| The iPhone/iPod Touch Medical App Crash Course |
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| News - Class News | ||||||||||||||||
| Sunday, 26 July 2009 18:19 | ||||||||||||||||
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A large part of the class has jumped on the iPhone/iPod Touch bandwagon for the clinical years ahead. There are a few ideas floating around about which medical applications are the best to chose from considering the huge number that are available. Although it's just another opinion (mine, so an awesome one
The Big FourIf for some reason someone points a gun to your head and says you can only download four medical applications, these would be the four. All but one are free, and the one that isn't costs a whopping 0.99¢ which I'm guessing even someone on a med school budget can afford. These four will cover just about all your needs when it comes to drugs, diagnosing, differential diagnosis and medical calculations.
After installing the app on your device, you'll need to register. They'll want your email, name and what medical school you're attending so that they can "verify" you're actually a medical student. The verification process never works correctly, but you'll be allowed to use it anyway. Their ultimate goal is for you to buy the full-blown paid version of Epocrates ($159 a year), so the free version will have some limitations. Certain methods of browsing drugs won't be available, access to lab information won't be there, along with an IV compatibility checker and OTC drug information. These missing functions really aren't that big of a deal as other programs will fill the gaps if needed although those situations would probably be rare if ever. One nice, almost hidden feature is the collection of medical tables included with the program. To get to them, select "Browse Drugs, Diseases, Labs..." from the main screen and then select "Tables by Category."
 Skyscape is actually a collection of three different applications rolled into one. It's probably as close to an all-in-one medical application as you're going to find. Much like Epocrates, the Skyscape people hope that you'll go beyond what you're given for free and purchase their other products. Unlike Epocrates, these products are usually medical books and reference materials that have been formatted to use on an iPhone or iPod. These tend to be pretty expensive and unless you have cash to burn or a strong interest in a particular topic, you're probably not going to be too tempted by them. One possible exception is the "5-Minute Clinical Consult" which is program that allows you to put in your findings and then spits out a diagnosis. It comes highly rated from those who use it, but a one year subscription is $68 dollars, so it's not cheap.So then, after you've installed and registered, what are you going to get with Skyscape (for free)? Archimedes - A collection of over 150 medical calculations. Along with having the formulas, an explanation of what you're actually figuring out is included. OCM - An extremely helpful collection of evidence-based medicine covering a wide variety of topics. Disease presentation, treatments, differential diagnosis and epidemiology are just some of the areas of information available. This may possibly be your most-used medical application. RxDrugs - This application is similar in function to Epocrates. In some instances it may have a bit more information in some areas than Epocrates and can be good as a second reference source for drugs.
 With this one you're going to have to be a big spender, but it's worth it. Diagnosaurus (quite a mouthful) is a differential diagnosis dream. The program groups diagnoses by organ system, symptom or disease. You can also lump the different diagnoses into one group and search them all at once. It's extremely helpful at making sure you know all of the possible causes for a particular symptom as well as making sure you have a complete differential diagnosis. So, how would this be helpful? Here's a couple of examples...Let's say you're on a surgery rotation and you have a patient with a lower GI bleed. You'd like to know all the possible causes, both common and rare before the next pimping session. Using Diagnosaurus DDx you just go to "Symptoms" and then "Lower gastrointestinal (GI) bleeding" and you have a list of 11 potentially common causes along with 6 potential rare causes and it took you about 20 seconds to get them. Maybe you're on a peds rotation and a kid comes in with a sore throat. You put in "Pharyngitis" and you have 10 potential differential diagnoses along with 8 other causes of a sore throat. Perhaps Uncle Bob just got back from overseas with a case of the runs. After putting in "Traveler's diarrhea" you have both the most common and less common causes along with how the presentation should alter the differential. In short it's the best way to get an impressive list of differential diagnoses as quickly as possible.
 You can probably guess what this one is. It's a whole bunch of medical calculations in one place. Many of the other programs will also have medical equations, and this is another place to find them. You could probably get away with just using the "Archimedes" application that comes with Skyscape, but this app is so popular and used, it's hard not to put it on the "must have" list. If anything, it'll save you a step or two from trying to find the equation you're looking for in another program. Really not much more to say about it, so I'll include what the makers have to say:
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) I hope that maybe this will take a little bit of the guess work and trial and error out of finding the right applications to use. There's an icon at the beginning of each section that if clicked will take you to the iTunes store where you can download it or just find more information. If you have trouble with the link, you can also go into the iTunes store or use the "App Store" icon on your iPhone or iPod and search for the application by name. 
Don't worry, if you should decide to use Epocrates, your medical soul is still safe. Epocrates is a free drug reference library that includes dosing information, contraindications, adverse reactions, drug interactions, pharmacology, pricing info and even pictures of the drugs. You can set a formulary which allows you to check to see if a particular drug is available for a patient under certain drug plans and if a cheaper alternative might be available. Another tool is the "Pill ID" which allows you to identify a drug simply by the way it looks. This can come in handy when a patient comes in with a collection of pills they're taking but aren't quite sure of what they are. Epocrates also comes with a basic set of medical calculator equations, but you'll probably find that other applications will do those better. 
