The AASM SleepTM Android App integrates with the AASM SleepTM platform allowing patients to engage in telemedicine encounters via an Android device. Built using Xamarin.Android, this application was launched in September of 2017 on the Google Play store and in December of 2017 on the Amazon App store.

Built with ease of use as a primary focus, this application enables a patient to log in to their encounter quickly and easily using one of two methods:

  1. The username and password the patient selected when registering with AASM SleepTM.
  2. An access code generated when a physician schedules an appointment with a patient.

If a patient uses the access code approach, they are immediately logged in to the physician’s lobby where they wait until the physician is ready to start the encounter. If the patient fully logs in to their account, they are presented with a list of physicians to which their account is connected. They can choose to join the lobby for any of these physicians where they will wait until that physician starts an encounter with them.

Architecture And Features

The development of this application required the use of many platform specific features so it was built using Xamarin.Android. To facilitate the creation of this mobile app, AASM SleepTM database interactions were exposed via a web API built in ASP.NET 4.5 using MVC 5. Identity server 4 was used to protect this API using OpenID Connect and OAuth 2.0.

Shared Code

API Communication

All communications with the Identity Server and API are platform independent. To reuse this code, these communications were implemented in a portable class library. This includes logging the patient in using two factor authentication, and all other calls to the API for data stored within the database.

Real-Time Communication With SignalR

This mobile app connects to the SignalR hub of the web application for real time communication between both parties. This allows the physician to immediately see when a patient has joined their lobby and allows the patient to be notified as soon as a physician invites them to an encounter. All communications with the SignalR hub are platform independent allowing both the Android and iOS apps to use the same code.

Platform Specific Code

Interactive Video

The video based encounter relies on the Xamarin bindings for the native Android OpenTok SDK. OpenTok is a WebRTC based platform for interactive video. The encounter screen allows the patient to change their camera that is transmitting the feed, mute/unmute the patients microphone, mute/unmute the physicians audio, and request an end to the encounter. Ending the encounter requires both parties to mutually agree that the encounter is finished. One party requests the end of the encounter, and the other party must agree.

Fingerprint Authentication

If available, the user can use the device’s fingerprint sensor to log in to their account. After initially logging in to their account, the user can open the application settings to enable to this feature. Subsequent logins will ask the user to log in using the fingerprint sensor.


This project, along with iOS version of the AASM SleepTM mobile app, was my first experience using Xamarin for mobile app development. Using the same server side web development language I use on a daily basis for Android development was a joy, and implementing Android specific layouts and features proved to be simple based on past experience with native Android development. I plan to stick with Xamarin for all of my mobile app development for the foreseeable future.

Sleep ISR

Sleep ISR was developed by the AASM to help sleep facilities meet the inter-scorer reliability requirement for accreditation. Sleep ISR posts a new sleep record consisting of 200 epochs each month that technologists can score and compare their results to those of a gold standard panel. Continue reading

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