How medical professionals can use Evernote and mobile devices to improve productivity and learning

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Readers of the iMedicalApps forums will have seen that Evernote was rated particularly highly by a number of commenters when asked ‘How do you use mobile technology to help with your studies’. As  a result of this, I was encouraged to try Evernote out for an extended period and see what impact it could make upon my learning.

I am pleased to say that I have now had enough time to explore Evernote and can now highly recommend it as one of the best note taking apps for medical purposes.

So without further ado…

What is Evernote?

Evernote is an app available on a wide range of devices including Desktop, Web, Android, iPhone, iPad, Blackberry, Windows 7  that allows you to ‘Capture anything’. The idea is that you can make and save notes on the go and add a variety of media to each note. Each note is part of a notebook.

There is an excellent search function whereby you can search by keyword, tag or even printed and handwritten text inside images. Evernote is constantly synced and backed up to the cloud. There is a free version with a limited upload capacity and premium version which gives you significantly more upload capacity.

When it comes to creating notes on Evernote, there is a considerable range of options available including text entry, photos, attachments, audio recording, location based information, calendar link, email and tags.

With all these options available to create notes, you should be able to find a method that works for you. Evernote have recently purchased Penultimate, so we expect to see the ability to make notes with a stylus come to Evernote soon.

Tags are one of the more powerful features of Evernote. When you create/edit a note, you can add or remove tags. These are keywords associated with your note which link notes on different subjects (very similar to Twitter Hashtags). An example would be to tag any notes that have instructions on how to carry out physical exams ‘Exam’.

Now while the note for a cardiovascular exam and a knee exam would be located in different notebooks, clicking on the tag ‘Exam’ would show both notes. This is useful as it allows you to build up a very powerful search database which is accessible on the go.

One of the potential weakness’s in Evernotes notetaking abilities is its handling of PDFs. Currently it is not possible to annotate or edit PDFs attached to a particular note. Instead, I recommend using one of our top PDF notetaking apps and then using the ‘share’ button to open in Evernote which will create a new note with the PDF as an attachment.

Another alternative which is quite handy is to use your Evernote email address. When you sign up for an Evernote account you are given an email address which will automatically add anything sent to it. The easiest way to do this is to add this address as a contact in your address book and title it Evernote (see screenshot). Then it is quite simple to forward anything to this address by simply typing ‘Evernote’ into the “To” field.

The free version of Evernote, only allows access to online notebooks which means that you need to have internet connectivity in order to view your notes. Upgrading to the premium version of Evernote removes this limit and allows you to store offline notebooks.

How can I use Evernote in day to day practice?

The genius of Evernote is its integral cloud sync and ability to access notes from anywhere. Evernote has numerous applications for healthcare professionals and is flexible enough to be adapted to everyones individual needs.

What I describe below is the method which I have found to be most successful:

When you first set up Evernote, I would set up a series of Notebooks and Notebook Stacks. A Stack is a fancy way of saying a collection of Notebooks. I have created a Stack for Medicine and a notebook for each subject area within it. I have also created a ‘holding’ notebook where any notes I make throughout the day will be synced.


In daily use, I create a new note everytime I see a patient, have a discussion with one of the doctors, attend a lecture or encounter any new medical situation that I haven’t seen before. I make the title of the note the topic and then make brief notes which are appropriate to the situation. This can include things such as key signs and symptoms or perhaps a clinical pearl of high yield information.

Using the advanced features of Evernote, it is possible to record audio or even take photographs. Obviously, it is important to check hospital policy and obtain consent before taking any photos and be very wary of recording any patient identifiable features/data (more on that below).

As I go through the day, I often end up accumulating anywhere between 5-15 notes. As Evernote stores all this information in the cloud, it automatically downloads itself to my computer when I turn it on. I then go through each note and ‘fill it out’ using information from a wide range of sources including UpToDate, textbooks, lectures and any other sources of information. Building my notes the evening that I first learnt/encountered a particular topic means that I reinforce the learning that I did before.

Finally, I also sort the days notes into their respective Notebooks. The idea being that I can then switch to any particular Notebook and instantly access all the notes I have made on that topic.

Having electronic notes are advantageous over traditional paper notes for a number of reasons:

  1. They can be searched using the inbuilt search function or robust tag mechanism
  2. There is no danger of losing them as they are stored offsite in the cloud
  3. They can be edited retrospectively and constantly updated
  4. It is easy to include a range of media including photos, mindmaps, videos and more
  5. They can be easily shared with other people
  6. Can be integrated with study card apps to turn prose notes into quick flash cards to test oneself

When it comes to revising, it is possible to print/export notebooks or convert them into PDF for reading later.

