less likely for the OS to kill the app’s background service when memory is low.

Android currently offers two companion device profiles for third-party applications: the Watch profile and the Glasses profile. As their names suggest, these are for smartwatch and smart glass companion apps, respectively, and grant permissions necessary for posting notifications, accessing phone calls, reading SMS, and more.

While digging through Android 16 QPR2 Beta 2, I found code for a third companion device profile for third-party apps. The new “Medical” profile is intended for companion apps to medical devices and grants permissions for posting notifications, managing Bluetooth connections, and sending alerts at precise times.

Here is the code for the new Medical profile role, followed by an explanation of each element:

• Behavior: The ‘v37’ prefix suggests the profile is tied to SDK version 37, which corresponds to next year’s Android 17 release. (For context, Android 16 is SDK version 36).
• Exclusive/exclusivity: The profile is not exclusive, so multiple apps can hold this role. This makes sense, as a user might have several medical devices managed by different apps.
• Feature flag: This determines if the role is enabled. The flag is currently off in Android 16 QPR2 Beta 2, so the Medical profile isn’t active yet.
• System-only/visible: Third-party apps can request this role (systemOnly: false), but it won’t be visible for users to manage in Android’s Default Apps settings (visible: false).
• Permissions: This is the most important part, defining what the app can do. The key permissions granted are:
  • Notifications: Crucial for sending critical alerts and for signaling to the OS that the app is performing important work, which helps prevent it from being killed.
  • Bluetooth: Allows the app to discover, connect with, and be discoverable by nearby medical hardware.
  • Exact Alarms: Needed for apps that must perform a task at a precise time, such as taking a scheduled sensor reading.

The new Medical role provides a standardized way for Android to recognize that an app has a critical function, ensuring it’s prioritized over standard battery and memory conservation measures. This is a significant step forward, but the profile will be most beneficial for a specific class of devices.

Companion apps for medical devices that deliver medication on an exact schedule — like insulin pumps, smart medication dispensers, and respiratory aids — will benefit the most from this role. On the other hand, devices that need to operate continuously, such as blood glucose and cardiac monitors, will still need additional permissions not covered by this profile.

For instance, the app for the Freestyle Libre 3 glucose monitor requests permission to always run in the background and override Do Not Disturb mode so it can immediately notify users of dangerous blood sugar events. The Medical role doesn’t grant these two permissions at the moment, but perhaps that’ll change in the future.

In any case, we’re glad to see Google finally give medical devices some much-needed attention. As medical devices become smarter, so too should our smartphones’ handling of them. Google has to carefully balance battery life and privacy when designing Android, but these measures often conflict with the needs of medical devices. Apps currently have to work around many of Android’s restrictions, but hopefully, they’ll be treated as first-class citizens in Android 17.