Just three years ago, BIP (Before iPhone), Palm was the leader of medical personal digital assistant (PDA) applications and was integrating the PDA with cell technology to market the smartphone. We have seen the demise of the PDA and the rise of the smartphone with all the functionality of the PDA and voice -data connectivity using cell service. Practicing clinicians are adapting this new technology rapidly with iPhone leading the way. Many medical schools are adapting iPads for medical texts.
Clinical instructors should become familiar with the excellent free medical reference apps that are available for use in classroom and clinical teaching. The following list are my “Fav Five” free medical apps students and instructors can use during patient case studies, small group discussions or doing clinical work-ups. These apps download from the iTunes app store to iPhone, iPod touch or iPad and work independent of Wifi or cell connectivity.
My Fav Five Free Medical Apps
1. Diagnosaurus - http://books.mcgraw-hill.com/medical/diagnosaurus/index.html a free (or $1) download from McGraw-Hill and Unbound Medicine is a wonderful e-book on differential diagnosis. It is a quick and easy review to make sure you are thinking of all the possibilities. “One sees what one knows” and this program can broaden your vision with over one thousand diagnosis listed by presenting symptoms, disease or body system.
2. Merck Medicus- Mobile http://www.merckmedicus.com/pp/us/hcp/templates/tier2/PDAtools.jsp a free download after registration. A toolbox of linked references is provided including excel;lent medical textbooks:
Harrisons Practice is an authoritative, evidence based e-textbook organized by a searchable list of symptoms and diseases. Each topic has a basics section with an overview, epidemiology, and pathophysiology. The diagnosis section details the history, physical examination, laboratory test, imaging and differential diagnosis. The treatment section gives pharmacologic and non-pharmacologic interventions and preventive treatments. The ongoing care section reviews monitoring, complications, prognosis, and prevention. The resources section lists the ICD-9 codes, lists of related topics, Internet sites, and an annotated bibliography with hyperlinks to PubMed. The last section is called pearls, and is a list of clinical summary statements that are valuable to commit to memory. The Merck Manual, reads like the classic reference book we all know and love. The pocket Guide to diagnostic tests details normal ranges, collection methods, imaging studies, and abnormal value differential diagnosis. All three of these references are cross linked so you can jump to related topics between books with one tap. The medline tool will give you the latest article titles to choose which abstracts you want to read from your favorite medical journals. It is a fast way to keep up with the latest research in your specialty. Overall, this is a must have resource for all PAs and the price is fabulous – free.
3. Epocrates Rx Free version http://www.epocrates.com/ a free download for the quickest drug database with a drug interaction program, pill identification with pictures and descriptions, dosing calculator, formulary lists, and basic drug pharmacology. There are several medical calculators and miscellaneous tables. Being able to sort through the different insurance plan formularies for your patients is a huge time and aggravation saver. There is an option to buy a subscription for the integrated clinical content from the British Medical Journal Point of Care, as Epocrates Essentials, but the free Harrison’s Practice or Medscape may be sufficient for disease reference.
4. Skyscape – http://www.skyscape.com is the leader in medical e-books for iPhone. There are e-books for sale as subscriptions in every specialty and they are all cross-linked for easy navigation. They have several free references, guidelines, monographs, and calculators listed at http://www.skyscape.com/estore/store.aspx?category=35&WT.mc_id=55551&WT.srch=1 Some of the useful free resources to have even if you do not want the e-textbooks include:
5. Medscape Mobile -This app is a combination medical reference and drug database with over 7,000 prescription, over-the–counter, and herbal drugs. There is a robust drug-drug interaction checker supporting multiple entries and drugs are listed by class. Additional information includes: dosing interaction, side effect, pharmacology and cost information. There is no automatic drug dosing calculator or formulary information. The disease section is organized by specialty and has referenced bulleted facts for quick review. There is a clinical procedure and protocol section with ACLS/BLS, anatomy pictures, tables, lab values and more. CME is provided using case presentations that can be read in down time. www.medscape.com
Using Apps in the classroom - Each clinical student researches a disease to role play that presents with common symptoms in an emergency department. They keep this disease secret and are assigned to another student who role plays the clinician. They are given 10 minutes each to interview each other as a patient and clinician. They each get a 10 minute break to use their electronic resources to construct a medical note, formulate a differential diagnosis and a plan consisting of further testing, therapy, medications and patient education.. They each role play presenting the case as student to supervising clinician. Finally they role play teaching the patient about their plan.
This is a fun exercise that provides practical application of medical history skills, reference app use and verbal presentation skills in the classroom setting. Students are very comfortable with the electronic reference apps when they enter the world of clinical rotations with real patients and real diseases.
To see Mobile Medicine @ Emory go to http://health.library.emory.edu/collections/mobile-resources
The best place to get news and app advice for your medical iLife is at http://www.imedicalapps.com/