iMedicalApps » Apps For Patients

iPhone Medical App helps with patient communication – Xprompt Multilingual Assistance [App Review]

Amit Patel, MD — Sat, 10 Apr 2010 05:53:07 +0000

Every physician or clinical medical student has interacted with a patient who doesn’t speak their language. Frequently, interpreters need to be called for emergency department or inpatient encounters or outpatient clinic visits, and the delays can be frustrating and even hazardous to patient care.

Families of patients are often used by healthcare providers, but there are situations where using family members to translate may not represent an ideal choice – family doesn’t speak the provider’s language, no family present, delivering bad news to a patient, or emotionally difficult decisions.

Here we review the Xprompt multilingual assistance app from Blue Owl Software, a promising program that seeks to overcome the language barrier so often present in the healthcare setting.

Blue Owl Software, the developer of Xprompt, is a Massachusetts-based enterprise. This young company, founded in 2008 by Guenther Haeussermann, has, in collaboration with Project Management Associates, put together “successful integration solutions” for the following clients: US Army, First Energy, Aera Energy, New Brunswick Power and Nebraska Public Power District. Blue Owl boasts Xprompt as its first iPhone/iPod Touch application. In attesting to the quality of their product, Blue Owl claims the development of Xprompt represents an international project in which “130 people from 50 countries have collaborated and continue to support Xprompt with their competence.” All of these collaborators, Blue Owl affirms, have a medical education.

As for the app itself, the home screen (shown above) presents the languages offered (here, the 3 languages that come pre-installed with the app), along with the white bubble to download more languages. Each language pack contains approximately 800 medically-themed phrases, and any two languages offered can be combined.

From this home screen, users can assign languages to the “Care Staff” (represented by a stethoscope icon on the title bar) and to the “Patient” (represented by a Band-Aid icon on the title bar). Again, any two languages offered by Xprompt can be combined in this manner. After choosing the two languages to be combined, the healthcare provider can choose from a menu of seven categories (shown above) that include gestures, medical history, exams and procedures, care routines, supporting communication, instructions, and a general dictionary.

Through the different category screens (each category features well-organized sections to help hone in on a desired phrase), a phrase can be selected, which is then shown in the patient’s chosen language on the screen in large text, and also spoken in the patient’s language through the iPhone audio (shown below). Of note, there are two sign languages offered (British and German), for which video sequences (as opposed to audio outputs) are played. At the phrase bubble screen (shown below), 3 buttons are presented: one to re-play the phrase audio, one to mark the phrase as a favorite, and one to exit the phrase screen.

At any point, the program can be quickly “reversed” by clicking on the patient box, and patients, from their languages, can select any phrase to be conveyed in the care staff’s selected language (shown below). Of note, the patient’s menu features somewhat different categories from the care staff’s: gestures, my answers, my questions, my needs, my complaints, manners, and the general dictionary. It quickly becomes clear that the Xprompt app can facilitate an interactive dialogue between the care staff and patient in this manner.

As an alternative to using the menu of categories to find a phrase, a search function (opened by clicking on the magnifying glass icon on the title bar) allows for quick finding of specific questions/phrases (shown below).

In summary, having done my clinical rotations in the ethnically diverse city of Saint Louis – some might find this diversity surprising – I quickly grasped the potential utility of this tool: I’ve had a number of patients that didn’t speak English. Often we’d enlist the help of family members, but there were cases when either the family members didn’t speak English well, or no family members were present. In these cases, calling and scheduling interpreters sometimes delayed healthcare, and having a tool like Xprompt handy could have facilitated taking a solid history from the patient and/or family, conducting physical exam maneuvers, and helping to explain what diagnostics or treatments could be offered.

As I had no German- or Spanish-speaking patients on my service this past week, several of my Spanish-speaking colleagues and I tried this tool out on each other for hypothetical patient encounters. We found the English-Spanish (and vice versa) translations to be pretty accurate, and almost everything we wanted to express in these situations was covered by the phrases offered in the app.