Video Demonstration

How health care providers can use Evernote to improve their productivity

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Discussion ( 19 comments ) Post a Comment
  • Hello Tom,

    I see you posted your article on Evernote that you’ve been talking about on the iMedicalApps forum. Great article and I’m glad to see you’re a convert now. :)

    Robert
    Android Technologies, Inc.

  • Great overview Tom.
    This article highlights an important point: an app doesn’t have to be labeled “Medical” to be useful to medical professionals. Simple, but lots of people tend to forget that when they browse the AppStore.

    Marc-Emile Plourde Subscriber
  • Even though there is one one paragraph on the lack of HIPAA compliance, that is enought for me. This is the exact issue with “the cloud” and BYOD devices. While EverNote is a fantastic tool, “the cloud” is not some perfect place where all data is safe.

    In the practice I administer, if I cannot control where the data is stored, that thing, app, is not used. There is simply too much risk! Period.

    Nice tool but I cannot subject my practice to the risk I am unable to mitigate.

    George Fahnulleh
    • The purpose of this aren’t isn’t to say you should use Evernote and Dropbox to store patient data. This article’s purpose is to teach health care providers how they can use Evernote and Dropbox to better learn and to store medical litature and reference data. No patient data at all.

      Iltifat Husain, MD iMedicalApps Editor
      • Dr. Husain,

        I understand. The issue for me as a practice administrator/HIPAA Compliance Officer, is that cannot monitor exactly what information is stored in evernote. Even if I hear “I only did it this once, because it was urgent,” it may constitute a violation that we can ill afford.

        Again, the lack of the ability to enforce IT security policies, and the attendent possibility of HIPAA violations, outweighs any comfort and convenience the provider may enjoy.

        George Fahnbulleh
        • Right, but there is no patient data that should be stored in the app. We are only explaining how health care professionals can use the app for personal usage. It’s the same thing if any consumer wanted to store their favorite PDF files. Just because you’re a physician doesn’t mean you are storing patient data or that all your personal files need to be HIPAA compliant.

          Iltifat Husain, MD iMedicalApps Editor
  • Ive been using Evernote for personal use for a while now. Grocery lists, blog topics, ect. I only have the free version, and haven’t really explored its full potential yet. Thanks to this post, I’ll look into the app further. I have thousands of PDFs, .doc files and pictures I’ve accumulated over the years pertaining strictly to treatment methods, Patient education, medical reference, seminar notes and so on. They are organized fairly well on my hard drives but not synced over the several computers/iPads/iPhone I use frequently. Importing these into Evernote could be the answer to my organizational issues.

    Dr. B

  • I am an avid Evernote user and agree that there is some danger of HIPAA violation using the software, but it DEPENDS ON THE DATA. I think the author made it quite clear that sensitive and personally identifiable information must be avoided. If the argument is made that because there is the potential to upload HIPAA-inappropriate material, the same argument could be made for text messaging or tweeting, email outside of secured agency systems, etc. If you’re going to avoid using Evernote as a personal helper for these reasons, I think you’re throwing the baby out with the bathwater. That said, I would like to see Evernote encrypting everything stored in the cloud as a necessity. They are moving toward addressing this concern: see https://support.evernote.com/link/portal/16051/16058/Article/1652/What-type-of-encryption-does-Evernote-use.

  • Great article, Tom. I have just started using Evernote, and now that I have organized the notebooks properly, I really see how useful it is. Because the information is so readily accessible, I find that this program is especially handy when studying for board exams. As I go through practice questions, I enter the key points or topics for further review into a notebook based on the subject. This helps to reinforce the knowledge when accessing the notes later. Thanks,

    Doug

    Beach-Rak Subscriber
    • I especially agree with the board review comment. I love the fact that I can access the points I learn on my iPad or iPhone while I am on the go. Its great to use for taking notes on your iPad while you are listening to CME lectures or general lectures at conference.

      Iltifat Husain, MD iMedicalApps Editor
  • Agree Tom.
    evernote is fantastic. I’m a couple of months in, and the investment in time is paying off nicely, especially now I use a tablet at educational events. The automatic geographical tags can be a quick and easy way to organise (eg conference notes)
    I think it’s a no brainer that this is only really for cpd stuff and general organisation, not anything patient identifiable.
    Its improving week on week with the updates, and the audio and speech to text can be well useful. Agree with your wishlist though.

    Jarrod

    • I think the key phrase you mention is “investment of time”. It doesn’t take time getting the hang of it — but it does take time before it becomes useful. About a month in, I started seeing a huge payoff in regards to improved learning and organization.

      Iltifat Husain, MD iMedicalApps Editor
  • Great article. But should have on your site a feature to be able to print the article only.

  • Can you share the “notes” with a contained group? ie can a team of residents give permission for one resident to see the others notes?

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