Owners of the FreeStyle Libre 3, one of Abbott Laboratories’ flagship glucose monitors, received an email this week warning them to “disable automatic system updates on your iPhone” because the new operating system’s StandBy Mode and Assistive Access Mode “may impact your ability to receive time-sensitive notifications including glucose alarms and notifications indicating that alarms are unavailable.”
“Key Steps to Optimize your FreeStyle Libre System on iOS 17,” the email reads. “While our teams are working quickly to verify and confirm compatibility, we recommend that you disable automatic operating system updates on the smartphone using the mentioned apps. Please check the compatibility guide on myfreestyle.com before the new operating system is installed.”
Abbott is telling customers who have already upgraded to disable StandBy Mode, which activates the iPhone’s Lock Screen while it’s charging and placed on its side. They are also being advised to turn off “Assistive Access” mode, an accessibility mode for people with disabilities. Abbott says that this mode “will impact your ability to activate a sensor, modify your alarm settings, or receive glucose alarm notifications from our apps.”
Abbott writes on its website that failure to take action when users get an alarm, or failure to use the device “as instructed in labeling may result in missing a severe low or high glucose event and/or making a treatment decision, resulting in injury.”
If something critical (lives) life depends on some software working, they probably should’ve always been recommending that people disable major .0 updates. That’s systems administration 101.
True but it’s also on the doctor, pharmacist, and especially the vendor to communicate it to patients. Patients aren’t sysadmins and can’t be expected to know what sysadmins do.
That said, it’s also on the app developer to make sure their app works on release day. And that’s especially true for critical apps.
Looking into this a bit more, it looks like both of the use cases they’re concerned about are pretty edgecase-y.
They’re worried about users not getting glucose notifications. And the user has to intentionally turn off notifications in a settings panel for one use case, and for the other use case, a caregiver must intentionally opt into a hidden accessibility mode that is literally designed to turn a smart phone into a dumb phone.
This smells like the Abbott legal team is being overly cautious.
I worked for a major (medical) company that would skip .0 releases, precisely to combat stigma and folks skipping it.
We did have one particularly bad release that we ended up telling folks to delay taking.
IMO, the real secret to most critical upgrades, and at the heart of skipping .0 releases, is to test in non-production, talk with super users and peers, and patch intentionally and quickly. If you have the resources.