Pricing: Xprompt multilingual assistance is $6.99, with 3 languages (English, German, and Spanish) pre-installed. Approximately 20 more languages are available for purchase for $2.99 each from within the app (as shown below).

Likes:

*Easy-to-use interface that is quick to master via well-organized categories and sections (with a search function to boot)

*Strong variety of “high-yield” medical phrases

*Any two languages offered can be combined

*Infinitely useful for foreign travelers

Dislikes/Future Updates I’d Love to See:

*Pricing – it would be nice if the basic purchase included all the offered languages, instead of paying an extra $2.99 for each language downloaded

*800 phrases in each language pack is terrific, but even more would be welcome

*Waiting for more languages to be offered (several are already in the works); for example, having Bosnian offered would be very useful in Saint Louis!

Conclusion:

The Xprompt Multilingual Assistance app represents a promising tool for clinicians working at medical centers or in practices where they often see non-English-speaking individuals. In these settings, this app has tremendous clinical utility to facilitate an interactive dialogue and maximize the healthcare provider-patient relationship.

Visit the App Website »

View Customer Reviews on iTunes »

Download Now on iTunes for $6.99 »

Related Posts:

Merck Manual Home Edition Aims to Help Patients Communicate More Efficiently With Physicians [App Review]

Iltifat Husain — Thu, 26 Nov 2009 12:22:00 +0000

Unlike many applications in the medical section of the App Store, Merck Manual is not made for medical professionals. Instead, the app is aimed at lay people with no healthcare experience. The app hopes to help these people understand medical knowledge easier. We were definitely fans of the Professional Edition, which we recently reviewed. The Professional Edition does a great job with synthesizing the information medical professionals need the most, and basically putting a medical encyclopedia in your hand. I liken the Professional Edition to a Medical Wikipedia, at least in terms of the pertinent content it contains and the feel. The user interface, navigation, and content are beautifully laid out in the Professional Edition, I was hoping to find the same features in the Home Edition as I was preparing for this review.

When the home screen opens up you’re presented with four main navigation routes, “Browse by Selection”, “Exploring the Index”, “Emergencies & Injuries”, and “Search”. Unless someone wants to really learn medical knowledge for fun (weird?), I can’t see people clicking on the Browse by Selection category. Rather, I’m sure the majority of people immediately type in what they are looking for in Search.

For the purposes of this review I’m going to use pneumonia as an example to look up. When you type in pneumonia you’re presented with the different types. Aspiration, Community Acquired Pneumonia(CAP), and Hospital Acquired Pneumonia(HAP) are the three that stuck out to me as some of the most common. I clicked on Community Acquired Pneumonia as my choice. From there you are given a great blurb about CAP and some high yield information. You are given information about causes, symptoms, diagnosis, treatment, and surprising to me, “prevention”. I was impressed to see this included as one of the subheadings. Prevention is often an after thought when people are looking up different conditions but is definitely essential to know, e.g., you should quit smoking to reduce your chance of getting CAP again.

When you’ve located the portion of medical information you actually want to read, such as treatment, and you see a medication listed, this app gives you the option to tap the word and you’re given the generic name of the drug without even having to navigate away from the App. Throughout the text you are presented with hyperlinks of key words, somewhat similar to hw Wikipedia is set up. The fact that you can copy and paste any of the text and even email articles out can be extremely useful. It would be key to use the email function if you have a sick family member and you want the rest of the family to get a better idea of their condition, or if you want to access the information online at a later time.

