By Dr. Jessica Otte

In early January, Elsevier and Modality released a new addition to their suite of popular iPhone medical apps. It is a true multimedia offering, combining text and video to explain the pre-procedure considerations, the technique and positioning to perform the procedure, and the complications and other advertisements for follow-up care. Overall, 27 different procedures are covered; these range from the basic (catheterization and wart treatment) to the more involved (lumbar puncture).

Being a resident physician, I am competent with some of these techniques to the extent that I can perform them by feel. Some, like circumcision, I’ve never seen, let alone performed. Fortunately, Procedures Consult provides a foundation for each. As I’ve mentioned in other reviews of procedure-teaching apps, there is no substitute for hands on experience under the guidance of an expert. However, applications like these may allow you to skip the ’see one’ stage of the common ’see one,’ ‘do one,’ ‘teach one’ approach to developing a skill.

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Perhaps it is in the middle of Grand Rounds, during a conversation with colleagues, or maybebetween seeing patients – there are times when a quick scan of the most recent medical literature would be helpful.

PubMed Mobile (Free) is an app for Android that allows the user to search PubMed, save articles and searches, view abstracts, and export selected abstracts and citations for future use.

The developer CRinUS also makes the similar apps: PubChem Mobile, and Entrez Sequence.  All three apps are free.

Here, I review PubMed Mobile, developed by CRinUS.

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Low back pain is virtually an epidemic in the United States. In many surveys, it is listed in the top 3 most frequent patient complaints resulting in a visit to a physician. It also appears to be more prevalent in the United States than in other industrialized societies, with only a muddle of theories available explain this costly difference. For this reason, a systematic methodology of evaluating the patient with back pain is clearly important. This would help the primary care physician, usually the first evaluate the patient, who is quietly worried that she or he might miss an ominous but uncommon etiology such as metastatic cancer. Also from the public health perspective, this methodology would help prevent multiple, unnecessary and costly imaging studies. And, in fact, many detailed evidence-based recommendations have been published over the years, going as far back as 1994.

While the availability of many evidence-based practice guidelines is of great benefit, the multiplicity also becomes a burden for the practicing physician who needs a quick and handy way to answer the question of what to do for a particular patient. Thus, the birth of a category of desktop and mobile applications named clinical decision support systems (CDSS). This growing and important sector bridges the gap between evidence based guidelines and clinical computer applications. Some of the larger players in this sector, such as Zynx Health, aim to integrate directly into the electronic health records (EHRs) used at hospitals. Others have opted for convenient, free-standing applications quickly available to the physician. The iPhone app Low Back Pain Clinical Management Guidelines is an example of the latter.

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Health care professionals have been patiently waiting for the expansion of the Android universe to hit the world of medical apps.  With the exception of Unbound Medicine – who have done a very nice job in rolling their products into the Android Market – users of Android mobile devices have thus far been relegated mostly to the world of medical calculators and dictionaries. For Android owners, the release of Epocrates could not have come sooner. If you are in the field of medicine, you are probably familiar with Epocrates.  We reviewed Epocrates on the iPhone before.  And for health care professionals and students, Epocrates, honestly, needs no introduction.  From the short-white-coat student to the tech-savvy clinician, Epocrates has, for years, been an essential tool in refreshing those synapses you made in pharmacology class (or didn’t make). The field of pharmacology is ever changing.  Epocrates helps many of us stay on top of it all, and improve care for patients.

Keep in mind, the version of Epocrates Rx currently available and reviewed here is still in BETA.  So many of the richer features available on other platforms are still missing for Android. Also, one of the difficulties in reviewing any app for Android is the potential for variability in user experience between OS versions, and from phone to phone.  This review is based on the HTC MyTouch, which runs on Android OS v1.6.

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Learning a new skill can be an intimidating task for budding health care professionals – especially when it comes to learning medical procedures.  There is a difference, any doctor will tell you, between reading about a procedure and actually doing it.  Educators are beginning to take full advantage of new technology – like the iPhone/iPod – to help bridge the gap between comprehending and performing medical procedures.

Procedures – Hospital Collection is a new app that uses bulleted text, clinical images, and audio/video instruction to familiarize the learner with the preparation, relevant anatomy, and individual steps of common procedures in the hospital setting.

This app is not the first we have reviewed that offers instruction on performing routine hospital-based procedures. In many ways, Procedures – Hospital Collection is like the more expensive Procedures Consult – Internal Medicine App in its content.

So… how does it stack up to Procedures consult?  In this post we’ll do a full review of Procedures – Hospital collection, and use the Procedure Consult series as comparison

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