Post image for Pocket Lab Values provides is a well-designed reference but lacking in important areas

By: Rajat Kumar, MS3

The number of things for which physicians can send tests seems to be growing at an exponential rate. And as we continue to gain insight into the biologic and biochemical basis of medical conditions, physicians use these tests even more to diagnose disease, follow progression, and assess effectiveness of therapy.

And as any medical student can tell you, interpreting lab values is a skill that takes time to master. Pocket Lab Values by developer Joefrey Kibuule – who is also a medical student – for the iOS platform attempts to provide healthcare professionals with a concise guide to common labs with reference values and the correlating clinical conditions in an easily accessible reference at the point-of-care. Though well-designed, it has some important limitations that we found limiting for its overall value.

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Post image for Pill Identifier Lite :  Head-to-Head comparison against pill identifiers in Epocrates and Lexi-Comp

Pill Identifier Lite :  Head-to-Head comparison Against pill identifiers in Epocrates and Lexi-Comp

Pill Identification can represent a challenging but occasionally even life-saving endeavor for healthcare professionals and the general public.  Examples where pill identification techniques can be of great assistance include: an ER physician diagnosing beta-blockade toxicity in a bradycardic patient or oral hypoglycemic toxicity in a seizing patient, parents discovering an unknown stray pill in their teenager’s belongings, an EMS finding an unresponsive patient who overdosed on opiates, or a hospitalist unraveling an elderly patient’s antihypertensive regimen in the setting of acute renal failure.  Thus, pill identification is often crucial in clinical practice.

On June 1, 2011, the Pill Identifier Lite App for iPhone from Drugs.com hit the #1 spot in the paid medical app rankings in the iTunes App Store.  This App, based on the Drugs.com Pill Identifier Wizard website (here), aims to help users identify pills by color, shape, and imprint from the convenience of the iPhone or iPad.

Read below the jump to see how the Pill Identifier Lite stacks up against the Epocrates (reviewed here) and Lexi-Comp (reviewed here) Pill Identifier functions, concluding with a direct comparison:

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Post image for Study suggests that teledermatology programs are not an alternative to in-person evaluation

Programs that deliver specialty care to underserved areas utilizing telemedicine are being launched all over the world. However a recent study published in the British Journal of Dermatolgy raises some questions about the limitations of this technology, particularly some unintended consequences that appear to have adverse patient outcomes.

The study looked at a series of dermatolgy referrals for suspicious skin lesions, gathering data on 400 patients within a VA site. What they found was that for many of those patients these visits led to important diagnoses – but not always for the lesion for which they were actually referred.

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Post image for Evidence based decision making taken to a new level by the BMJ

By: Tom Lewis

As the cost of healthcare continues to grow at unsustainable rates, there has been an increasing emphasis on ensuring that the care being delivered by individual clinicians is evidence-based. From optimal medical management of heart failure patients to appropriate cancer screening regimens, its important that clinicians know that the recommendations they make to their patients is supported by available data.

The Best Practice app is a point of care tool from the BMJ Evidence Centre designed to support clinicians in their decision making from diagnosis to treatment. Decision-support information is provided with a step-by-step approach that is structured around the patient consultation, diagnosis, treatment, management and prevention. Despite a few drawbacks, this app has the potential to make a positive impact on patient care.

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Post image for SmartHeart turns your smartphone into a personal ECG

SHL Telemedicine has announced the release of SmartHeart, a lightweight and portable device that they claim can take “hospital-grade” ECGs by “anyone, anywhere, anytime.” The device connects wirelessly to smartphones and can transmit the ECG to a physician for a preliminary diagnosis. The possibilities for a device like this are endless – but so are the questions it raises.

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Post image for Physicians should cautiously navigate exciting waters of social media and medicine

By: Darwin Wan, MS3

 

A stern warning regarding social media usage has been delivered to the medical community in April with news of Dr. Alexandra Thran’s reprimanding by Rhode Island’s state medical board.  Dr. Thran had already been fired last year from Westerly Hospital in Rhode Island for the posting of confidential patient information online.  Although the patient’s name was not included, the board filing stated that enough information was included that enabled others to identify the patient. The action by the state board signifies that a doctor may not just lose a job for a social media transgression but, in a severe case, her livelihood.

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Post image for Physical Exam Essentials aims to improve students practical skills

By: Tom Lewis, MSII

As Sir William Osler, one of the fathers of modern American medicine, said, “The primary work of a professor of medicine in a medical school is in the wards, teaching his pupils how to deal with patients and their diseases.” And the most important component of interacting with patients to clinicians like Osler was the physical exam. We can all certainly recall the first time we used our stethoscopes to diagnose valvular disease, palpated the swollen lymph node that lead to a diagnosis of cancer, and so on.

Physical Exams Essentials is designed to recap key point of practical examination for medical students and junior clinicians. This application contains a list of practical examinations complete with clinical presentations that help diagnose relevant common pathology. The app is designed to help physicians in training develop the skills that some would argue are being lost in modern medicine, and does so quite well.