What I liked:

Navigation and User Interface are beautifully designed
Hyperlinks within the text allow you to skip around related content easily
Content is High Yield and presented so non-medical professionals can understand
Ability to E-mail or copy portions of selected articles is a nice touch
Bookmarking of your favorite articles
Can manipulate text size
Could see this actually improving a patient-physician relationship

What I didn’t like:

Search feature is essential, yet you have to spell the word absolutely correct to access content in this manner. When I typed in “pneu”, I did not get any results. Its easy for me to type pneumonia, I’ve written the word on patients charts hundreds of times, but I could see how this would be annoying to the people the Home Edition is trying to reach. A feature that offers you suggested words when you don’t spell correctly is crucial in this application.
Pictures. There are some pictures in this app, but they are definitely not enough. In an app geared towards patients, it would be crucial to have a picture laden application.

Conclusion:

Overall, I really enjoyed using this application. Even thought I’m from the medical side of the world, and I prefer the Professional Edition of the Merck Manual, I can see how non-medical people could find this application very useful. I feel this application’s main competitor is Wikipedia. Both have great content and provide the same sort of key information. Nevertheless, The Merck Manual does have known MDs developing the application, so you can feel little bit more assured about the validity of the content in this application.

While reviewing this app, I realized it could be used in the clinic setting as well. If you have a patient with a known diagnosis, you could give the patient an iPod Touch with this application on there and allow them to use the device to look up key information before the physician walks into the room. This would allow the patient to have a better understanding of their condition, and allow them to ask more advanced and pertinent questions. I still think the physician would need to talk for the same length of time, but the information that is said might be retained better by the patient if they had just read similar information on the mobile device.

All in all, if this App is used properly, it could definitely help improve the doctor/patient relationship.

View Customer Reviews on iTunes »

Download Now on iTunes for $9.99 »

Visit the App Website »

By: Iltifat Husain, MD/MPH student, MS4

Related Posts:

3D Brain App is Free, Fun to Use, And Useful at the Same Time [App Review]

Iltifat Husain — Thu, 12 Nov 2009 09:38:38 +0000

The App, 3D Brain, has been out since October, but it’s location under the “education” category of the App Store allowed it to slip under our radar. The 3D app is derived from the Genes to Cognition Online website, funded by the Dana Foundation and Hewlett Foundation. Using the native iPhone gestures, the app allows you to zoom and rotate images of the brain in a three dimensional fashion. In this post I’ll cover how this app can be used with your patients.

When you open up this application you are greeted with a picture of the brain, color coded by regions. You can rotate this picture around and also zoom in and out. In the toolbar there is a great Help Section that tells you how to use the zoom and rotate features. The toolbar also allows you to reveal labels, search for different parts of the brain, and get more information on the various parts of the brain you are viewing.

I can’t emphasize how fun this app is to use. There is definitely a “wow” factor pertaining to their utilization of the iPhones graphics. When I show this app to colleagues many of them go ahead and download it right there because of how fun it is. Wi-Fi is needed to download this app because of it’s size (49.5mb).

I could see this app being used to help study for basic brain anatomy but I feel it has a greater potential, such as being used to education patients on different brain pathologies. When trying to explain to a family member why their loved one is having difficulty with speech after a stroke you could quickly show Broca’s area in a three dimensional fashion. Your point would get across a lot better this way than to exclusively show CT or MRI images.

In the future I’d love to see them incorporate cross sectional images of the brain with detailed labeling. This would help with learning more anatomy and it would also help you explain more complex diseases, such as Parkinsons.

Needless to say, it’s definitely an app that all neurologists should have. But even if you’re not a neurologist, it’s free so you might as well download it and have fun playing with the three dimensional imaging.

View Customer Reviews on iTunes »

Download Now on iTunes for Free »

Visit the App Website »

Related Posts:

New Swine Flu App Released, Made by Harvard Medical School

Iltifat Husain — Wed, 28 Oct 2009 19:23:00 +0000

There has been a flurry of H1N1 applications, and they are all a bit hard to differentiate. There is a notable app that was recently released. The app, HMSMobile Swine Flu Center, was developed by Harvard Medical School and costs $1.99. This is the first Swine Flu App in the App Store with a big-time medical name behind it. The app itself has built in videos explaining H1N1 and other related topics. It also has the "outbreaks near me" feature that most of the swine flu applications have. Of note, the app has a "business add on" feature, that provides advice to businesses on how to prepare for outbreaks in the workplace.

There is a nice video of the application on the Harvard website that can be found here:

The iTunes link to the application can be found here.

Related Posts:

Healthcare App for your patients: Fish4Health

Iltifat Husain — Sat, 15 Aug 2009 19:33:00 +0000

Fish4Health is a free application that provides fish information for pregnant and nursing women. This app is particularly useful for all the Obstetrics providers who get asked about fish consumption by their pregnant patients. Purdue University provides a lot of the information about this application (fish4health.net ), so it has a solid academic backing.

The application itself has a solid build. The app has a list of all the major types of fish, tells you how much mercury is in the fish and how much you should eat per week. There is a fish consumption toolbar, where the best choices for fish consumption are listed, as well as the fish to avoid.

You can find a recently written article on this application here. This is a good application to recommend to your pregnant patients who love eating fish. Continue on to comment-

-iMedical Apps Team

Related Posts:

iEmergency App Provides ICE Information in Unique Ways [App Review]

Yousif Alkadhi, MD — Tue, 28 Jul 2009 17:52:00 +0000

iEmergency, by Kavapoint LLC is an “In Case of Emergency” program for the iPhone and iPod Touch devices and costs $0.99 for the full version, and is available in a “Lite” version for free. We’ll be reviewing the full version in this post (hoping that in case of an emergency, we opted to spend the dollar).

For your buck you get a simple, easy to use application that you hope you never have to use. The pages are navigated from 5 tabs at the bottom of the screen. “MyInfo” lists your name and up to three emergency contacts (they can be dialed directly from within the app), and is integrated with your regular phone contacts (in fact, you have to select numbers that you already have saved in the phone’s contacts. The “contacts” tab lists additional information, such as other contacts and their relation to you (parent, spouse, etc…), your physician, hospital, insurance company and even medical record number. The “Medical” tab allows you to list your DOB, blood type, medications, allergies, and any chronic medical conditions you may suffer from. Finally, the “wallpaper” tab allows you to (you guessed it), make a wallpaper to put up on your lockscreen that directs medical personnel with who to contact, any kind of reward information, and instructions to open the app in order to get more medical information.

What the app does well:

It puts everything together really nicely, all for just a buck. All of the things this app does can be done on your own (for example, Photoshop or paint even can edit backgrounds & you could write an “ICE” note in the iPhone’s notes application). However, this puts it all together in a clean tidy app.

What could be improved:

Some of the fields (such as the wallpaper message, or your name) will default to an all caps setting that you can’t undo, basically making you manually uncap every letter before typing it.

Who would I recommend this app for?

*This app would be a no-brainer to purchase if you have some life-threatening or chronic medical condition and even more so with a long list of medical conditions and medications.

*I think it’d be amazingly helpful as a clinician if my patient could just hand me their phone with a list of their medical conditions, medications and allergies (or any prepared list for that matter).

*This app would be most useful for the patient that has a complex past medical history and is traveling away from their usual health care providers / hospital.

*For the general users, you’ll have to balance how much of your information you want people that find your phone (and or wallet) to have.

*For just a dollar though, if you decide you want ICE information on your phone, this is the way to go. You can find the app on iTunes here.

Should you get it?

Will I (or you) actually use this? First of all, I’ve not been a huge fan of ICE (In Case of Emergency) programs in the past. In fact, I don’t even have an “ICE” phone number in my contacts list. And I’ve never looked through any of my patient’s phones (during a resuscitation or otherwise). It would be interesting to know how often EMS & Paramedics actually check phones for ICE contacts (please let us know in the comments section).