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Post image for Prepare for Pulmonary & Critical Care boards with the ACCP-SEEK iPhone and iPad medical question bank

Founded in 1935, the well-respected American College of Chest Physicians (ACCP) prides itself as “the global leader” in pulmonary, critical care, and sleep medicine.  In keeping with their mission, ACCP publishes SEEK, or Self-Education and Evaluation of Knowledge, to help physicians prepare for these specialty board exams.

ACCP’S SEEK is for pulmonary board exam preparation, in many ways, what ACP’s MKSAP is for medicine board exam preparation—the foundation of appropriate preparation.

SEEK centers on case-based questions that teach diagnosis and management.  Of interest, the ACCP has joined forces with Amphetamobile (AMMO), the developer of EatingWell, iOrtho, and Quoted, to create the ACCP-SEEK App for the iPhone and iPad.

Read below the jump to learn about the ACCP-SEEK App, which brings SEEK to your mobile device for on-the-go use when preparing for pulmonary boards.

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Post image for VueMe app could reduce repeat radiology studies, empowers patients to store medical images on the cloud

One of the most frustrating parts of medicine is trying to get access to a patient’s radiology studies that were performed at an outside hospital or from a completely different geographic area, especially when time is lacking.

Most films are standardized and can be viewed on a DICOM machine — but they require patients to carry around CDs, not ideal and practical. And if you want to get an image from another hospital system, often times you have to get a courier to get the actual CD, or just get the results faxed to you. Again, not ideal situations.

Often times, this lack of continuity leads to repeat radiology studies being performed, especially in acute settings.

But, what if all the medical images were stored on a central cloud? And physicians could share those images with each other, and even better, patients could control who had access to all of their medical images.

This cloud based solution is one step closer to reality with two key announcements by MIM software yesterday. (read more)

Post image for Dosecast iOS app targets one of healthcare’s biggest weaknesses – medication compliance

By: William Tobia, M.S., M.B.A.

It was C. Everett Koop, M.D. that said:“Drugs don’t work in patients who don’t take them.”

Non compliance has been documented by industry, such as the large pharmaceutical benefits manager Medco who state “recent research shows that many people with chronic health conditions do not take their medication as often as prescribed…”

In this article, John J. Mahoney writes “Health care costs continue to hit all-time highs, with patient noncompliance as a significant contributing factor” and argues that pharmaceutical benefits should be “value based”, accounting for compliance as well as other factors.

Numerous approaches have been commercialized attempting to effectively deal with the issue of patient medication noncompliance. These include, among others, the DSM TCG OtCM™  System and the Vitality GlowCaps™.

Will these, as well as other potential solutions find their way on to your iPad? That’s exactly what Dosecast is trying to do – and the pharmaceutical industry should take note.

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Post image for Surgical Radiology app provides high quality training and is a great value

By Brian Wells, MSM, MPH

Surgical Radiology is an app that aims to teach appropriate surgical radiology interpretation skills for surgeons and trainees.

It emphasizes the clinical implications for imaging findings and prompts the user to identify the imaging abnormality and suggest treatments, where appropriate.

It is a free app written for the iOS platform (iPhone & iPad), developed by Drs. Dangleben and Lee at the Lehigh Valley Health Network, a Level I Trama Center in Pennsylvania with a general surgery residency.

When using the app, the user is shown a pop up image, and you’re prompted to find the pathology. When the user taps on the image, the diagnosis pops up. A multiple choice question related to the image then populates the screen. To make it more interesting, a timer in the top right hand corner, and counts down from 30 seconds . Users can compare their scores using iOS’s native Gamecenter — one of the first times we’ve seen a medical app use the gaming platform from Apple. (read more)

Post image for Veterans Administration hospitals CIO says VA must become “iPad friendly”

In a nod to the reality of rapid physician adoption of tablets and smartphones, the CIO of the VA system recently stated that the VA must find a way to accommodate  iPads at a  conference on federal information technology.

According to Baker, the fact is that 100,000 residents rotate through the VA each year and “they’re all carrying mobile devices”. In order for them to do their jobs, they want to be able to access resources on the internet.

In an article published at nextgov.com, CIO Roger Baker said

I’ve told my folks I don’t want to say ‘no’ to those devices anymore…I want to know how I say yes

The key, according to Baker, is security. While the iPad can be secured, proper protocols need to be developed. Otherwise, the device can be likened to a “huge unencrypted USB stick with no pin”. In order to facilitate development of security protocols, a pilot program has been launched giving out iPads to select employees in situations where security is looser.

In an easy to understand analogy, he proposed

If it won’t go on a device where you’re willing to put all your banking information, your pins, your passwords, [then] don’t put veterans’ information on it.

As we have published on this site before, there are ways to secure your iOS device adequately for medical use (“How to secure your iPhone or iPad for medical use“). The issues are not always technological, often it is a question of policies and habits of the users. A positive contribution by a large scale institution like the VA can only help to instill good habits and a better understanding of security in future doctors.