So, say you have the program, but you have a password lock on your phone in case it’s ever lost or stolen? The makers of iEmergency address this issue with a printable card from their website for your wallet that will direct emergency personnel to the iPhone app, and even give them your phone’s lock code (if you’ve listed it). Here’s the thing though, what if you get mugged and your friendly mugger decides to take both your phone and your wallet? Now not only do they have an unlocked phone, but all your medical information as well. And the printable card for your wallet? Why not just print out your medical conditions, blood type and allergies on the card and keep that in your wallet (this will still work even when your iPhone’s battery is dead)?

Related Posts:

CallMD and A.D.A.M. are teaming up to diagnose you, good idea?

Iltifat Husain — Sat, 18 Jul 2009 17:33:00 +0000

Well it looks like CallMD, the website that offers online and phone medical advice from doctors and nurses is teaming up with A.D.A.M. (company that provides medical technologies). A.D.A.M. already has an app out (pictured), called Medzio Health Manager. The app allows you to search for medical topics based on your symptoms and it lets you search for local clinics/hospitals. It doesn’t appear to be affiliated with any clinics, and when you do search, it uses google maps to search basic key words. Needless to say, its a pretty basic app. Thats where CallMD comes in. My assumption is they are going to use a Medzio type free app to help you organize your “symptoms” and then link you to the CallMD team for a fee.

Here is a piece of the article, and a quote from CallMD:

Mobile consumers use our service because the traditional health services and nurse lines just don’t work for them anymore,” said Curt McCallister, vice president of medical programs at CallMD. “We selected A.D.A.M. after evaluating several consumer health information providers and found the A.D.A.M. content and tools to be unsurpassed. We were also looking for a partner that could provide more than just health articles, and A.D.A.M.’s Symptom Navigator web and mobile device tools allow us to provide additional information to our clinicians. We were especially excited to be able to partner with them on the Medzio iPhone application, which we believe will have a huge impact on the way people seek and receive care.” (Full article link can be found here)

The first part is definitely a bit bogus. If it’s anything serious, you’re going to go see your doctor or some medical provider. There is no way you can make an online or phone diagnosis definitively. You can get a pretty good “idea”, but you still need a good physical exam and lab tests. I think the main utility will be for people with small symptoms who want some peace of mind.

Also, is this app going to really be a game changer? You can already call CallMD through their hot line. From the quote above you get the sense that it might make things easier for CallMD. They will probably have some standardized symptoms and key information they will ask their users to input through the iphone, and this will make it easier for the docs and nurses to go through the patients information.

Needless to say, this eventual app and partnership is going to give patients with iphones a more streamlined access to a doctor or nurse, and it will be interesting to see how much people are willing to pay for “peace of mind”.

Related Posts:

The American Heart Association offering Fist Aid/CPR app

Iltifat Husain — Thu, 16 Jul 2009 18:56:00 +0000

The American Heart association is offering a First Aid / CPR app, titled "Pocket First Aid & CPR". There have a number of CPR and First Aid apps already in the app store, but this is the first one that has the backing from the people who actually set the standard (AHA).

Some of the more notable features about this app are the illustrations, videos, and ability to store important medical information (insurance information, doctors information). The videos include the guy we have all grown to love from ACLS training (ha). The app also has information from a broad variety of medical topics that might require acute care, such as choking, bites, burns, and more.

The nice thing about this app is you don’t need cell phone reception to use this. It’s a stand alone app, which means you need to have wi-fi to download it since its a pretty big size (68 mb because of videos). The fact that you can easily update this app is nice, and will help you stay on top of standard of care.

I’m a bit surprised by the price, $3.99. I know the AHA paid Jive Media to make the app, but it would have been nice if the price was lower and I think more people would be inclined to buy it.

Now only if the American Heart Association (AHA) could come out with an app for ACLS training. It would be easier to learn from that and keep your memory fresh, instead of having to carry the cards around in the white coat.

You can find information about the app here. If you want to check out the app in the App store here is the link. There is a video of the app in action that I found here.

Related Posts: